Table 3.
Studies investigating Se status in Europe (including the UK).
| Country | Study Description | Subject Details/Number | Se Status by Body Compartment |
|---|---|---|---|
| UK [5] | Randomised, double-blind, placebo-controlled trial of Se supplementation on thyroid function | 501 males and females aged 60–74 years | Mean baseline plasma Se, 91 μg/L |
| UK [20,60] | A longitudinal analysis of Se intakes in UK South Asian and Caucasian women: oral presentation | 135 Caucasian premenopausal (19–40 years), 135 Caucasian postmenopausal (55–70 years), 39 Asian premenopausal (19–40 years) and 39 Asian postmenopausal (55–70 years) women. | Full plasma GPx expression (serum or plasma Se level of 98.7 μg/L [8] was not achieved by 51.1% of the UK (Caucasian and Asian), 63.3% of UK Asian and 45.2% of UK Caucasian subjects |
| UK [24] | Retrospective cohort, including previously reported indices of bone health and dietary Se intake and Se analysis (during 2010) of previously collected plasma and serum in the D-FINES study [60]. | 51 UK resident postmenopausal women (35 Caucasian; 16 Asian, 55–75 years; 41 UK resident premenopausal women (27 Caucasian; 14 Asian), 19–40 years | Mean serum or plasma Se status μg/L in postmenopausal Caucasian and Asian women, respectively, was 100.91 ± 16.94 μg/L and 99.69 ± 23.73 μg/L; in premenopausal Caucasian and Asian women, respectively, it was 96.68 ± 11.76 μg/L and 92.10 ± 17.22 μg/L |
| Spain [26] | Cross-sectional analysis of food intake and serum Se in elderly people | Dietary intake assessed in 205 institutionalized elderly using 1-year FFQ: women (n = 125); men (n = 125) | Mean serum Se levels μg/L: women 87.9 ± 16.6; men 86.2 ± 17; bakery, fish and shellfish, meat, meat products and dairy products were associated with serum Se; animal, but not vegetable protein contributed to serum Se |
| Spain [27] | Cross-sectional analysis using a 3-day food record and serum analysis | 483 children (216 boys and 267 girls) aged between 8 and 13 years | The mean serum Se was 71.1 μg/L; however, it was <60 μg/L in 13.9% of subjects, and <45 μg L/ in 5.6% |
| Republic of Slovenia [33] | A cohort study to assess Se status during 3 months of basic military training | 15 recruits | Plasma Se was between 70 and 80 ng/g (** 71.75–82 μg/L; ##, ^^, # 76.87 μg/L) |
| UK [37] | Longitudinal Se status in healthy British adults: assessment using biochemical and molecular biomarkers | 24 women, mean age 45 years; 39 males, mean age 45 years | Women’s baseline plasma Se was 1.11 μmol/L (* 87.65 μg/L). Male’s baseline plasma Se was 1.16 μmol/L (* 91.59 μg/L) |
| Spain [42] | Cross-sectional study to determine whether being overweight/obesity is associated with children’s Se status | 573 Madrid schoolchildren aged 8–13 years | Children with excess weight (BMI > P85) had lower serum Se than those of normal weight (64.6 ± 16.8 μg/L compared to 75.3 ± 12.2 μg/L) |
| Italy [43] | Population-based case-control series to determine the relationship between Se exposure and risk of cutaneous melanoma | 54 melanoma patients and 56 controls | Median plasma Se was 99 μg/L in the cases and 89 μg/L in the controls; median toenail Se was 0.64 μg/g in the cases and 0.65 μg/g in the controls |
| Greece [62] | Cross-sectional analysis of maternal-neonatal serum Se and copper levels in Greeks and Albanians | Subjects: 1118 Greek and 820 Albanian immigrant mothers | Mean serum Se in Greek mothers was 68.3 ± 8.5 μg/L and Greek new-borns 37.2 ± 8.9 μg/L; mean serum Se in Albanian mothers was 37.4 ± 8.9 μg/L and Albanian new-borns 34.33 ± 9.1 μg/L |
