ReviewThe importance of selenium and zinc deficiency in cardiovascular disorders
Introduction
Cardiovascular diseases usually linked with lifestyle, are amongst the main causes of death, especially in the elderly population. An important component of one’s lifestyle is diet and appropriate intake of macroelements and trace elements. The role of trace elements in health and disease has been emphasized in multiple scientific publications. Moreover, supplementation of trace elements to improve health is becoming increasingly popular. The following review presents current views on the relationship between the concentration of trace elements such as selenium and zinc in the body, and their impact on the morphology and function of the cardiovascular system. Research discussing the effect of selenium and zinc supplementation on the function of the heart and blood vessels was also reviewed.
Section snippets
Role of selenium in the body
Selenium is one of the trace elements necessary for the proper functioning of the body. It is contained in products of plant origin (cereals, brazil nuts, broccoli, onions, garlic, lentils, carrots, potatoes) and animal products (beef, lamb, pork, poultry, fish - tuna) (Fairweather-Tait et al., 2010). The reference range for plasma selenium, as well as its recommended daily supply are age dependent. The reference values for both parameters are presented in detail in Table 1, Table 2. The
Role of zinc in the body
Zinc, like selenium, is one of the trace elements. The Recommended Dietary Allowances (RDAs) for zinc, as well as its serum levels are age specific. The reference values for both parameters are presented in detail in Table 3, Table 4 (Institute of Medicine (US), 2001; Nader et al., 2018). The best sources of zinc include beef, mutton, offal (liver), crustaceans, fish, cereal grains, root vegetables, nuts and legumes (Bhowmik et al., 2010).
In the body zinc performs many important functions.
Dilated cardiomyopathy – Keshan disease
As mentioned earlier, Keshan disease is a heart disease with a documented association with selenium deficiency which was named after Keshan region of Heilongjiang Province in north-eastern China (Lei et al., 2011). In 1935, a sudden increase in the incidence of unknown disease was observed among the residents of the region; it was manifested by sudden chest tightness, pain, nausea and vomiting. In the clinical trial, various degrees of cardiac arrhythmias were found, as well as acute or chronic
Atherosclerosis and ischemic heart disease
Zinc, like selenium, seems to affect the formation of atherosclerotic plaque. Experiments carried out on endothelial cells cultured in zinc-poor media showed that its deficit leads to a decrease in integrity and an increase in endothelial permeability. Zinc deficiency also affected the severity of cell apoptosis. In turn, enrichment of media with zinc improved their structure (Hennig et al., 1992; Meerarani et al., 2000). Increased inflammation and impaired endothelial cell structure may
Selenium and zinc supplementation and the cardiovascular system
Numerous scientific findings linking low selenium levels with increased cardiovascular risk have raised high expectations for the beneficial effects of its supplementation. Unfortunately, the results of clinical trials conducted so far are truly diverse, and the meta-analyses consistently report the lack of impact of supplementation on reducing the risk of incidence and the mortality due to cardiovascular diseases. A meta-analysis made by Rees et al. (2013) included 19,715 patients. Statistical
Summary
Despite the trace amount of selenium and zinc in the body, these elements are necessary for its proper functioning. Their impact on maintaining the body’s oxidoreductive balance and protecting cells from free radicals is particularly important. Both their deficiency and excess are unfavourable for health. Keshan disease has a confirmed cause and effect relationship with selenium deficiency. Findings on the relationship between selenium and other cardiovascular diseases such as atherosclerosis,
Conflict-of-interest/financial disclosure statement
The authors declare that they have no conflict of interest.
The study was funded by local grant from the Wroclaw Medical University (no. STM.A100.17.050).
Declaration of Competing Interest
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Acknowledgement
Funding: The study was funded by local grant from the Wroclaw Medical University (no.STM.A100.17.050).
References (77)
- et al.
Role of selenium in male reproduction - a review
Anim. Reprod. Sci.
(2014) - et al.
Long-term zinc deprivation accelerates rat vascular smooth muscle cell proliferation involving the down-regulation of JNK1/2 expression in MAPK signaling
Atherosclerosis
(2013) - et al.
A bioinformatics view of zinc enzymes
J. Inorg. Biochem.
(2012) - et al.
Factors associated with longitudinal plasma selenium decline in the elderly: the EVA study
J. Nutr. Biochem.
(2007) - et al.
