Higher Dietary Se Intake Is Associated With the Risk of New-Onset Fracture: A National Longitudinal Study for 20 Years

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.