A Clinical Tool to Predict Low Serum Selenium in Patients with Worsening Heart Failure.


Journal

Nutrients
ISSN: 2072-6643
Titre abrégé: Nutrients
Pays: Switzerland
ID NLM: 101521595

Informations de publication

Date de publication:
21 Aug 2020
Historique:
received: 29 05 2020
revised: 15 08 2020
accepted: 17 08 2020
entrez: 23 8 2020
pubmed: 23 8 2020
medline: 7 4 2021
Statut: epublish

Résumé

Selenium is an essential micronutrient, and a low selenium concentration (<100 µg/L) is associated with a poorer quality of life and exercise capacity, and an impaired prognosis in patients with worsening heart failure. Measuring selenium concentrations routinely is laborious and costly, and although its clinical utility is yet to be proven, an easy implemented model to predict selenium status is desirable. A stepwise multivariable logistic regression analysis was performed using routinely measured clinical factors. Low selenium was independently predicted by: older age, lower serum albumin, higher N-terminal pro-B-type natriuretic peptide levels, worse kidney function, and the presence of orthopnea and iron deficiency. A 10-points risk-model was developed, and a score of ≥6 points identified >80% of patients with low selenium (sensitivity of 44%, specificity of 80%). Given that selenium and iron overlap in their physiological roles, we evaluated the shared determinants and prognostic associates. Both deficiencies shared similar clinical characteristics, including the model risk factors and, in addition, a low protein intake and high levels of C-reactive protein. Low selenium was associated with a similar or worse prognosis compared to iron deficiency. In conclusion, although it is difficult to exclude low selenium based on clinical characteristics alone, we provide a prediction tool which identifies heart failure patients at higher risk of having a low selenium status.

Identifiants

pubmed: 32825781
pii: nu12092541
doi: 10.3390/nu12092541
pmc: PMC7551091
pii:
doi:

Substances chimiques

Micronutrients 0
Peptide Fragments 0
Serum Albumin 0
pro-brain natriuretic peptide (1-76) 0
Natriuretic Peptide, Brain 114471-18-0
Selenium H6241UJ22B

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Fourth Framework Programme
ID : FP7-242209-BIOSTAT-CHF

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Auteurs

Ali A Al-Mubarak (AA)

Department of Cardiology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands.

Niels Grote Beverborg (N)

Department of Cardiology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands.

Stefan D Anker (SD)

Innovative Clinical Trials, Department of Cardiology and Pneumology, University Medical Centre Göttingen (UMG), 37075 Göttingen, Germany.

Nilesh J Samani (NJ)

Department of Cardiovascular Sciences, University of Leicester, Leicester LE39QP, UK.
NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester LE39QP, UK.

Kenneth Dickstein (K)

Stavanger University Hospital, 4011 Stavanger, Norway.
Department of Clinical Science, University of Bergen, 5007 Bergen, Norway.

Gerasimos Filippatos (G)

Department of Cardiology, Heart Failure Unit, Athens University Hospital Attikon, 124 06 Athens, Greece.

Dirk Jan van Veldhuisen (DJ)

Department of Cardiology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands.

Adriaan A Voors (AA)

Department of Cardiology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands.

Nils Bomer (N)

Department of Cardiology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands.

Peter van der Meer (P)

Department of Cardiology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands.

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