Selenium supplementation and insulin resistance in a randomized, clinical trial

Elizabeth T Jacobs, Michael P Lance, Lawrence J. Mandarino, Nathan Ellis, Hsiao-Hui Chow, Janet A Foote, Jessica A. Martinez, Chiu-Hsieh Hsu, Ken Batai, Kathylynn Saboda, Patricia A. Thompson

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective While controversial, observational and randomized clinical trial data implicate the micronutrient selenium (Se) in the development of type 2 diabetes (T2D). The aim of this study was to test the hypothesis that Se supplementation adversely affects pancreatic β-cell function and insulin sensitivity. Research design and methods In a subset of 400 individuals participating in a randomized, placebo-controlled trial of Se at 200 μg/day for colorectal adenomatous polyps, fasting plasma glucose and insulin were measured before randomization and within 6 months of completing intervention. Change in the homeostasis model assessment-β cell function (HOMA2-%β) and insulin sensitivity (HOMA2-%S) were compared between arms. A subgroup of 175 (79 Se and 96 placebo) participants underwent a modified oral glucose tolerance test (mOGTT) at the end of intervention and change in glucose values was assessed. Results No statistically significant differences were observed for changes in HOMA2-%β or HOMA2-%S between those who received Se compared with placebo. After a mean of 2.9 years on study, mean HOMA2-%β values were 3.1±24.0 and 3.1±29.8 for the Se and placebo groups, respectively (p=0.99). For HOMA2-%S, the values were '0.5±223.2 and 80.9±1530.9 for the Se and placebo groups, respectively (p=1.00). Stratification by sex or age did not reveal any statistically significant effects on insulin sensitivity by treatment group. For mOGTT, mean baseline fasting blood glucose concentrations were significantly higher among participants in the placebo group compared with the Se group (96.6±14.6 and 92.3±12.0, respectively; p=0.04), a trend which remained through the 20 min assessment. Conclusions These findings do not support a significant adverse effect of daily Se supplementation with 200 μg/day of selenized yeast on β-cell function or insulin sensitivity as an explanation for previously reported associations between Se and T2D. Further clarification of longer term effects of Se is needed. Clinical trial registry NIH Clinical Trials.gov number NCT00078897.

Original languageEnglish (US)
Article numbere000613
JournalBMJ Open Diabetes Research and Care
Volume7
Issue number1
DOIs
StatePublished - Feb 1 2019

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Selenium
Insulin Resistance
Randomized Controlled Trials
Placebos
Glucose Tolerance Test
Type 2 Diabetes Mellitus
Fasting
Clinical Trials
Adenomatous Polyps
Glucose
Micronutrients
Random Allocation
Registries
Blood Glucose
Homeostasis
Research Design
Yeasts
Insulin

Keywords

  • HOMA
  • homeostatic model assessment
  • insulin resistance
  • OGTT
  • selenium
  • supplementation

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

Selenium supplementation and insulin resistance in a randomized, clinical trial. / Jacobs, Elizabeth T; Lance, Michael P; Mandarino, Lawrence J.; Ellis, Nathan; Chow, Hsiao-Hui; Foote, Janet A; Martinez, Jessica A.; Hsu, Chiu-Hsieh; Batai, Ken; Saboda, Kathylynn; Thompson, Patricia A.

In: BMJ Open Diabetes Research and Care, Vol. 7, No. 1, e000613, 01.02.2019.

Research output: Contribution to journalArticle

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abstract = "Objective While controversial, observational and randomized clinical trial data implicate the micronutrient selenium (Se) in the development of type 2 diabetes (T2D). The aim of this study was to test the hypothesis that Se supplementation adversely affects pancreatic β-cell function and insulin sensitivity. Research design and methods In a subset of 400 individuals participating in a randomized, placebo-controlled trial of Se at 200 μg/day for colorectal adenomatous polyps, fasting plasma glucose and insulin were measured before randomization and within 6 months of completing intervention. Change in the homeostasis model assessment-β cell function (HOMA2-{\%}β) and insulin sensitivity (HOMA2-{\%}S) were compared between arms. A subgroup of 175 (79 Se and 96 placebo) participants underwent a modified oral glucose tolerance test (mOGTT) at the end of intervention and change in glucose values was assessed. Results No statistically significant differences were observed for changes in HOMA2-{\%}β or HOMA2-{\%}S between those who received Se compared with placebo. After a mean of 2.9 years on study, mean HOMA2-{\%}β values were 3.1±24.0 and 3.1±29.8 for the Se and placebo groups, respectively (p=0.99). For HOMA2-{\%}S, the values were '0.5±223.2 and 80.9±1530.9 for the Se and placebo groups, respectively (p=1.00). Stratification by sex or age did not reveal any statistically significant effects on insulin sensitivity by treatment group. For mOGTT, mean baseline fasting blood glucose concentrations were significantly higher among participants in the placebo group compared with the Se group (96.6±14.6 and 92.3±12.0, respectively; p=0.04), a trend which remained through the 20 min assessment. Conclusions These findings do not support a significant adverse effect of daily Se supplementation with 200 μg/day of selenized yeast on β-cell function or insulin sensitivity as an explanation for previously reported associations between Se and T2D. Further clarification of longer term effects of Se is needed. Clinical trial registry NIH Clinical Trials.gov number NCT00078897.",
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AU - Jacobs, Elizabeth T