Prevalence of zinc deficiency in cardiac surgery patients
Heart Lung Circ.
(2018) - et al.
Divergent effects of zinc depletion in brain vs non-brain endothelial cells
Biochem. Biophys. Res. Commun.
(2005) - et al.
Selenium bioavailability: current knowledge and future research requirements
Am. J. Clin. Nutr.
(2010) - et al.
Zinc deficiency alters barrier function of cultured porcine endothelial cells
J. Nutr.
(1992) - et al.
High selenium exposure lowers the odds ratios for hypertension, stroke, and myocardial infarction associated with mercury exposure among Inuit in Canada
Environ. Int.
(2017) - et al.
The effect of selenium supplementation on coronary heart disease: a systematic review and meta-analysis of randomized controlled trials
J. Trace Elem. Med. Biol.
(2017)
High-selenium lentil diet protects against arsenic-induced atherosclerosis in a mouse model
J. Nutr. Biochem.
Zinc protects against apoptosis of endothelial cells induced by linoleic acid and tumor necrosis factor alpha
Am. J. Clin. Nutr.
Production and reversal of the neuromuscular pathology and related signs of zinc deficiency in guinea pigs
J. Nutr.
Impact of the discovery of human zinc deficiency on health
J. Trace Elem. Med. Biol.
Zinc: an antioxidant and anti-inflammatory agent: role of zinc in degenerative disorders of aging
J. Trace Elem. Med. Biol.
The importance of selenium to human health
Lancet
Serum selenium concentration and risk of ischaemic heart disease in a prospective cohort study of 3000 males
Atherosclerosis.
Blood pressure levels and hypertension prevalence in a high selenium environment: results from a cross-sectional study
Nutr. Metab. Cardiovasc. Dis.
Severe zinc deficiency: effects on the distribution of nine elements (potassium, phosphorus, sodium, magnesium, calcium, iron, zinc, copper and manganese) in regions of the rat brain
J. Nutr.
Inhibition of TNF-alpha induced ICAM-1, VCAM-1 and E-selectin expression by selenium
Atherosclerosis
Selenium inhibits high glucose- and high insulin-induced adhesion molecule expression in vascular endothelial cells
Arch. Med. Res.
Effect of selenium- and glutathione-enriched yeast supplementation on a combined atherosclerosis and diabetes hamster model
J. Agric. Food Chem.
Still reduced cardiovascular mortality 12 years after supplementation with selenium and coenzyme Q10 for four years: a validation of previous 10-year follow-up results of a prospective randomized double-blind placebo-controlled trial in elderly
PLoS One
Clinical and echocardiographic correlates of serum copper and zinc in acute and chronic heart failure
Clin. Res. Cardiol.
Selenium, copper, zinc and hypertension: an analysis of the National Health and Nutrition Examination Survey (2011-2016)
BMC Cardiovasc. Disord.
Suboptimal dietary zinc intake promotes vascular inflammation and atherogenesis in a mouse model of atherosclerosis
Mol. Nutr. Food Res.
Regulation and function of selenoproteins in human disease
Biochem. J.
A potential medicinal importance of zinc in human health and chronic disease
Int. J. Pharm. Biomed. Sci.
An original discovery: selenium deficiency and Keshan disease (an endemic heart disease)
Asia Pac. J. Clin. Nutr.
Zinc deficiency and cellular oxidative stress: prognostic implications in cardiovascular diseases
Acta Pharmacol. Sin.
Selenoproteins and cancer prevention
Annu. Rev. Nutr.
Zinc: the trace element of major importance in human nutrition and health
Int. J. Med. Sci. Public Health
Scientific opinion on dietary reference values for selenium
EFSA. J.
Zinc and regulation of inflammatory cytokines: implications for cardiometabolic disease
Nutrients.
Blood selenium concentration in various populations of healthy and sick people – review of literature from the years 2005–2010
Galen. Cas. Med. Farm. Hem. Srod. Nauke
Role of zinc in physiological and pathological processes of the body
Diagn. Lab.
Zinc and copper levels in severe heart failure and the effects of atrial fibrillation on the zinc and copper status
Biol. Trace Elem. Res.
Association of reduced zinc status with angiographically severe coronary atherosclerosis: a pilot study
Angiology.
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