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Abstract：
Background: The association between dietary selenium (Se) intake and osteoporosis-related fractures remains inconsistent. We aimed to examine the dose relationship between Se intake and incident fracture among Chinese adults. Methods: The dietary data were retrieved from the China Health and Nutrition Survey conducted between 1991 and 2011, and 17,150 participants aged above 20 were included. A 3-day, 24-h recall of food intake was performed to assess cumulative average dietary Se intake. The fracture was based on self-report in each survey between 1997 and 2011. The association between Se intake and fracture was tested by Cox regression, and the non-linear association was examined by restricted cubic splines (RCS). Results: There were 976 fracture cases during a mean of 10.2 years follow-up. In a fully adjusted Cox model, across the quartiles of Se intake, the hazard ratios (HRs) for fracture were 1.07 (95% CI .86-1.33), 1 (reference), 1.25 (95% CI 1.02-1.53), and 1.33 (95% CI 1.07-1.65). RCS showed a parabolic association (P non-linear = 0.037) between Se and fracture for men as well as a U-shape dose-response (P non-linear = 0.04) between Se and fracture for subjects living in highly urbanized areas. Conclusion: In conclusion, there is a non-linear association between selenium intake and fracture, with higher intake associated with increased risk. The shape of the association varies by gender and urbanization level.
摘要：
背景：膳食硒（Se）摄入量与骨质疏松症相关骨折之间的关系仍然不一致。我们旨在研究中国成年人硒摄入量与意外骨折之间的剂量关系。方法:采用1991-2011年中国健康与营养调查方法,纳入17150名20岁以上人群的膳食数据。一个3天,进行了24小时食物摄入量的召回，以评估累积平均膳食硒摄入量。骨折是基于1997年至2011年期间每次调查的自我报告。通过Cox回归检验了硒摄入量与骨折之间的关系，非线性关联由有限三次样条(RCS)检查。结果:骨折976例,平均随访10.2年。在完全调整的Cox模型中，跨硒摄入量的四分位数，骨折的风险比（HR）为1.07（95%CI.86-1.33），1（参考），1.25（95%CI1.02-1.53），和1.33（95%CI1.07-1.65）。RCS显示出男性Se与骨折之间的抛物线关联（P非线性=0.037），以及生活在高度城市化地区的受试者Se与骨折之间的U形剂量反应（P非线性=0.04）。结论：总之，硒摄入量和骨折之间存在非线性关联，较高的摄入量与风险增加相关。协会的形式因性别和城市化水平而异。
