ABSTRACT
BACKGROUND: Selenium and single-nucleotide-polymorphisms in selenoprotein genes have been associated to diabetes. However, the interaction of selenium with genetic variation in diabetes and oxidative stress-related genes has not been evaluated as a potential determinant of diabetes risk. METHODS: We evaluated the cross-sectional and prospective associations of plasma selenium concentrations with type 2 diabetes, and the interaction of selenium concentrations with genetic variation in candidate polymorphisms, in a representative sample of 1452 men and women aged 18-85 years from Spain. RESULTS: The geometric mean of plasma selenium levels in the study sample was 84.2µg/L. 120 participants had diabetes at baseline. Among diabetes-free participants who were not lost during the follow-up (N=1234), 75 developed diabetes over time. The multivariable adjusted odds ratios (95% confidence interval) for diabetes prevalence comparing the second and third to the first tertiles of plasma selenium levels were 1.80 (1.03, 3.14) and 1.97 (1.14, 3.41), respectively. The corresponding hazard ratios (95% CI) for diabetes incidence were 1.76 (0.96, 3.22) and 1.80 (0.98, 3.31), respectively. In addition, we observed significant interactions between selenium and polymorphisms in PPARGC1A, and in genes encoding mitochondrial proteins, such as BCS1L and SDHA, and suggestive interactions of selenium with other genes related to selenoproteins and redox metabolism. CONCLUSIONS: Plasma selenium was positively associated with prevalent and incident diabetes. While the statistical interactions of selenium with polymorphisms involved in regulation of redox and insulin signaling pathways provide biological plausibility to the positive associations of selenium with diabetes, further research is needed to elucidate the causal pathways underlying these associations.
Subject(s)
Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/epidemiology , Gene Regulatory Networks , Selenium/blood , ATPases Associated with Diverse Cellular Activities/genetics , Adult , Aged , Aged, 80 and over , Cross-Sectional Studies , Diabetes Mellitus, Type 2/genetics , Electron Transport Complex II/genetics , Electron Transport Complex III/genetics , Female , Gene-Environment Interaction , Humans , Incidence , Male , Middle Aged , Oxidation-Reduction , Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha/genetics , Polymorphism, Single Nucleotide , Prevalence , Prospective Studies , Spain/epidemiology , Young AdultABSTRACT
Hypertension and smoking are related with oxidative stress (OS), which in turn reports on cellular aging. Zinc is an essential element involved in an individual's physiology. The aim of this study was to evaluate the relation of zinc levels in serum and urine with OS and cellular aging and its effect on the development of hypertension. In a Spanish sample with 1500 individuals, subjects aged 20-59 years were selected, whose zinc intake levels fell within the recommended limits. These individuals were classified according to their smoking habits and hypertensive condition. A positive correlation was found (Pearson's C=0.639; p=0.01) between Zn serum/urine quotient and oxidized glutathione levels (GSSG). Finally, risk of hypertension significantly increased when the GSSG levels exceeded the 75 percentile; OR=2.80 (95%CI=1.09-7.18) and AOR=3.06 (95%CI=0.96-9.71). Low zinc levels in serum were related with OS and cellular aging and were, in turn, to be a risk factor for hypertension.
Subject(s)
Cellular Senescence/physiology , Hypertension/etiology , Oxidative Stress/physiology , Zinc/metabolism , Adolescent , Adult , Aged , Aged, 80 and over , Biomarkers/metabolism , Cross-Sectional Studies , Female , Glutathione Disulfide/metabolism , Humans , Hypertension/metabolism , Male , Middle Aged , Risk Factors , Spain , Young AdultABSTRACT
The interaction of selenium, a component of antioxidant selenoproteins, with genetic variation in lipid-related pathways has not been evaluated earlier as a potential determinant of blood lipid levels. We aimed at evaluating the effects of gene-environment interactions between plasma levels of selenium and polymorphisms in lipid metabolic pathways on plasma lipid levels in a study population from Spain (N=1,315). We observed statistically significant associations between plasma selenium and lipid levels (differences in total, low-density lipoprotein [LDL]-cholesterol, and triglycerides comparing the 80th with the 20th percentiles of plasma selenium levels were, respectively, 12.0 (95% confidence interval 6.3, 17.8), 8.9 (3.7, 14.2), and 9.0 (2.9, 15.2) mg/dl). We also found statistically significant interactions at the Bonferroni-corrected significance level (p=0.0008) between selenium and rs2290201 in FABP4 for total and LDL cholesterol levels and rs1800774 in CETP for elevated LDL cholesterol. Other polymorphisms showed statistically significant differential associations of plasma selenium levels and lipids biomarkers at the nominal p-value of 0.05. Reported statistical interactions with genes involved in lipid transport and transfer provide biological support to the positive associations of selenium with lipids shown in cross-sectional studies and lead to the hypothesis that selenium and lipid levels share common biological pathways that need to be elucidated in mechanistic studies.
