In 2007, supplementation with the trace element selenium in a trial was unexpectedly found to be associated with an excess risk of type 2 diabetes. Given the concerns raised by these findings and the large number of recent studies on this topic, we reviewed the available literature with respect to this possible association. In this paper, we assessed the results of both experimental and nonexperimental epidemiologic studies linking selenium with type 2 diabetes incidence. Through a systematic literature search, we retrieved 50 potentially eligible nonexperimental studies and 5 randomized controlled trials published through June 11, 2018. To elucidate the possible dose–response relation, we selected for further analysis those studies that included multiple exposure levels and serum or plasma levels. We computed a pooled summary risk ratio (RR) of diabetes according to selenium exposure in these studies. We also computed a RR for diabetes incidence following supplementation with 200 µg/day of selenium compared with placebo in trials. In the nonexperimental studies, we found a direct relation between selenium exposure and risk of diabetes, with a clear and roughly linear trend in subjects with higher plasma or serum selenium levels, with RR at 140 µg/L of selenium exposure compared with a referent category of < 45 µg/L equal to 3.6 [95% confidence interval (CI) 1.4–9.4]. A dose–response meta-analysis focusing on studies with direct assessment of dietary selenium intake showed a similar trend. In experimental studies, selenium supplementation increased the risk of diabetes by 11% (RR 1.11, 95% CI 1.01–1.22) compared with the placebo-allocated participants, with a higher RR in women than in men. Overall, results from both nonexperimental and experimental studies indicate that selenium may increase the risk of type 2 diabetes across a wide range of exposure levels. The relative increase in risk is small but of possible public health importance because of the high incidence of diabetes and the ubiquity of selenium exposure.

Selenium exposure and the risk of type 2 diabetes: a systematic review and meta-analysis

Background: Psychometrics has a very important role and with the increase in the number of cross cultural research projects, there is need to adapt the scales to measure the health status.
Objective: It was aimed to describe the validation process comprehensively based on recent practices and to overview a practical guideline of validation study. Method: Search was done in PubMed, PubMed Central & Google Scholar with searching key words ranging date from January 2000 to December 2015. Finally 78 articles were selected for review and through methodological review was done in accordance with the review objectives. Result: Review revealed that cultural adaptation followed similar steps with few variations. There was huge variation in study design, sampling technique & sample size. Cronbach’s alpha & test-retest reliability was mostly used form of reliability with variations in assessment of validity. Exploratory Factor Analysis was used more for statistical analysis & followed similar criteria with few variations. Conclusion: Cross cultural measurement of health outcomes is really an important and challenging issue that needs elaborative guideline to take appropriate steps to solve problems.

Cross Cultural Adaptation & Psychometric Validation of Research Instruments: a Methodological Review

Most of us have cause to be grateful for the massive reductions in infant mortality and deaths from infectious diseases that have occurred in Western societies during this century. However even these seemingly unequivocal bene®ts of industrialisation and prosperity create their own new problems of healthcare and social provision, and they raise new challenges of disease prevention. For the present at least, the major causes of morbidity and mortality in the west are those of old age, principally cardiovascular disease, cerebrovascular disease and cancer. These conditions have a complex aetiology, partly environmental in origin, and over the last twenty years or so there has been a growing recognition that dietary factors are of major importance. This has stimulated interest in both public health nutrition and in chemoprevention, through which, it is hoped, health may be extended further into old age. The `antioxidant hypothesis' seeks to explain much of the pathophysiology of vascular disease and neoplasia in terms of free-radical mediated damage to cells and tissues, and it is currently amongst the most in ̄uential, though still largely unproven, approaches to the problems of agerelated disease. The editor of this volume, Dr HS Garewal, is both a clinician and researcher. In his preface to the book, Dr Garewal identi®es the need for a broad introduction to the antioxidant hypothesis, covering many different disease states, and appealing to researchers, to physicians and other health professionals, and to students. The result, which forms part of the CRC Series in Modern Nutrition, is a collection of overviews by senior researchers and specialists which are, in effect, `snapshots' of current knowledge, designed to broaden the perspectives of specialists in particular areas of antioxidant research and to serve as `stepping stones' toward additional reading and future research ®ndings. In his preface the editor points out that one of the principal reasons for the extraordinary degree of interest which antioxidants have generated is their almost complete lack of harmful side-effects. This may be true, but advocates of mass dietary change, food supplementation or chemoprevention need to be very certain of the long-term safety of the measures which they seek to encourage. In this context the opening chapter on `The Safety of b-carotene and the antioxidant vitamins C and E' by Prof A Diplock provides a valuable review of the subject. In particular it tackles head-on the problems raised by the apparently adverse effects of b-carotene observed in smokers in the recent intervention studies with antioxidant vitamins conducted in Finland and the USA. The author gives a frank but balanced assessment of the implications of the work, and of the problems of applying the philosophy and techniques of clinical trials to nutrition research. The book continues with two chapters on `Antioxidants and immune function' and more speci®cally `Antioxidants and AIDS'. These are short primers on the topics rather than exhaustive reviews, but they provide a useful introduction to an area of research which is complex and poorly understood. Chapters 5±8 deal with the more conventional topic of antioxidants and cancer prevention. The epidemiological aspects are reviewed in detail by Dr J Maclarty, who again openly acknowledges the dif®culties of deriving conclusions about the ef®cacy of particular compounds from epidemiological studies based on consumption of complex diets which are rich in biologically active components, many of which may function as anticarcinogens through mechanisms not involving inhibition of free-radical mediated damage. The other chapters in this group deal with lung cancer and cancer of the oral cavity respectively, and with the emerging evidence for a substantial anticarcinogenic effect of selenium. Chapters 9 and 10 deal with the second major area of western disease for which it is hoped that antioxidants offer a reduction in risk, that of cardiovascular disease. Both chapters are relatively short but they provide succinct reviews of the effects of antioxidants on LDL oxidation, and of the epidemiological evidence for a bene®cial effect against disease risk, respectively. The book concludes with an interesting and fairly detailed account of the relationship between antioxidants and the prevention of age-related eye disease. This is a relatively short book but it contains around 1000 references, and it succeeds in bringing together a group of disparate but complex and inter-related issues in an attractive and readily accessible format. It will serve well to inform the student and technically literate general reader, and to broaden the perspectives of the specialist looking beyond his or her particular interest in the diverse and rapidly developing ®eld of antioxidant research.

