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Background:  The association between dietary selenium (Se) intake and osteoporosis-related fractures remains inconsistent. We aimed to examine the dose relationship between Se intake and incident fracture among Chinese adults.   Methods:  The dietary data were retrieved from the China Health and Nutrition Survey conducted between 1991 and 2011, and 17,150 participants aged above 20 were included. A 3-day, 24-h recall of food intake was performed to assess cumulative average dietary Se intake. The fracture was based on self-report in each survey between 1997 and 2011. The association between Se intake and fracture was tested by Cox regression, and the non-linear association was examined by restricted cubic splines (RCS).   Results:  There were 976 fracture cases during a mean of 10.2 years follow-up. In a fully adjusted Cox model, across the quartiles of Se intake, the hazard ratios (HRs) for fracture were 1.07 (95% CI .86–1.33), 1 (reference), 1.25 (95% CI 1.02–1.53), and 1.33 (95% CI 1.07–1.65). RCS showed a parabolic association ( P  non-linear = 0.037) between Se and fracture for men as well as a U-shape dose-response ( P  non-linear = 0.04) between Se and fracture for subjects living in highly urbanized areas.   Conclusion:  In conclusion, there is a non-linear association between selenium intake and fracture, with higher intake associated with increased risk. The shape of the association varies by gender and urbanization level.

Higher Dietary Se Intake Is Associated With the Risk of New-Onset Fracture: A National Longitudinal Study for 20 Years