Christine D. Thomson

Assessment of requirements for selenium and adequacy of selenium status: a review

Objective: The intent of this review is to evaluate the scientific evidence for the assessment of adequacy of selenium status and of the requirements for selenium. From this evidence, attempts have been made to define levels of plasma selenium and dietary selenium intake, which could be used for the assessment of deficiency or adequacy of selenium status.Method: The first section briefly reviews the methods for assessment of selenium status. The second section outlines the requirements for selenium based on a number of criteria, and how these have been translated into recommended intakes of selenium. In the final section, levels of plasma selenium and dietary intake based on different criteria of adequacy have been proposed.Results and conclusion: The minimum requirement for selenium is that which prevents the deficiency disease, Keshan disease. The recommended intakes of selenium have been calculated from the requirement for optimum plasma glutathione peroxidase (GPx) activity that must, because of the hierarchy of selenoproteins, also take account of the amounts needed for normal levels of other biologically necessary selenium compounds. Whether optimal health depends upon maximization of GPx or other selenoproteins, however, has yet to be resolved, and the consequences of less-than-maximal GPx activities or mRNA levels need investigation. Intakes, higher than recommended intakes, and plasma selenium concentrations that might be protective for cancer or result in other additional health benefits have been proposed. There is an urgent need for more large-scale trials to assess any such beneficial effects and to provide further data on which to base more reliable estimates for intakes and plasma selenium levels that are protective.

Long-term supplementation with selenate and selenomethionine: selenium and glutathione peroxidase (EC 1.11.1.9) in blood components of New Zealand women.

Thirty-three New Zealand women aged 18-23 years received daily for 32 weeks, 200 micrograms Se as Se-enriched yeast (selenomethionine), or brewers yeast mixed with selenate, or no added Se (placebo) in a double-blind trial. Se supplementation raised (P = 0.001) platelet glutathione peroxidase (EC 1.11.1.9; GSHPx) activity, and also Se and GSHPx in whole blood, erythrocytes and plasma. Selenomethionine was more effective in raising blood Se concentrations than selenate, but both were equally effective in raising GSHPx activities in whole blood, erythrocytes and plasma, indicating a similar bioavailability for the two forms. These observations and those of gel filtration studies of erythrocytes and plasma proteins reported elsewhere (Butler et al. 1991) are consistent with the incorporation of Se from selenomethionine into a general tissue protein pool while selenate is directly available for GSHPx synthesis, and explain the poorer correlation between Se and GSHPx in individuals with higher Se status. However, selenate raised platelet GSHPx activities to a greater extent than did selenomethionine suggesting some other effect of selenate on platelets which needs further investigation. A response of GSHPx activity in these New Zealand subjects indicates that their dietary Se intake is insufficient to meet recommended intakes based on the criterion of saturation of GSHPx activity, and could reflect a marginal Se status. The level of blood Se necessary for saturation of GSHPx of about 100 ng Se/ml whole blood confirms observations in earlier studies.

Selenium and iodine intakes and status in New Zealand and Australia

Most New Zealand soils contain relatively low concentrations of the anionic trace elements F, I and Se. Some areas of Australia also have a history of I deficiency. In view of current interest in establishing nutrient reference intakes for Se and I in New Zealand and Australia, it is timely to review current understanding of the intakes and status of these two elements. In spite of a recent increase in Se status, the status of New Zealanders remains low compared with populations of many other countries and may still be considered marginal, although the clinical consequences of the marginal Se status are unclear. There are no recent reports of blood Se levels in Australia, but earlier reports indicate that they were generally greater than those of New Zealanders. Similarly, the consequences of decreasing I status in Australia and New Zealand are unclear. Mild I deficiency in New Zealand has resulted in enlarged thyroid glands indicating an increased risk of goitre. Currently there is little evidence, however, of any associated clinical disease. Public health recommendations to reduce salt intake, together with the reduction in I content of dairy products, are likely to result in further decreases in the I status of New Zealand and Australian residents. Some action is needed to prevent this decline and it may be necessary to consider other means of fortification than iodized salt. The consequences of possible interactions between Se and I in human nutrition are also unclear and no practical recommendations can be made.

Quantitative selenium metabolism in normal New Zealand women.

