Dietary Selenium Intake and All-Cause Mortality in Diabetic Kidney Disease: A Dose-Response Relationship

OBJECTIVE Selenium plays a complex role in human health as an essential nutrient. Basic research has shown that selenium has antioxidant and anti-inflammatory effects. At present, the relationship between dietary selenium intake and mortality of diabetic kidney disease is unclear. This study affirmed the relationship between dietary selenium intake and all-cause mortality among adults with DKD. RESEARCH DESIGN AND METHODS From the National Health and Nutrition Examination Survey 2001-2014, 2,183 individuals with DKD were included in this analysis. The mortality rate was determined through the linkage of National Death Index records up to 31 December 2015. A Cox proportional hazards regression model was used to estimate the hazard ratios and 95% confidence intervals. The Kaplan Meier plotter is capable of analyzing the relationship between survival and selenium intake. RESULTS 1063 deaths occurred during an average follow-up period of 8 years. A total of 298 deaths (54.880%) were observed in the lowest quartile of selenium intake, whereas 226 deaths (41.392%) were recorded in the highest quartile group. Adjusted for multiple variables, including demography factors, dietary factors, lifestyles, glucose control, and important comorbidities, selenium intake associated with a lower all-cause mortality risk in a dose-response relationship. Compared to the group with the lowest selenium intake, the hazard ratio(HR) of the highest group was 0.712 (95% CI 0.558,0.908) for mortality ( P _trend = 0.021) with adjustment of potential confounding potential factors. CONCLUSION After adjusting for confounding variables, In people with DKD, dietary selenium intake was associated with a reduced mortality risk.