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Effects of Selenium Supplementation on the Indices of Disease Activity, Inflammation and Oxidative Stress in Patients with Rheumatoid Arthritis: a Randomized Clinical Trial

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Abstract

The aim of study was to evaluate the effect of selenium supplementation on disease activity, inflammation, and oxidative stress in patients with rheumatoid arthritis (RA). This study was a randomized double-blind placebo-controlled trial on 59 patients with RA. Participants were randomly divided to receive 200 μg/day of selenium or a placebo for 12 weeks. The disease activity score (DAS.CRP and DAS.ESR), erythrocyte sedimentation rate (ESR), serum levels of C-reactive protein (CRP), fasting blood glucose, lipids, antibodies to cyclic citrullinated protein (anti-CCP), nitric oxide, glutathione, and total antioxidant capacity were assessed. The mean of DAS.CRP and DAS.ESR decreased significantly within both study groups after the intervention. However, the between-group comparisons revealed no significant differences. The CRP levels decreased significantly in the selenium group, and this decrease was near the significance level compared to the placebo (P = 0.05). However, after adjusting for baseline values, the observed difference between groups did not remain significant. In addition, the values of ESR and anti-CCP decreased significantly within the selenium group. Although, between-group comparison did not statistically significant, the change in ESR and anti-CCP in the selenium group was small clinically relevant compared to the placebo [the effect size (95% CI) for ESR: 0.38 (− 0.14, 0.89), and for anti-CCP: 0.32 (− 0.2, 0.83)]. Our study showed that selenium caused a small clinically relevant improvement in some RA biomarkers such as ESR and anti-CCP. Future studies that evaluate the effects of novel forms of supplements such as selenium nanoparticles on the clinical symptoms and biomarkers of RA are suggested. Trial Registration: At www.irct.ir as IRCT20190924044869N1 on 2020–06-14.

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Data Availability

The datasets generated during and/or analyzed during the current study are not publicly available due to the rules and regulations of the Research Center for Biochemistry and Nutrition in Metabolic Diseases at the Kashan University of Medical Science, but are available from the corresponding author on reasonable request.

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Funding

This work was supported by the Vice-Chancellor for Research and Technology of Kashan University of Medical Sciences, Kashan, Iran (grant number: 98188).

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Authors and Affiliations

  1. Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran

    Batool Zamani

  2. Department of Internal Medicine, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran

    Fereshteh Taghvaee

  3. Department of Epidemiology and Biostatistics, School of Health, Kashan University of Medical Sciences, Kashan, Iran

    Hossein Akbari

  4. Student Research Committee, Department of Nutrition, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran

    Abbas Mohtashamian

  5. Research Center for Biochemistry and Nutrition in Metabolic Diseases, Basic Science Research Institute, Kashan University of Medical Sciences, Kashan, Iran

    Nasrin Sharifi

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  1. Batool Zamani
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Batool Zamani, Fereshteh Taghvaee, Hossein Akbari, Abbas Mohtashamian, and Nasrin Sharifi. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Nasrin Sharifi.

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This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Kashan University of Medical Sciences, Kashan, Iran (IR.KAUMS.MEDNT.REC.1398.129).

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Zamani, B., Taghvaee, F., Akbari, H. et al. Effects of Selenium Supplementation on the Indices of Disease Activity, Inflammation and Oxidative Stress in Patients with Rheumatoid Arthritis: a Randomized Clinical Trial. Biol Trace Elem Res 202, 1457–1467 (2024). https://doi.org/10.1007/s12011-023-03782-1

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