Subject(s)
Cholesterol Ester Transfer Proteins/genetics , Fatty Acid-Binding Proteins/genetics , Lipids/blood , Polymorphism, Single Nucleotide , Selenium/blood , Cholesterol, LDL/blood , Cross-Sectional Studies , Female , Gene-Environment Interaction , Humans , Male , Middle Aged , Signal Transduction , Spain , Triglycerides/bloodABSTRACT
The objective of this study was to evaluate the relationship between trace and toxic amounts of zinc (Zn) in biological samples (blood and urine) and the smoking habits of hypertensive patients and healthy control subjects in Valladolid (Spain). In order to compare biological samples, the concentrations of these samples were measured using inductively coupled plasma mass spectrometry. The limits of detection for Zn in blood plasma ranged between 4.22 and 17.34 µmol l(-1) and were <0.08 µmol g(-1) creatinine in urine. The results of this study indicate that the highest mean values of serum Zn were found in non-hypertensive nonsmokers (13.39±4.35 µmol l(-1)), whereas the highest urine Zn values were observed in hypertensive nonsmokers (2.78±2.13 µmol l(-1)). Higher Zn serum/urine quotient levels were observed in non-hypertensive and nonsmoking women, whereas lower levels were noted in non-hypertensive and smoking women (P=0.012). This study identified a correlation between Zn serum/urine quotients and cotinine levels (a marker of smoking), a correlation that suggests that smoking lowers the Zn serum/urine quotient, which was lower in hypertensive subjects than in control subjects.
Subject(s)
Hypertension/metabolism , Smoking/metabolism , Zinc/metabolism , Adult , Female , Humans , Male , Middle Aged , Spain , Young Adult , Zinc/blood , Zinc/urineABSTRACT
The role of selenium exposure in preventing chronic disease is controversial, especially in selenium-repleted populations. At high concentrations, selenium exposure may increase oxidative stress. Studies evaluating the interaction of genetic variation in genes involved in oxidative stress pathways and selenium are scarce. We evaluated the cross-sectional association of plasma selenium concentrations with oxidative stress levels, measured as oxidized to reduced glutathione ratio (GSSG/GSH), malondialdehyde (MDA), and 8-oxo-7,8-dihydroguanine (8-oxo-dG) in urine, and the interacting role of genetic variation in oxidative stress candidate genes, in a representative sample of 1445 men and women aged 18-85 years from Spain. The geometric mean of plasma selenium levels in the study sample was 84.76 µg/L. In fully adjusted models the geometric mean ratios for oxidative stress biomarker levels comparing the highest to the lowest quintiles of plasma selenium levels were 0.61 (0.50-0.76) for GSSG/GSH, 0.89 (0.79-1.00) for MDA, and 1.06 (0.96-1.18) for 8-oxo-dG. We observed nonlinear dose-responses of selenium exposure and oxidative stress biomarkers, with plasma selenium concentrations above ~110 µg/L being positively associated with 8-oxo-dG, but inversely associated with GSSG/GSH and MDA. In addition, we identified potential risk genotypes associated with increased levels of oxidative stress markers with high selenium levels. Our findings support that high selenium levels increase oxidative stress in some biological processes. More studies are needed to disentangle the complexity of selenium biology and the relevance of potential gene-selenium interactions in relation to health outcomes in human populations.
Subject(s)
Gene-Environment Interaction , Oxidative Stress , Selenium/blood , 8-Hydroxy-2'-Deoxyguanosine , Adolescent , Adult , Aged , Biomarkers/blood , Cross-Sectional Studies , Deoxyguanosine/analogs & derivatives , Deoxyguanosine/urine , Female , Genotype , Glutathione/metabolism , Glutathione Disulfide/urine , Humans , Male , Malondialdehyde/urine , Middle Aged , Spain , Young AdultABSTRACT
BACKGROUND: Tuberculosis (TB) continues to be an important health problem, in many cases the Hospital Emergency Services (HES) are the first contact of the patients with the sanitary system, there is not known the impact of this disease in the above mentioned services. The objectives of this study are to know the importance of TB in HES and to describe hospital discharges (MBDS) with TB diagnosis and if they had already been diagnosed in the HES. METHODS: A retrospective descriptive study of discharges with TB diagnosis in the hospital ward and in the HES of a tertiary care university hospital from 2002 to 2006. The Diagnostic concordance study and analysis of variables according to two groups: Coincidents (discharge with TB diagnosis in the HES and in the MBDS) and Only in the MBDS. Calculate statisticals of central tendency and dispersal for the quantitative variables and proportions and tables of contingency with application of the test chi(2) for the qualitative ones. RESULTS: Of the 172 (0.26%) emergencies admitted which were hospital discharges with Tb diagnosis, 61(35.5%) came in HES. The diagnostic concordance was 0.43(43.66%). The hospital discharges with Tb diagnosis (coincidents) changed from 47 (17) in 2002 to 21(5) in 2006. The 65.1% (68.9% in coincidents) were males. As regards age groups (coincidents%): 0-14: 6 (33.3%), 15-45: 81(47%), 46-65: 46(28.7%), 65: 39(19.7%); excluding group 0-14, p=0.009. Respiratory location (coincidents): 110 (50) and positive direct examination of smears for acid-fast bacilli (coincidents): 87 (43). Between well-known risk factors immigration stands out (p=0.001). CONCLUSIONS: The discharges with TB diagnosis declined during the period studied. The diagnostic concordance in the HES was moderate. We would have to insist more on seniors, and in people with well-known risk factors. In the HES the respiratory TB is also the most frequent being the direct examination of smears for acid-fast bacilli the principal diagnostic method.
