Nutritional status of selenium in overweight and obesity: A systematic review and meta-analysis

Background & aims: Selenium is an antioxidant and anti-inflammatory nutrient and regulates important physiological processes, such as carbohydrate and lipid metabolism, immune system actions, and adipocyte differentiation. Given these important functions, several studies have assessed the nutritional status of selenium to elucidate whether its homeostasis is impaired by excess adiposity, which in turn could contribute to the adipose tissue dysfunction and metabolic disorders. However, the results of these studies are quite controversial. Therefore, this systematic review and meta-analysis aimed to assess differences in the nutritional status of selenium in overweight/obese individuals. Methods: We searched the PubMed, Scopus, Web of Science, Embase, Cochrane Library, and Virtual Health Library databases. Studies comparing overweight or obese individuals with eutrophic individuals and assessing at least one marker of selenium were included. Comprehensive Meta-Analysis software was used to perform meta-analysis. The effect size was calculated using the raw mean difference or the standardized mean difference, with 95% confidence interval and a p-value of <0.05. Heterogeneity was determined using the I-2 index. Subgroup analyses were performed according to sex, body mass index (BMI), and selenium content in the soil. The protocol of this review was registered in the Prospective Register of Systematic Reviews (registration number: CRD42020185405). Results: This systematic review included 73 articles, of which 65 articles were eligible for meta-analysis. There were no significant differences between the overweight/obesity and eutrophy groups in terms of dietary intake and plasma/serum levels of selenium and selenoprotein P levels. The activity of plasma/serum glutathione peroxidase was decreased in the overweight/obese children and adolescents; however, the difference was no statistically significant when the enzyme activity was analyzed in erythrocytes and whole blood. In the adult age group, overweight/obese individuals had decreased activity of both glutathione peroxidase isoforms compared to those individuals with eutrophy. In particular, the activity of erythrocyte glutathione peroxidase was significantly decreased in obese individuals and those living in regions with low-to-moderate selenium content in the soil. Regarding selenium excretion markers, overweight/obese individuals had lower levels of selenium in the urine and nails and a trend of higher levels of selenium in the hair than eutrophic individuals. Conclusions: In conditions of excess adiposity, the main alteration in the nutritional status of selenium is a decrease in glutathione peroxidase activity, particularly in adults with obesity. In addition, reduced levels of selenium in urine and nails can be found in overweight or obese individuals. (C) 2022 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.