1. Quantitative selenium metabolism has been studied in normal young New Zealand women by measuring total Se intake and urinary and faecal Se output, and by using values for absorption, excretion and turnover of 75Se determined after administration of[75Se]selenomethionine or [75Se]selenite. 2. In a period of 14 d when a normal ad lib. diet was being consumed, mean dietary Se for four women was 24.2 microgram/d, mean urinary Se was 13.1 microgram/d and mean faecal Se was 10.8 microgram/d; mean Se balance during this time was + 0.3 microgram/d. 3. Intestinal absorption of food Se was 0.76--0.83 of intake (mean 0.79). 4. Whole-body Se was calculated in three different ways; (a) using the specific activity of urinary Se and retained whole-body 75Se; (b) using plasma Se and the occupancy of 75Se in whole-body and plasma; (c) using absorbed food Se and the occupancy of absorbed 75Se in whole-body. 5. Whole-body Se calculated from measurements obtained following the administration of [75Se]selenomethionine was 4.7--10.0 mg (mean 6.9) using method (a), 4.1--7.2 mg (mean 5.2) using method (b) and 4.3--8.9 mg (mean 6.2) using method (c). 6. Whole-body Se calculated from results obtained after giving [75Se]selenite was 2.7--3.4 mg (mean 2.9) using method (a), 2.3--5.0 mg (mean 3.5) using method (b) and 2.1--3.0 mg (mean 2.6) using method (c). 7. The results of this study indicate that the minimum dietary requirement of Se for the maintenance of normal human health is probably not more than 20 microgram/d.

Selenium concentrations and glutathione peroxidase activities in whole blood of New Zealand residents.

1. A relationship was found between selenium concentrations and glutathione peroxidase (EC 1.11.1.9) activities in whole blood of 264 New Zealand residents (r 0-71, P less than 0-001). 2. New Zealand residents returning from visits overseas of 7 months to 3 years had elevated blood Se, but normal GSH-Px activities, whereas for some new settlers in New Zealand both Se and GSH-Px activities were high.

On supplementing the selenium intake of New Zealanders

1. The daily intake of selenium by three subjects was supplemented with 100 microgram Se as selenomethionine (Semet-Se) or sodium selenite (selenite-Se)/d for 10-11 weeks, or with 65 microgram Se as in mackerel (Scomber japonicus) (fish-Se)/d for 4 weeks. 2. Urinary and faecal excretion of Se was measured and also Se concentration in whole blood, plasma and erythrocytes. Measurements on blood were made at intervals after supplementation had ceased. 3. Selenite-Se was not as well absorbed (0.46 of the intake) during the first 4 weeks as Semet-Se (0.75 of the intake) and fish Se (0.66 of the intake). 4. Blood Se increased steadily with Semet-Se, from 0.08 to 0.18 microgram Se/ml, but more slowly with selenite-Se, reaching a plateau in 7-8 weeks at 0.11 microgram Se/ml. Plasma Se increased more rapidly with Semet-Se than with selenite-Se, so that initially with Semet-Se plasma Se was greater than erythrocyte Se. 5. Daily urinary excretion increased with all forms of supplement, with initially a greater proportion of absorbed selenite-Se being excreted than Semet-Se or fish-Se. A close relationship was found between plasma Se and 24 h urinary excretion. The findings suggested that there was a rapid initial excretion of presumably unbound Se then a slower excretion of residual unbound, loosely bound or bound Se. 6. Total retentions of 3.5 mg selenite-Se and 4.5 mg Semet-Se were large when compared with an estimate of body content of 6 mg Se, derived in another paper (Stewart, Griffiths, Thomson & Robinson, 1978). Retention of Semet-Se and fish-Se appeared to be reflected in blood Se, whereas for selenite-Se, blood Se reflected retention for only a short period after which Se appeared to be retained without altering the blood Se. This suggested that Semet-Se and selenite-Se were metabolized differently. 7. A double blind-dosing trail with 100 microgram Semet-Se was carried out for 12 weeks on twenty-four patients with muscular complaints in Tapanui, a low-Se-soil area. Blood Se increased in the experimental group (from 0.067 to 0.143 microgrm Se/ml); clinical findings were not conclusive and will be presented elsewhere. 8. Bood Se was measured in New Zealand residents before travelling to Europe or to North America. On return their blood Se was increased, and depending upon the period of time spent outside New Zealand some values reached concentrations found in visitors and new settlers to New Zealand. 9. The results from these studies and the earlier studies of single and multiple dosing have been used to look at the various criteria in use for assessing Se status of subjects. It is suggested that plasma Se be used in preference to 24 h urinary excretion, and in addition to whole blood Se and glutathione peroxidase (EC 1.11.1.9) activity.

