Das essenzielle Spurenelement Selen: Selenbedarf in Gesundheit und Krankheit

Zusammenfassung

Selen ist ein für den Menschen essenzielles Spurenelement und ein Mikronährstoff, dessen biologische Wirkungen v. a. über Selenoproteine, welche die seltene Aminosäure Selenocystein im aktiven Zentrum haben, vermittelt werden. Etliche Selenoproteine wie die Glutathionperoxidasen (GPx) und die Thioredoxinreduktasen (TrxR) haben antioxidative bzw. redoxaktive Funktionen. Eine Reihe möglicher positiver Effekte von Selen auf die menschliche Gesundheit wird (z. T. kontrovers) diskutiert, so bei der Prävention einiger Tumorerkankungen, bei autoimmunen Schilddrüsenerkrankungen und bei viralen Infektionen. Selen wird ein positiver Einfluss auf die Funktion von Immunsystem und Gehirn sowie für die männliche Fertilität und in der Schwangerschaft zugeschrieben. In der Nahrung findet sich Selen hauptsächlich in Form der Aminosäuren Selenomethionin und Selenocystein, während Nahrungsergänzungsmittel auch größere Mengen der anorganischen Selenverbindungen Natriumselenit und -selenat enthalten können. Kürzlich hat die Europäische Behörde für Lebensmittelsicherheit (EFSA) den Referenzwert für adäquate Selenversorgung bei Erwachsenen auf 70 µg/Tag festgelegt. Die DGE gibt den Referenzwert für Frauen mit 60 und für Männer mit 70 µg Selen/Tag an. Dieser Wert basiert auf der Selenaufnahme, die nötig ist, um die Konzentration des Selentransportproteins Selenoprotein P (SePP1) im Blut zu sättigen. Die tägliche Selenaufnahme vieler Europäer – und so auch der Deutschen – liegt darunter; allerdings kommt Selendefizienz sehr selten vor. Andererseits ist eine Selensupplementation mit höheren Dosen, als für die Optimierung der Konzentration von SePP1 im Blut benötigt, vermutlich nicht mit zusätzlichen Vorteilen verbunden und kann möglicherweise sogar negative Effekte auf die menschliche Gesundheit haben. Deshalb wird eine Selensupplementation der gesunden Bevölkerung nicht generell empfohlen. Menschen, die selenhaltige Nahrungsergänzungsmittel nehmen wollen, sollten zunächst ihre Selen- oder SePP1-Konzentration im Plasma/Serum bestimmen lassen. Für Menschen mit niedrigem Selenstatus oder erhöhtem Selenbedarf könnte eine Selensupplementation nützlich sein.

Abstract

Selenium is an essential trace element and micronutrient for humans that exerts most of its biological actions through selenoproteins, which have the rare amino acid selenocysteine in their active centre. Several selenoproteins such as glutathione peroxidases (GPx) and thioredoxin reductases (TrxR) have antioxidant and redox-active functions. Assumed (and in part controversially discussed) beneficial effects of selenium on human health include the prevention of some types of cancer, slower progression of autoimmune thyroid diseases, adjuvant therapy of viral infections and support of immune, reproductive and cognitive functions. In the diet, selenium is mainly present in form of the amino acids selenomethionine and selenocysteine, while dietary supplements may also contain higher amounts of inorganic selenium compounds such as sodium selenite and selenate. Recently, the European Food Safety Authority (EFSA) has set the dietary reference value for adequate selenium intake of adults to 70 µg/day, as did the German Society for Nutrition (DGE) with 60 µg/day for women and 70 µg/day for men. These values are based on the requirements to saturate blood levels of the selenium transport protein selenoprotein P (SePP1). Many Europeans – including Germans – ingest less selenium; however, selenium deficiency is not a general problem. On the other hand, selenium supplementation beyond the doses required for SePP1 optimisation may not provide additional health benefits and, according to some studies, may even provoke adverse side effects. Therefore, dietary selenium supplementation is not recommended for healthy people in general. Persons who wish to take selenium-containing dietary supplements should have measured their plasma/serum selenium or SePP1 levels first. Selenium supplementation might be useful for persons with low selenium status and/or increased needs of selenium.

Schlüsselwörter

AIDS - Intensivmedizin - autoimmune Schilddrüsenerkrankungen - Krebs - Präeklampsie - neurodegenerative Erkrankungen - männliche Fertilität

Keywords

AIDS - intensive care - autoimmune thyroid diseases - cancer - preeclampsia - neurodegenerative diseases - male fertility

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