AU - Lance, Michael P

AU - Mandarino, Lawrence J.

AU - Ellis, Nathan

AU - Chow, Hsiao-Hui

AU - Foote, Janet A

AU - Martinez, Jessica A.

AU - Hsu, Chiu-Hsieh

AU - Batai, Ken

AU - Saboda, Kathylynn

AU - Thompson, Patricia A.

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N2 - Objective While controversial, observational and randomized clinical trial data implicate the micronutrient selenium (Se) in the development of type 2 diabetes (T2D). The aim of this study was to test the hypothesis that Se supplementation adversely affects pancreatic β-cell function and insulin sensitivity. Research design and methods In a subset of 400 individuals participating in a randomized, placebo-controlled trial of Se at 200 μg/day for colorectal adenomatous polyps, fasting plasma glucose and insulin were measured before randomization and within 6 months of completing intervention. Change in the homeostasis model assessment-β cell function (HOMA2-%β) and insulin sensitivity (HOMA2-%S) were compared between arms. A subgroup of 175 (79 Se and 96 placebo) participants underwent a modified oral glucose tolerance test (mOGTT) at the end of intervention and change in glucose values was assessed. Results No statistically significant differences were observed for changes in HOMA2-%β or HOMA2-%S between those who received Se compared with placebo. After a mean of 2.9 years on study, mean HOMA2-%β values were 3.1±24.0 and 3.1±29.8 for the Se and placebo groups, respectively (p=0.99). For HOMA2-%S, the values were '0.5±223.2 and 80.9±1530.9 for the Se and placebo groups, respectively (p=1.00). Stratification by sex or age did not reveal any statistically significant effects on insulin sensitivity by treatment group. For mOGTT, mean baseline fasting blood glucose concentrations were significantly higher among participants in the placebo group compared with the Se group (96.6±14.6 and 92.3±12.0, respectively; p=0.04), a trend which remained through the 20 min assessment. Conclusions These findings do not support a significant adverse effect of daily Se supplementation with 200 μg/day of selenized yeast on β-cell function or insulin sensitivity as an explanation for previously reported associations between Se and T2D. Further clarification of longer term effects of Se is needed. Clinical trial registry NIH Clinical Trials.gov number NCT00078897.

AB - Objective While controversial, observational and randomized clinical trial data implicate the micronutrient selenium (Se) in the development of type 2 diabetes (T2D). The aim of this study was to test the hypothesis that Se supplementation adversely affects pancreatic β-cell function and insulin sensitivity. Research design and methods In a subset of 400 individuals participating in a randomized, placebo-controlled trial of Se at 200 μg/day for colorectal adenomatous polyps, fasting plasma glucose and insulin were measured before randomization and within 6 months of completing intervention. Change in the homeostasis model assessment-β cell function (HOMA2-%β) and insulin sensitivity (HOMA2-%S) were compared between arms. A subgroup of 175 (79 Se and 96 placebo) participants underwent a modified oral glucose tolerance test (mOGTT) at the end of intervention and change in glucose values was assessed. Results No statistically significant differences were observed for changes in HOMA2-%β or HOMA2-%S between those who received Se compared with placebo. After a mean of 2.9 years on study, mean HOMA2-%β values were 3.1±24.0 and 3.1±29.8 for the Se and placebo groups, respectively (p=0.99). For HOMA2-%S, the values were '0.5±223.2 and 80.9±1530.9 for the Se and placebo groups, respectively (p=1.00). Stratification by sex or age did not reveal any statistically significant effects on insulin sensitivity by treatment group. For mOGTT, mean baseline fasting blood glucose concentrations were significantly higher among participants in the placebo group compared with the Se group (96.6±14.6 and 92.3±12.0, respectively; p=0.04), a trend which remained through the 20 min assessment. Conclusions These findings do not support a significant adverse effect of daily Se supplementation with 200 μg/day of selenized yeast on β-cell function or insulin sensitivity as an explanation for previously reported associations between Se and T2D. Further clarification of longer term effects of Se is needed. Clinical trial registry NIH Clinical Trials.gov number NCT00078897.

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