The association between non-alcoholic fatty liver disease (NAFLD) and advanced fibrosis with blood selenium level based on the NHANES 2017-2018

Abstract

Background & Objective Selenium was one of the essential trace elements that played a pivotal role in human health. Although previous studies have investigated the relationship between selenium and non-alcoholic fatty liver disease (NAFLD) and fibrosis, these findings were still inconclusive. Our study was aimed to explore the association between blood selenium level and NAFLD and advanced liver fibrosis diagnosed by vibration controlled transient elastography (VCTE) in US adults. Methods All data were extracted from National Health and Nutrition Examination Survey database (2017–2018). Participants were divided into four groups according to quartile of blood selenium level. Liver stiffness and controlled attenuation parameter (CAP) were measured by VCTE. Multiple logistic regression models and subgroup analyses were conducted to determine the association between blood selenium level and NAFLD and advanced liver fibrosis diagnosed by a variety of methods. Results A total of 3336 participants were enrolled in main analysis. In multiple logistic regression models, the higher blood selenium level (>205.32, ≤453.62 μg/L) had a significant positive association with NAFLD (β = 1.31). Moreover, high blood selenium level had significantly inversely association to advanced liver fibrosis (β = 0.61). In subgroup analysis, the main inversely correlation between blood selenium and advanced liver fibrosis was found in males with high blood selenium level. Despite dietary selenium intake being adjusted or in different subgroups, the associations between blood selenium level and NAFLD/advanced liver fibrosis remained significant. Conclusions This study showed that blood selenium level were positively association with NAFLD among US population. Participants with lower blood selenium level showed a higher percentage of advanced liver fibrosis. Blood selenium is more likely to cause NAFLD and liver fibrosis due to imbalances in selenium homeostasis rather than dietary selenium intake. Key messages High blood selenium level was association with NAFLD diagnosed by vibration controlled transient elastography. Participants with lower blood selenium level had high percentage of advanced liver fibrosis. NAFLD and liver fibrosis are caused by an imbalance of selenium homeostasis, not by dietary selenium intake.

Validation of nonalcoholic fatty liver disease (NAFLD) related steatosis indices in metabolic associated fatty liver disease (MAFLD) and comparison of the diagnostic accuracy between NAFLD and MAFLD

“…viral hepatitis and overdose of alcohol) [22]. Viral hepatitis was defined by the presence of HCV-RNA and/or confirmed hepatitis C antibodies (hepatitis C virus) or the hepatitis B surface antigen (hepatitis B virus) [15]. Overdose alcohol was indicated if >30 g/day for men and >20 g/day for women [15].…”

“…The NHANES is a continuous cross-sectional survey conducted by the National Center for Health Statistics (NCHS) for the assessment of health and nutritional status among the general public of the USA, which included unbiased demographics, dietary, examination, laboratory and questionnaire data. The NHANES has become a frequent database used to study MAFLD or NAFLD because of recently available data on FibroScan liver steatosis assessment [12][13][14][15]. The study cohort was obtained from the NHANES database (2017-2018).…”

Examining the Pathogenesis of MAFLD and the Medicinal Properties of Natural Products from a Metabolic Perspective

“…Thus, the therapeutic effect of selenium supplementation on MAFLD may be partly achieved by inhibiting ferroptosis. However, epidemiologic evidence about the association between blood selenium levels and MAFLD appears to be contradic-tory [262][263][264]. Given the unique features of selenium, it is an attractive avenue to explore the role of selenium in MAFLD pathogenesis.…”

Exploring the interactions between metabolic dysfunction-associated fatty liver disease and micronutrients: from molecular mechanisms to clinical applications

“…Studies have shown that lower blood selenium levels are associated with a higher incidence of advanced liver fibrosis ( 151 ). Conversely, higher blood selenium levels (above ~130 μg/L) have been positively correlated with both MAFLD and ghrelin, indicating a dose–response relationship ( 150 , 152 ).…”