| Portugal [63] | Cross-sectional analysis of data from healthy Portuguese subjects of the Lisbon population | 136 women aged 20–44 years; 47 men aged 45–70 years | Mean serum Se 81 ± 14 μg/L in women; the oldest subjects had the highest concentrations (regardless of gender), although higher serum Se values were noted in men |
| France [64] | Cross-sectional study: The SUpplementation en VItamines et Mineraux AntioXydants SU.VI.MAX) study | 1821 women (30–60 years) and 1307 men (45–60 years) | Baseline mean serum Se for men was 1.13 ± 0.20 μmol/L (* 89.22 ± 15.79 μg/L) and women 1.08 ± 0.19 μmol/L (* 85.28 ± 15.00 μg/L) |
| Germany [65] | Cross-sectional analysis of Se and antioxidant vitamin status | 178 elderly women (absence of severe disease; mean age: 63.2 years (SD ± 2.73) | Mean serum Se in omnivores (n = 159) 1.17 ± 0.22 μmol/L (* 92.38 μg/L) and vegetarians 1.09 ± 0.22 μmol/L (* 86.07 μg/L); sixty five (38.9%) women had serum Se concentrations below 1.1 μmol/L (* 86.86 μg/L) and 153 (91.6%) below 1.5 μmol/L (* 118.44 μg/L) |
| Czech Republic (West Bohemia) [66] | Cross-sectional analysis to assess Se deficiency of West Bohemia population | Age: 6–65 years; sex: male and female | Serum mean Se: 55.4 ± 13.8 μg/L; urine: 15.4 ± 5.7 μg/L; 13.6 ± 6.0 μg/g creatinine. hair: 0.268 ± 0.051 μg/g Se indexes were concluded to be low |
| EU, various countries [67] | Nested case-control assessing plasma Se and prostate cancer risk: results from the European Prospective Investigation into Cancer and Nutrition (EPIC) | 959 men (with incident prostate cancer) 1059 matched controls | Mean plasma Se in controls ranged from 63.2 μg/L to 76.6 μg/L; lowest levels in Greece and Germany and highest in the UK and Sweden; plasma concentrations in EPIC (mean: 70 μg/L) |
| Estonia [68] | Cross-sectional analysis of 5 studies between 1993 and 2001 | 404 subjects included women, pregnant women and men aged 19.5 to 52 years, but not declared in all studies | Serum Se concentration ranged from 26 to 116 μg/L (mean: 75 μg/L), which were comparable to analyses that were completed in the Finnish population prior to the use of Se-enriched fertilizers |
| Denmark [69] | Cross-sectional analysis of serum Se and selenoprotein P status in adult Danes within an 8-year follow up | 817 subjects: women, 18–22 years, 40–45 years, 60–65 years; men, 60–65 years. | Mean serum Se 98.7 ± 19.8 μg/L; serum Se increased with age in both sexes and decreased by 5% on average from 1997 to 1998; there was a weak correlation between serum Se and fish intake; Se status was concluded to be acceptable |
| UK [70] | Cross-sectional analysis of Se blood levels | 68 pre-term infants (35 boys and 33 girls) | Mean plasma Se at term and 6 months were 0.49 ± 0.15 μmol/L (* 38.69 μg/L) and 0.72 ± 0.14 μmol/L (* 56.85 μg/L) and red blood cell Se 1.68 ± 0.40 μmol/L (* 132.65 μg/L) and 1.33 ± 0.19 μmol/L (* 105.02 μg/L), respectively |
| UK [71] | Cross-sectional analysis of Se status and its correlates in a British National Diet and Nutrition Survey (NDNS) | 883 independent and 251 institution living men and women, aged 65 years and over | Plasma mean Se 0.94 μmol/L (* 74.22 μg/L) for independents and plasma mean Se 0.90 μmol/L (* 71.06 μg/L) for those in the institutional setting |
| Germany [72] | Cross-sectional analysis of participants in the Lipid Analytic Cologne cohort | 792 participants who never smoked, who did not use antihypertensives and who did not have diabetes or known atherosclerotic disease | Mean serum Se concentration was 68 ± 32 μg/L |