Antioxidants and Disease Prevention

Hashimoto's thyroiditis (HT) is a chronic autoimmune thyroid disease caused by an interaction between genetic factors and environmental conditions, both of which are yet to be fully understood. The management of HT depends on its clinical manifestations, commonly including diffuse or nodular goiter with euthyroidism, subclinical hypothyroidism and permanent hypothyroidism. However, in most cases of patients with HT, lifelong levothyroxine substitution is required. The additional role of diet for the management of HT is usually overlooked. A literature search regarding the importance and the influence of iodine, selenium, vitamin D and gluten on HT was conducted. In HT careful supplementation of possible deficiencies is recommended for the dietary management of these patients. The use of a diet low in gluten among HT patients with or without celiac disease (CD) is discussed.

A concise review of Hashimoto thyroiditis (HT) and the importance of iodine, selenium, vitamin D and gluten on the autoimmunity and dietary management of HT patients.Points that need more investigation.

Selenium is essential for humans and the deficit of Se requires supplementation. In addition to traditional forms such as Se salts, amino acids, or selenium-enriched yeast supplements, next-generation selenium supplements, with lower risk for excess supplementation, are emerging. These are based on selenium forms with lower toxicity, higher bioavailability, and controlled release, such as zerovalent selenium nanoparticles (SeNPs) and selenized polysaccharides (SPs). This article aims to focus on the existing analytical systems for the next-generation Se dietary supplement, providing, at the same time, an overview of the analytical methods available for the traditional forms. The next-generation dietary supplements are evaluated in comparison with the conventional/traditional ones, as well as the analysis and speciation methods that are suitable to reveal which Se forms and species are present in a dietary supplement. Knowledge gaps and further research potential in this field are highlighted. The review indicates that the methods of analysis of next-generation selenium supplements should include a step related to chemical species separation. Such a step would allow a proper characterization of the selenium forms/species, including molecular mass/dimension, and substantiates the marketing claims related to the main advantages of these new selenium ingredients.

https://www.mdpi.com/2072-6643/10/10/1466/pdf

Selenium Analysis and Speciation in Dietary Supplements Based on Next-Generation Selenium Ingredients.

The association between serum selenium levels and type 2 diabetes mellitus (T2DM) is controversial. We performed a systematic review and non-linear dose–response meta-analysis of observational studies to investigate the association in the present study. A comprehensive literature search was conducted using MEDLINE and EMBASE databases. A pooled odds ratio (OR) and related 95 % confidence interval (95 % CI) for T2DM between the highest and lowest serum selenium categories, and a non-linear dose–response relationship between selenium and T2DM were estimated. A total of five studies (of 13,460 participants) were identified as meeting the inclusion criteria. The pooled OR indicated that there was a significantly higher prevalence of T2DM in the highest category of blood selenium compared with the lowest (OR = 1.63, 95 % CI: 1.04–2.56, P = 0.033). Moreover, a significant non-linear dose–response relationship was observed between serum selenium levels and T2DM (P  132.5 μg/l). The positive association between serum selenium levels and T2DM existed in populations with relatively low levels and high levels of serum selenium, indicating a likely U-shaped non-linear dose–response relationship between serum selenium and T2DM.

