Nonlinear association between serum selenium and all-cause mortality in U.S. adults with NAFLD: a cohort study

BACKGROUND: Selenium, an essential trace element, modulates oxidative stress and inflammation-key factors in non-alcoholic fatty liver disease (NAFLD) progression. This study explores the relationship between serum selenium and all-cause mortality in NAFLD patients, a group vulnerable to oxidative damage. METHODS: = 331), 1,787 NAFLD patients were included. Serum selenium was categorized into quartiles (Q1-Q4: 104.73-376.80 μg/L). Cox proportional hazards models estimated hazard ratios (HRs) with adjustments for demographics, lifestyle, comorbidities and biomarkers. Restricted cubic spline (RCS) and Kaplan-Meier analyses assessed dose-response relationships and survival differences. Subgroup analyses examined effects by age, sex and comorbidities. RESULTS: > 0.05). CONCLUSION: Moderate selenium levels are associated with reduced all-cause mortality in NAFLD, particularly in older adults. These findings highlight selenium's potential in lowering mortality risk in metabolic disease populations, though further research is needed to clarify its role in NAFLD progression.