| 5 European Cities [73] | A 6-year prospective study of fracture-related factors: the Osteoporosis and Ultrasound Study (OPUS) | 2374 postmenopausal women | Mean baseline serum Se was 94.3 (range 54.4–161.2) μg/L; the mean of the low quintile was 69.50 (range 39.46–77.06) μg/L, and the mean of the high quintile was 128.43 (range 115.99–205.25) μg/L; higher Se was associated with higher hip bone mineral density (BMD) at study entry |
| The Netherlands [74] | A 16.2-year prospective longitudinal study of The Netherlands cohort | 120,852 subjects aged 55–69 years completed a dietary and lifestyle questionnaire on dietary habits and provided toenail clippings for baseline Se determination | Mean Se concentration was approximately 0.563 μg/g at baseline and did not change significantly throughout the study |
| Denmark [75] | A 16-year longitudinal follow up of the Copenhagen Male Study | 3333 males aged 53–74 years | 167 (5.1%) subjects died of lung cancer: 5.0% of them with low serum Se (0.4–1.0 μmol/L) (* 31.58–78.96 μg/L), 5.1% with medium serum Se 1.1–1.2 μmol/L (* 86.86–94.75 μg/L) and 5.1% with high serum Se 1.3–3.0 μmol/L (* 102.65–236.88 μg/L) |
| UK [76] | Baseline data from a double-blind, placebo-controlled, pilot trial | 230 primiparous pregnant women | The overall median whole-blood Se concentration at baseline was 1.31 (* 103.44 μg/L) (range 0.84–3.33) μmol/L (* 66.33–262.94 μg/L) |
| UK [77] | Cross-sectional analysis of anthropometric indices with Se-status biomarkers using data from 2000 to 2001 (NDNS) | 1045 (577 female, 468 male) British Caucasian adults ages 19–64 | Median plasma and erythrocyte Se concentrations were 1.08 (0.98, 1.20) μmol/L (* 85.28 (77.38, 94.75) μg/L) and 1.62 (1.38, 1.91) μmol/L (*127.92 (108.96, 150.81) μg/L), respectively; for males, values were 1.09 (0.99, 1.22) μmol/L (* 86.07 (78.17, 96.33) μg/L) and 1.54 (1.34, 1.79) μmol/L (* 121.60 (105.81, 141.34) μg/L), respectively; for females 1.07 (0.97, 1.18) μmol/L (* 84.49 (76.59, 93.17) μg/L) and 1.71 (1.43, 1.99) μmol/L (* 135.02 (112.91, 157.13) μg/L), respectively |
| UK [78] | Data from the UK PRECISE (Prevention of Cancer by Intervention with Selenium) pilot, randomized, double-blind, placebo-controlled trial | 501 elderly volunteers | Mean plasma Se concentration was 88.5 ng/g (** 90.71 μg/L) at baseline |
| UK [79] | Data from the about Teenage Eating Study, a prospective observational study | 126 pregnant adolescents (14–18-year-olds) between 28 and 32 weeks gestation | Plasma Se (mean ± (SD)) was lower in the small-for-gestational-age group (n = 19: 49.4 ± 7.3 μg/L) compared with the appropriate-for-gestational-age group (n = 107: 65.1 ± 12.5 μg/L); smokers had lower Se compared with non-smokers (p = 0.01), and Afro-Caribbean women had higher Se compared with white Europeans (p = 0.02) |
| UK [80] | Randomised, double-blind, placebo-controlled trial | 119 free-living, non-smoking men and women, aged 50–64 years | Mean baseline plasma Se was approximately 90 ng/mL = 90 μg/L |
| UK [81] | Cross-sectional analysis of Se status with cardio-metabolic risk factors in the general population | 1042 white participants (aged 19–64 year) from the 2000–2001 UK NDNS | Mean plasma Se concentration was 1.10 ± 0.19 μmol/L (* 86.86 ± 15 μg/L) |
| UK [82] | Randomized, placebo-controlled, parallel-group study stratified by age and sex | 501 volunteers aged 60 to 74 years | Mean plasma Se was 88.8 ng/g (** 91.02μg/L) at baseline |