/pdf/association-between-serum-selenium-level-and-type-2-diabetes-3z5xqzkbpw.pdf

Association between serum selenium level and type 2 diabetes mellitus: a non-linear dose-response meta-analysis of observational studies

Background 
Patients’ satisfaction has been considered as a crucial measurement of health care quality. Our objective was to develop a reliable and practical questionnaire for the assessment of in-patients’ satisfaction in Chinese people, and report the current situation of in-patients’ satisfaction in the central south area of China through a large-scale cross-sectional study.


Design 
In order to generate the questionnaire, we reviewed previous studies, interviewed related people, held discussions, refined questionnaire items after the pilot study, and finally conducted a large cross-sectional survey to test the questionnaire.


Setting 
This study was conducted in three A-level hospitals in the Hunan province, China.


Results 
There were 6640 patients in this large-scale survey (another 695 patients in the pilot study). A factor analysis on the data from the pilot study generated four dimensions, namely, doctors’ care quality, nurses’ care quality, quality of the environment and facilities, and comprehensive quality. The Cronbach’s alpha coefficients for each dimension were above 0.7 and the inter-subscale correlation was between 0.72 and 0.83. The overall in-patient satisfaction rate was 89.6%.


Conclusion 
The in-patient satisfaction questionnaire was proved to have optimal internal consistency, reliability, and validity.

/pdf/development-of-an-in-patient-satisfaction-questionnaire-for-1eos9zyruw.pdf

Development of an In-Patient Satisfaction Questionnaire for the Chinese Population

Objective To examine the correlation between dietary vitamin C intake and Type 2 diabetes. Methods A total of 5 168 participants from Xiangya Hospital, Central South University were randomly selected. According to the vitamin C intake, the participants were divided into 5 groups: a Q1 group (n=1 033), a Q2 group (n=1 034), a Q3 group (n=1 034), a Q4 group (n=1 034) and a Q5 group (n=1 033). They were also divided into a Type 2 diabetes group (n=502) and a non-diabetes group (n=4 666). The height, weight, and blood pressure were measured, and vitamin C intake and other dairy consumption were evaluated using a food frequency questionnaire and fasting plasma glucose (FPG). The analysis of variance (ANOVA), Chi-square test, Mann-Whitney U test and logistic regression model were used to analyze the relationship between dietary vitamin C and Type 2 diabetes. Results The univariate analysis showed that there were significant differences in the vitamin C consumption in energy intake, activity level, dietary fiber intake, nutritional supplementation status, drinking or not drinking, education level among the different vitamin C intake groups (all P 154.78 mg/d) in comparison with the lowest level (≤ 63.26 mg/d). The results suggested that the vitamin C intake was inversely associated with the Type 2 diabetes (r=-0.029, P Conclusion There is a significant negative correlation between the dietary vitamin C intake and the risk of Type 2 diabetes.

Relationship between dietary vitamin C and Type 2 diabetes

OBJECTIVE To investigate the risk factors for type 2 diabetes complicated with hypertension in adult residents in Liuyang, Hunan Province, P. R. China. METHODS The residents aged at or over 18 were selected through a method of multi-stage cluster random sampling from 10 towns in Liuyang. Questionnaires, physical measurements and laboratory tests were conducted. Type 2 diabetes complicated with hypertension were served as an experimental group, while simple diabetes, non-diabetes and non-hypertension (healthy control), or non-complication and healthy group (simple hypertension, simple diabetes, and healthy group) were served as control group, respectively. Three kinds of logistic regression model were used to analyze the risk factors for type 2 diabetes complicated with hypertension. RESULTS A total of 5 669 residents were included in the analysis, and the response rate was 97.74%. The results showed that the prevalence of type 2 diabetes complicated with hypertension of residents at or over 18 years old in Liuyang was 2.6% (95%CI: 2.2%, 3.1%). Logistic regression analyses demonstrated that for people at or over 60 years old, obesity and abnormal triglyceride were the independent risk factors for type 2 diabetes complicated with hypertension. CONCLUSION Aging, obesity and abnormal triglyceride can increase the risk of type 2 diabetes complicated with hypertension in adult residents in Liuyang.

Xin-liang Wang

Papers

Association between serum selenium level and type 2 diabetes mellitus: a non-linear dose-response meta-analysis of observational studies

Development of an In-Patient Satisfaction Questionnaire for the Chinese Population

Relationship between dietary vitamin C and Type 2 diabetes

Risk factors for type 2 diabetes complicated with hypertension in adult residents in Liuyang