The association between low serum selenium, vitamin A, and vitamin E levels and mortality from cardiovascular disease (CVD) was investigated in a case-control study nested in a 9-yr prospective study in the Netherlands. For 10,532 persons aged greater than or equal to 5 yr who participated in a 1975-1978 medical survey, serum was stored at -20 degrees C. For the 84 of 106 subjects aged 37-87 yr who died of CVD after the baseline exam, 168 cohort members alive at the end of 1983 and matched for age and gender were selected as controls. No significant associations between serum selenium. vitamin A, vitamin E, and CVD mortality were observed before and after multivariate analyses. The adjusted risk of death from CVD for subjects in the lowest selenium quintile (less than 105.0 micrograms/L) was 1.6 (95% CI, 0.8-3.2). For coronary and stroke death risk, estimates were 1.1 (95% CI, 0.5-2.6) and 3.2 (95% CI, 0.8-12.1). Our findings do not show a clear CVD risk from low selenium and vitamin levels. Although some of the risk estimates were strong, larger studies are required for definitive conclusions.

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The association of serum selenium with the subsequent risk of death from cancer was investigated in a case-control study that was nested in a prospective nine-year follow-up study in the Netherlands. In 1975-1978, 10,532 persons in the Dutch town of Zoetermeer who were aged five years or more participated in a medical survey. Serum samples were collected and stored at -20 C. For the 82 persons who died of cancer since the baseline examination, 164 cohort members still alive by the end of 1983 were selected as controls and matched for age, sex, and smoking. Cancer deaths that occurred in the first year of follow-up were excluded, leaving 69 cases for statistical analyses. The mean serum selenium level of 116.7 +/- 4.0 micrograms/liter among male cancer deaths (n = 40) was significantly different (p = 0.04) from that in the control subjects (126.4 +/- 3.1 micrograms/liter). In females, selenium levels were similar among cases and controls. The adjusted risk of death from cancer for men in the lowest quintile of serum selenium (below 100.8 micrograms/liter) was more than twice that of subjects with higher levels (relative risk = 2.7,90% confidence interval = 1.2-6.2). These data support recent findings of an increased cancer risk associated with low serum selenium levels in men but not in women.

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suinmary 1. Serum concentrations of IgG and IgM were measured in 87 hypertensive and 87 normotensive subjects, matched for age and gender, and selected from the same general population.2. No significant differences between these two groups were found, in contrast to some previous reports.3. The reasons for this discrepancy are discussed.