| Finland [83] | Cross-sectional and longitudinal associations of serum Se with cardiovascular risk factors | 1235 young Finns aged 3–18 years and followed from 1980 until 1986 | Mean (±SD) serum Se was 74.3 ± 14.0 ng/mL = 74.3 ± 14.0 μg/L at baseline and 106.6 ± 12.5 ng/mL = 106.6 ± 12.5 μg/L six years later |
| UK, Belgium, Italy [84] | Cross-sectional analysis of data from the Dietary Habit Profile in European Communities with Different Risk of Myocardial Infarction: the Impact of Migration as a Model of Gene-Environment Interaction (IMMIDIET) study to evaluate the effect of genetic and dietary habits on cardiovascular disease risk factors in non-diabetic subjects | Couples randomly recruited from general practice in southeast London, England (n = 263), the Flemish territory of Belgium (n = 267) and the Abruzzo region of Italy (n = 271) | The mean (SD) plasma Se (in μmol/L) in men without metabolic syndrome was 1.24 (* 97.91 μg/L) (0.23) and with metabolic syndrome was 1.24 (* 97.91 μg/L) (0.23); similar results for women without metabolic syndrome were 1.21 (* 95.54 μg/L) (0.23) and with metabolic syndrome 1.32 (* 104.23 μg/L) (0.28) |
| Poland [85] | Case-control to estimate Se concentration, glutathione peroxidase activity and total antioxidant status in patients with multiple sclerosis and the influence of dietary habits | 101 patients with relapsing-remitting MS (aged 18–58 years) and 63 healthy people (aged 19–65 years) | Serum Se in patients was 55.2 ± 16.2 μg/L compared with controls 79.2 ± 20.6 μg/L |
| Poland [86] | Cross-sectional study to determine serum and urinary Se in children with and without obesity | 80 children (age 6–17; 40 boys, 40 girls) | Serum Se (in μg/L) in control girls 102.3 ± 7.9, control boys 111.1 ± 9.5, obese girls 80.4 ± 8.2, obese boys 82.8 ± 10.3; urine Se (in μg/L) in control girls 55.9 ± 9.4 in control boys 60.3 ± 11.5, in obese girls 36.0 ± 7.5, in obese boys 36.7 ± 5.6 |
| Poland [87] | Case-control analysis of anti-oxidant defences in pubertal patients with type 1 diabetes mellitus (T1DM) and their siblings | 87 children with T1DM, 2–19 years old and their siblings comprised of 27 and 41 children, aged 4.5–16.5 years and 10.5–18 years, respectively, and 41 healthy children aged from 10.5 to 18 years | Plasma mean Se (μg/L) in T1DM children was 58.4, in their sibling was 53.45 and in the controls was 53.3 |
| Poland [88] | Case-control study in Szczecin, a region of northwestern Poland | 95 lung cancer cases, 113 laryngeal cancer cases and corresponding healthy controls | Among lung cancer cases, mean serum Se was 63.2 μg/L, compared to 74.6 μg/L for their matched controls. Among laryngeal cancer cases, the mean serum Se was 64.8 μg/L, compared to 77.1 μg/L for their matched controls |
| Austria [89] | Case-control study of people with autoimmune thyroiditis | Patients with autoimmune thyroiditis and matched group of healthy persons | Serum Se in the patients was 98.0 ± 15.6 μg/L and in controls was 103.2 ± 12.4 μg/L |
| Finland [90] | Systematic review | Sampling of human blood from the same 60 adults, annually | Mean plasma Se increased from 0.89 μmol/L (* 70.27 μg/L) in the 1970s to a general level of 1.40 μmol/L (* 110.54 μg/L) since introducing Se-supplemented fertilizers in 1984 |
| Germany [91] | Cross-sectional study in disorders in wound healing | 44 trauma patients with disorders in wound healing | Mean plasma Se was 0.79 ± 0.19 μmol/L (* 62.38 ± 15.00 μg/L) |
| Germany [92] | Prospective observational study to assess the effects of perioperative sodium-selenite administration on Se blood concentrations in cardiac surgical patients | 104 cardiac surgical patients | Whole blood Se was 89.05 ± 12.65 μg/L pre-surgery and 70.84 ± 10.46 μg/L post-surgery |
