Effects of Selenium Supplementation on Metabolic Status in Patients Undergoing for Coronary Artery Bypass Grafting (CABG) Surgery: a Randomized, Double-Blind, Placebo-Controlled Trial
This study was carried out to evaluate the effects of selenium supplementation on glycemic control, lipid profiles, and biomarkers of inflammation and oxidative stress in patients undergoing for coronary artery bypass grafting (CABG) surgery. This randomized, double-blind, placebo-controlled trial was performed among 33 patients undergoing for CABG surgery, aged 40–85 years old. Subjects were randomly allocated into two groups to intake either 200 μg/day selenium supplements as selenium yeast (n = 17) or placebo (n = 16) for 4 weeks. Glycemic control, lipid profiles, and biomarkers of inflammation and oxidative stress were assessed at baseline and at the end of trial. After the 4-week intervention, selenium supplementation significantly decreased fasting plasma glucose (FPG) (β, 6.76 mg/dL; 95% CI, − 13.13, − 0.40; P = 0.03), insulin (β, − 1.14 μIU/mL; 95% CI, − 2.01, − 0.28; P = 0.01); homeostasis model of assessment-estimated insulin resistance (HOMA-IR) (β − 0.35; 95% CI, − 0.62, − 0.08; P = 0.01); and total-/HDL-cholesterol ratio (β − 0.31; 95% CI, − 0.51, − 0.09; P = 0.008); and significantly increased HDL-cholesterol levels (β, 2.72 mg/dL; 95% CI, 0.89, 4.55; P = 0.005) compared with the placebo. Moreover, selenium supplementation led to a significant reduction in high-sensitivity C-reactive protein (hs-CRP) (β, − 0.68 mg/L; 95% CI, − 1.18, − 0.17; P = 0.01) and malondialdehyde (MDA) (β, − 0.27 μmol/L; 95% CI, − 0.47, − 0.07; P = 0.009), and a significant elevation in total glutathione (GSH) levels (β, 77.33 μmol/L; 95% CI, 56.11, 98.55; P < 0.001) compared with the placebo. Selenium supplementation did not affect other metabolic profiles. Overall, our study demonstrated that selenium supplementation for 4 weeks to patients undergoing for CABG surgery had beneficial effects on FPG, insulin, HOMA-IR, total-/HDL-cholesterol ratio, HDL-cholesterol, hs-CRP, GSH, and MDA levels, but did not affect other metabolic profiles. Clinical trial registration number: http://www.irct.ir: IRCT2017090533941N22.
KeywordsSelenium Supplementation Metabolic status Coronary artery bypass grafting
ZA contributed in conception, design, statistical analysis and drafting of the manuscript. AK and EA contributed in data collection and manuscript drafting. Z.A. supervised the study.
The current study was founded by a grant from the Vice-chancellor for Research, AUMS, and Iran.
Compliance with Ethical Standards
This investigation was done according to the principals of the Declaration of Helsinki and the study protocol was approved by the ethics committee of AUMS. All patients were informed about the aims and protocol of the study. Written informed consent was obtained from all subjects prior to the intervention.
Conflicts of Interest
The authors declare that they have no conflict of interest.
- 9.Ali-Hassan-Sayegh S, Mirhosseini SJ, Rezaeisadrabadi M, Dehghan HR, Sedaghat-Hamedani F, Kayvanpour E, Popov AF, Liakopoulos OJ (2014) Antioxidant supplementations for prevention of atrial fibrillation after cardiac surgery: an updated comprehensive systematic review and meta-analysis of 23 randomized controlled trials. Interact Cardiovasc Thorac Surg 18:646–654CrossRefGoogle Scholar
- 12.Akbarzadeh M, Eftekhari MH, Shafa M, Alipour S, Hassanzadeh J (2016) Effects of a new metabolic conditioning supplement on perioperative metabolic stress and clinical outcomes: a randomized, placebo-controlled trial. Iran Red Crescent Med J 18:e26207. https://doi.org/10.5812/ircmj.26207 CrossRefPubMedPubMedCentralGoogle Scholar
- 13.Jablonska E, Reszka E, Gromadzinska J et al (2016, 2016) The effect of selenium supplementation on glucose homeostasis and the expression of genes related to glucose metabolism. Nutrients 8(12)Google Scholar
- 15.Luepker RV, Apple FS, Christenson RH et al (2003) Case definitions for acute coronary heart disease in epidemiology and clinical research studies: a statement from the AHA Council on Epidemiology and Prevention; AHA Statistics Committee; World Heart Federation Council on Epidemiology and Prevention; the European Society of Cardiology Working Group on Epidemiology and Prevention; Centers for Disease Control and Prevention; and the National Heart, Lung, and Blood Institute. Circulation 108:2543–2549CrossRefGoogle Scholar
- 16.Pisprasert V, Ingram KH, Lopez-Davila MF, Munoz AJ, Garvey WT (2013) Limitations in the use of indices using glucose and insulin levels to predict insulin sensitivity: impact of race and gender and superiority of the indices derived from oral glucose tolerance test in African Americans. Diabetes Care 36:845–853CrossRefGoogle Scholar
- 25.Raygan F, Behnejad M, Ostadmohammadi V, Bahmani F, Mansournia MA, Karamali F, Asemi Z (2018) Selenium supplementation lowers insulin resistance and markers of cardio-metabolic risk in patients with congestive heart failure: a randomised, double-blind, placebo-controlled trial. Br J Nutr 120:33–40CrossRefGoogle Scholar
- 26.Tabrizi R, Akbari M, Moosazadeh M, Lankarani KB, Heydari ST, Kolahdooz F, Mohammadi AA, Shabani A, Badehnoosh B, Jamilian M, Assarian A, Asemi Z (2017) The effects of selenium supplementation on glucose metabolism and lipid profiles among patients with metabolic diseases: a systematic review and meta-analysis of randomized controlled trials. Horm Metab Res 49:826–830CrossRefGoogle Scholar
- 30.Shargorodsky M, Debby O, Matas Z, Zimlichman R (2010) Effect of long-term treatment with antioxidants (vitamin C, vitamin E, coenzyme Q10 and selenium) on arterial compliance, humoral factors and inflammatory markers in patients with multiple cardiovascular risk factors. Nutr Metab (Lond) 7:55. https://doi.org/10.1186/1743-7075-7-55 CrossRefGoogle Scholar
- 34.Salehi M, Sohrabi Z, Ekramzadeh M, Fallahzadeh MK, Ayatollahi M, Geramizadeh B, Hassanzadeh J, Sagheb MM (2013) Selenium supplementation improves the nutritional status of hemodialysis patients: a randomized, double-blind, placebo-controlled trial. Nephrol Dial Transplant 28:716–723CrossRefGoogle Scholar
- 39.Gaudino M, Antoniades C, Benedetto U, Deb S, di Franco A, di Giammarco G, Fremes S, Glineur D, Grau J, He GW, Marinelli D, Ohmes LB, Patrono C, Puskas J, Tranbaugh R, Girardi LN, Taggart DP, Ruel M, Bakaeen FG (2017) Mechanisms, consequences, and prevention of coronary graft failure. Circulation 136:1749–1764CrossRefGoogle Scholar
- 40.Damy T, Kirsch M, Khouzami L, Caramelle P, le Corvoisier P, Roudot-Thoraval F, Dubois-Randé JL, Hittinger L, Pavoine C, Pecker F (2009) Glutathione deficiency in cardiac patients is related to the functional status and structural cardiac abnormalities. PLoS One 4:e4871. https://doi.org/10.1371/journal.pone.0004871 CrossRefPubMedPubMedCentralGoogle Scholar