Metabolic studies of [ 75 Se]selenomethionine and [ 75 Se]selenite in the rat

1. Information was sought concerning the long-term fate of orally and intravenously administered [ 75 Se]selenomethionine and [ 75 Se]selenite in rats. 2. Urinary and faecal radioactivity was assayed during the 1st week and whole-body radio-activity was determined weekly for 16 weeks. Rats were killed at intervals for analysis of 75 Se tissue distribution. 3. Intestinal absorption after oral administration was estimated to be 91–93% for selenite and 95–97% for selenomethionine. 4. Urinary excretion of absorbed [ 75 Se]selenite was greater than that of [ 75 Se]selenomethionine during the 1st week. 5. After the 1st week, whole-body retention diminished exponentially at a similar rate in rats given either selenomethionine or selenite. Except for the erythrocytes, 75 Se content of individual tissues also decreased exponentially. 6. It appears that, after an initial period, 75 Se from either selenomethionine or selenite is metabolized similarly, suggesting that Se from both potential dietary sources is ultimately incorporated into the same metabolic pool.

The metabolism of [ 75 Se]selenite in young women

I. The long-term fate of an oral dose of [sSe]selenite was studied in three young women. 2. Urinary and faecal excretion, respiratory and dermal losses and whole-body retention of W e were measured, and also 75Se turnover in whole body, blood and tissues during a period of 16-20 weeks. 3. Intestinal absorption of [75Se]selenite by the three subjects was 70, 64 and 44 % of the dose. 4. Urinary excretion accounted for 14-20% of absorbed W e in the 1st week. There were only trace amounts of radioactivity in expired air and no dermal loss was detected. 5 . After an initial phase in which radioactivity decreased rapidly, whole-body retention of W e diminished exponentially with a half-time of 96-144 d. Radioactivity in the liver, heart and plasma decreased more rapidly than that in the whole body, but radioactivity in skeletal muscle and bone decreased more slowly.

Iodine status of New Zealand residents as assessed by urinary iodide excretion and thyroid hormones

The aims of this study were (1) to compare various measures of I status, and (2) to assess urinary I and thyroid hormone status of residents of two areas of New Zealand where, before the iodization of salt, goitre was endemic due to low soil I. A total of 189 subjects (102 males, eighty-seven females) were recruited from the Dunedin Blood Transfusion Centre, and 144 (sixty-seven males, seventy-seven females) from the Waikato Blood Transfusion Centre between November 1993 and June 1994. Blood was taken for thyroid hormone assays, and subjects collected a fasting overnight urine specimen, a double-voided fasting urine sample, and a complete 24 h specimen for iodide and creatinine analyses. Positive correlations (P < 0.0001) between daily iodide excretion and iodide concentrations in fasting and double-voided fasting urines, identical median values for iodide concentrations in the three samples, and similar numbers of subjects classified as at risk from I deficiency disorders according to the International Committee for the Control of Iodine Deficiency Disorders/World Health Organization categories (World Health Organization, 1994) confirmed indications from earlier studies that fasting urine samples were suitable for population studies. However 24 h urinary iodide excretion remains the recommended measure for individual I status. Waikato residents excreted more iodide in urine and all measures were significantly greater than for Otago residents. However median urinary iodide excretions for both areas (60 and 76 microgram/d for Otago and Waikato respectively) were considerably lower than those reported previously for New Zealand. Thyroid hormone concentrations were within normal ranges. Our findings suggest that I status of New Zealanders may no longer be considered adequate and may once again be approaching levels of intake associated with clinical I deficiency.

Selenium Supplementation in Total Parenteral Nutrition

Four adult patients with very low plasma selenium (Se) levels ( less than or equal to 1.5 microgram/100 ml) were given Se supplements while receiving total parenteral nutrition. A comparison was made using the compounds selenomethionine and sodium selenite given either intravenously or by mouth. Urinary excretion and Se plasma responses differed, and indicated that selenomethionine retention was greater. However, the incorporation of Se into the erythrocyte and its enzyme glutathione peroxidase was unpredictable and delayed and was not a good indicator of supplement response. No deleterious effects of supplements were observed. Se supplements are indicated especially in patients with a high risk of developing low Se levels and are best monitored by plasma Se levels.