| Germany [93] | Prospective observational study in the development of multi-organ dysfunction in cardiac surgical patients | 60 patients (age 65 ± 14 years) undergoing cardiac surgery with the use of cardiopulmonary bypass | Fifty patients exhibited a significant Se deficiency already before surgery. Se was significantly reduced after the end of surgery when compared to preoperative values (89.05 ± 12.65 to 70.84 ± 10.46 μg/L) |
| Greece [94] | A prospective cross-sectional study to assess the relationship of urine Se levels with thyroid function and autoimmunity in pregnant women | 47 euthyroid women in uncomplicated singleton pregnancies (mean age + SD: 30 + 5 years) | Urine Se in μg/L: 1st trimester 91 ± 60, 2nd trimester 82 ± 59, 3rd trimester 69 ± 57 |
| Denmark [95] | Case-control study in patients with newly-diagnosed autoimmune thyroid disease | 97 patients with newly-diagnosed Graves’ disease, 96 with hypothyroidism, 92 euthyroid subjects with high serum thyroid peroxidase antibody and 830 controls | Mean serum Se in Graves’ disease was 89.9 μg/L, in euthymic subjects 98.4 μg/L and in controls 98.8 μg/L |
| Spain [96] | Cross-sectional study of a healthy population | 84 healthy adults (31 males and 53 females) from the province of Granada | Mean plasma Se was 76.6 ± 17.3 μg/L (87.3 ± 17.4 μg/L in males, 67.3 ± 10.7 μg/L in females), whereas the mean erythrocyte Se was 104.6 μg/L (107.9 ± 26.1 μg/L in males and 101.7 ± 21.7 μg/L in females) |
| Spain [97] | Cross-sectional study of a healthy population in southern Spain | 340 subjects | 86.5% had plasma Se below 125 μg/L |
| Hungary [98] | A single-centre cross-sectional clinical survey following cardiac surgery | 197 consecutive patients undergoing on-pump operation | Mean blood Se was significantly lower in non-survivors 102.2 ± 19.5 μg/L compared with survivors 111.1 ± 16.9 μg/L |
| The Netherlands [99] | Prospective cross-sectional analysis during early gestation to determine the impact of Se status on the risk of preterm births | 1197 white Dutch women with a singleton pregnancy followed from 12 weeks’ gestation | Serum Se at 12 weeks’ gestation was significantly lower among women who had a preterm birth than among those who delivered at term mean 0.96 ± 0.14 μmol/L vs. 1.02 ± 0.13 μmol/L (* 75.80 ± 11.05 μg/L vs. * 80.54 ± 10.26 μg/L) |
| France [100] | The prospective, longitudinal Epidemiology of Vascular Ageing (EVA) study | 1389 subjects aged 59–71 years followed for 9 years | Mean baseline plasma Se was 1.08 ± 0.21 μmol/L (* 85.28 ± 16.58 μg/L) in men and 1.10 ± 0.20 μmol/L (* 86.86 ± 15.79 μg/L) in women |
| Italy, Slovenia, Croatia, Greece [101] | Prospective cohort with four recruitments areas to assess Se exposure due to fish consumption in the Mediterranean area | Various tissue samples from 900 Italian, 584 Slovenian, 234 Croatian and 484 Greek women | Mean Se concentrations: Italian mother’s blood 117 ng/g, Italian cord blood 113 ng/g Italian breast milk 18 ng/g; Slovenian cord blood 76 ng/g, Slovenian breast milk 17 ng/g; Croatian mother’s blood 90 ng/g, Croatian cord blood 96 ng/g, Croatian breast milk 18 ng/g; Greek cord blood 104 ng/g, Greek breast milk 21 ng/g; Italian urine 31 μg/g; Croatian urine 4 μg/g, Greek urine 24 μg/g |
* Se μg/L calculated using an atomic weight of 78.96; ** converted from ng/g using the density of plasma at approximately 1.025 g/mL; # not clear if it is a mean value; ^^ calculated average; ## sex not established.