Response to Van Koppen et al.
Response to Van Koppen et al.
复制标题
对 Van Koppen 等人的回应
DOI：
10.1097/hjh.0b013e32835fdf99
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发表时间：
2013
影响因子：
4.9
通讯作者：
Kramer,ChristopherM
中科院分区：
文献类型：
--
作者：
Keeley,EllenC;Mehrad,Borna;Kramer,ChristopherM
我们满怀期待地阅读了 Berthold 等人的研究。[1]并感谢作者对硒和高血压的另一项有趣的分析。然而，我们认为，该出版物在几个方面存在不足，即分析的硒生物标志物的数量、研究参与者入院原因的特征、微量元素补充信息、营养估计（如在德国，膳食硒摄入量以致高血压营养为主，即红肉、鸡蛋、牛奶等，而不是水果或蔬菜）以及对意外发现的潜在原因的批判性讨论。古龙脂质分析 (LIANCO) 队列患者的血清硒浓度存在这种不常见的性别差异，这背后的原因是什么？为什么只有 LIANCO 女性才表现出显着的相互作用？从硒与高血压之间的相互作用来看，如图1所示，唯一明显且显着的影响似乎仅限于血清硒浓度高于100mg/l的少数女性，这显然代表了德国人中的一个不寻常的亚群。人们想知道他们的临床异常、健康状况、多种维生素和微量元素的自我补充，以及血清硒水平相对较高的其他潜在原因。令人惊讶的是，数据表明，即使在相对缺硒的人群中，较高的血清硒浓度也可能与较高的血压和女性高血压患病率较高有关[1]。这些发现发人深省，并提出了有关补硒安全性的新问题，即使是在德国等缺硒人群中也是如此 [2, 3]。到目前为止，科学界普遍认为，纠正边缘供应个体的硒缺乏可以带来健康益处。 Berthold 等人的研究[1]对于心血管疾病来说，这意味着相反的情况。这一结果令人惊讶，因为大多数已发表的这方面的分析都报告了正相关或没有交互作用[1,4,5,7,8]。例如，Nawrot 等人[5] 2007 年得出的结论是，相对硒缺乏可能构成高血压发展的一个被低估的危险因素，特别是在欧洲男性中 [6]，Lubos 等人 [8] 2010 年推断，低硒浓度与急性冠脉综合征患者未来心血管死亡的风险相关。这些发现很难与 Berthold 等人的研究一致[1]。
We have read with great expectations the study of Berthold et al.[1] and would like to thank the authors for another interesting analysis on selenium and hypertension. However, in our view, the publication fell short in several respects, that is, the number of selenium biomarkers analyzed, characterization of study participants with respect to reason for hospital admission, information on trace element supplementation, nutrition estimates (as in Germany, dietary selenium intake is dominated by hypertensinogenic nutrition, ie red meat, eggs, milk and so on, but not by fruits or vegetables) and a critical discussion on potential reasons for the unexpected findings presented. What might underlie this uncommon sex-difference in serum selenium concentrations in the patients of the Lipid analytic cologne (LIANCO) cohort, and why do only the LIANCO women display significant interactions? Judging from the interactions between selenium and hypertension, as graphically depicted in Fig. 1, the only obvious and significant effects appear restricted to the small number of women with serum selenium concentrations above 100mg/l, which clearly represent an unusual subgroup of Germans. One wonders about their clinical oddities, health, multivitamin and trace element self-supplementation, and other potential reasons for a relatively high serum selenium status. Surprisingly, for us the data suggest that even in a population with a relative selenium deficiency higher serum selenium concentrations may be associated with higher blood pressure and a higher prevalence of hypertension in women [1]. These findings are thought-provoking and are raising new questions on the safety of selenium supplementation, even in selenium-deficient populations like in Germany [2, 3]. Until now, there was a widespread belief in the scientific community that correcting a selenium deficit in marginally supplied individuals provides health benefits; the study by Berthold et al.[1] implies the opposite with respect to cardiovascular disease. This result is surprising as the majority of published analyses in this respect report a positive correlation or no interaction [1, 4, 5, 7, 8]. For example, Nawrot et al.[5] in 2007 concluded that a relative selenium deficit might constitute an underestimated risk factor for the development of high blood pressure, especially in European men [6], and Lubos et al.[8] reasoned in 2010 that low selenium concentrations were associated with risk of future cardiovascular death in patients with acute coronary syndrome. These findings can only hardly be aligned to the study of Berthold et al.[1].