Subject(s)
Emergency Service, Hospital , Patient Discharge , Tuberculosis/epidemiology , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Retrospective Studies , Spain/epidemiology , Tuberculosis/diagnosis , Young AdultABSTRACT
Fundamento: La Tuberculosis (TB) sigue siendo un problema de salud importante, en muchos casos los servicios de urgencias hospitalarios (SUH) constituyen el primer contacto de los pacientes con el sistema sanitario. Se desconoce el impacto de esta enfermedad en dichos servicios. Los objetivos de este estudio son conocer la importancia de la TB en los SUH y describir las altas hospitalarias (CMBD) con diagnóstico de TB, y cuáles ya habían sido diagnosticadas en el SUH. Métodos: Estudio descriptivo retrospectivo de las altas con TB en hospitalización y en el SUH de un hospital terciario universitario entre 2002-2006. Estudio de concordancia diagnóstica y análisis de variables según dos grupos: Coincidentes (Alta con TB en el SUH y en el CMBD) y Sólo en el CMBD. Se calculan estadísticos de tendencia central y dispersión para las variables cuantitativas, y proporciones y elaboración de tablas de contingencia con aplicación del test chi2 para las cualitativas. Resultados: De las 172 (0,26%) urgencias ingresadas que fueron altas hospitalarias con TB, 61 (35,5%) procedían del SUH. La concordancia diagnóstica fue 0,43 (43,46%). Las altas hospitalarias con TB (coincidentes) pasaron de 47 (17) en 2002 a 21 (5) en 2006. El 65,1% (68,9% en coincidentes) fueron varones. Por grupos de edad (coincidentes%): 0-14: 6(33,3%), 15- 45: 81(47%), 46-65: 46(28,7%), >65: 39(19,7%); excluyendo de 0-14, p=0,009. Localización respiratoria (coincidentes): 110 (50) y baciloscopia positiva (coincidentes): 87 (43). Entre los factores de riesgo conocidos destaca la inmigración (p=0,001). Conclusiones: Las altas con TB descendieron durante el periodo estudiado. La concordancia diagnostica en el SUH fue moderada. Habría que incidir más en personas de mayor edad, y en aquéllas con factores de riesgo conocidos. En el SUH la TB respiratoria es también la más frecuente siendo la baciloscopia el método diagnóstico principal (AU)
Background: Tuberculosis (TB) continues to be an important health problem, in many cases the Hospital Emergency Services (HES) are the first contact of the patients with the sanitary system, there is not known the impact of this disease in the above mentioned services. The objectives of this study are to know the importance of TB in HES and to describe hospital discharges (MBDS) with TB diagnosis and if they had already been diagnosed in the HES. Methods: A retrospective descriptive study of discharges with TB diagnosis in the hospital ward and in the HES of a tertiary care university hospital from 2002 to 2006. The Diagnostic concordance study and analysis of variables according to two groups: Coincidents (discharge with TB diagnosis in the HES and in the MBDS) and Only in the MBDS. Calculate statisticals of central tendency and dispersal for the quantitative variables and proportions and tables of contingency with application of the test chi2 for the qualitative ones. Results: Of the 172 (0.26%) emergencies admitted which were hospital discharges with Tb diagnosis, 61(35.5%) came in HES. The diagnostic concordance was 0.43(43.66%). The hospital discharges with Tb diagnosis (coincidents) changed from 47 (17) in 2002 to 21(5) in 2006. The 65.1% (68.9% in coincidents) were males. As regards age groups (coincidents%): 0-14: 6 (33.3%), 15-45: 81(47%), 46-65: 46(28.7%), >65: 39(19.7%); excluding group 0-14, p=0.009. Respiratory location (coincidents): 110 (50) and positive direct examination of smears for acid-fast bacilli (coincidents): 87 (43). Between well-known risk factors immigration stands out (p=0.001). Conclusions: The discharges with TB diagnosis declined during the period studied. The diagnostic concordance in the HES was moderate. We would have to insist more on seniors, and in people with well-known risk factors. In the HES the respiratory TB is also the most frequent being the direct examination of smears for acid-fast bacilli the principal diagnostic method (AU)
