Erythrocyte selenium concentration as a marker of selenium status

Stefanowicz, Fiona; Talwar, Dinesh; O’Reilly, Denis St. J.; Dickinson, Natalie; Atkinson, John P.; Hursthouse, Andrew; Rankin, Jean; Duncan, Andrew

doi:10.1016/j.clnu.2013.01.005

Cited by 81 publications

(47 citation statements)

References 33 publications

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“…In addition, in these patients, plasma selenium was low and erythrocyte selenium concentration was normal. Their results suggest that plasma selenium is affected by the inflammatory response while erythrocyte selenium concentration is unaffected and can be used to reliably assess selenium status [12]. In our study, both survivors and nonsurvivors had low selenium concentration.…”

Section: Discussionmentioning

confidence: 57%

“…showed recently in a noninflamed population a strong positive correlation between erythrocyte and plasma selenium concentration that was not found in inflamed critically ill patients [12]. In addition, in these patients, plasma selenium was low and erythrocyte selenium concentration was normal.…”

Section: Discussionmentioning

confidence: 90%

“…Usually, nutritional status of selenium is commonly assessed by direct measurement of plasma selenium concentration or indirectly by measuring the activity of the GPx [12]. However, studies that evaluated patients with systemic inflammatory response, plasma selenium concentration showed controversial results [13-15].…”

Section: Introductionmentioning

confidence: 99%

“…In a study involving 91 critically ill patients, Stefanowicz et al . recently showed that plasma selenium is affected by the inflammatory response while erythrocyte selenium concentration is unaffected and can be used to reliably assess selenium status across a wide range of selenium intakes [12]. In addition, erythrocyte selenium concentrations reflect longer term nutritional status due to its incorporation in erythrocyte synthesis [16].…”

Section: Introductionmentioning

confidence: 99%

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Erythrocyte selenium concentration predicts intensive care unit and hospital mortality in patients with septic shock: a prospective observational study

et al. 2014

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IntroductionSelenoenzymes can modulate the extent of oxidative stress, which is recognized as a key feature of septic shock. The pathophysiologic role of erythrocyte selenium concentration in patients with septic shock remains unknown. Therefore, the objective of this study was to evaluate the association of erythrocyte selenium concentration with glutathione peroxidase (GPx1) activity, GPx1 polymorphisms and with ICU and hospital mortality in septic shock patients.MethodsThis prospective study included all patients older than 18 years with septic shock on admission or during their ICU stay, admitted to one of the three ICUs of our institution, from January to August 2012. At the time of the patients’ enrollment, demographic information was recorded. Blood samples were taken within the first 72 hours of the patients’ admission or within 72 hours of the septic shock diagnosis for determination of selenium status, protein carbonyl concentration, GPx1 activity and GPx1 Pro198Leu polymorphism (rs 1050450) genotyping.ResultsA total of 110 consecutive patients were evaluated. The mean age was 57.6 ± 15.9 years, 63.6% were male. Regarding selenium status, only erythrocyte selenium concentration was lower in patients who died in the ICU. The frequencies for GPx1 Pro198Leu polymorphism were 55%, 38% and 7% for Pro/Pro, Pro/Leu and Leu/Leu, respectively. In the logistic regression models, erythrocyte selenium concentration was associated with ICU and hospital mortality in patients with septic shock even after adjustment for protein carbonyl concentration and acute physiology and chronic health evaluation II score (APACHE II) or sequential organ failure assessment (SOFA).ConclusionsErythrocyte selenium concentration was a predictor of ICU and hospital mortality in patients with septic shock. However, this effect was not due to GPx1 activity or Pro198Leu polymorphism.

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Erythrocyte selenium concentration predicts intensive care unit and hospital mortality in patients with septic shock: a prospective observational study

et al. 2014

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“…Apart from the systemic inflammatory response, selenium deficiency should be understood as a true low selenium status with decreased tissue selenoenzyme activity [39] and that this deficiency leads to low plasma selenium concentration, as well as low selenoprotein P or glutathione peroxidase [40,41]. In addition, considering that selenium content in plasma is a very small part of body selenium content (0.5 to 1%) one cannot deduce from a low plasma selenium concentration a low tissue selenoenzyme activity and thus a true selenium deficiency [3].…”

Section: Discussionmentioning

confidence: 99%

Low plasma selenium concentrations in critically ill children: the interaction effect between inflammation and selenium deficiency

et al. 2014

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IntroductionLow plasma selenium concentrations are frequent in critically ill patients. However, whether this is due to systemic inflammation, a deficient nutritional state or both is still not clear. We aimed to determine the factors associated with low plasma selenium in critically ill children while considering the inflammatory response and nutritional status.MethodA prospective study was conducted in 173 children (median age 34 months) with systemic inflammatory response who had plasma selenium concentrations assessed 48 hours after admission and on the 5th day of ICU stay. The normal reference range was 0.58 μmol/L to 1.6 μmol/L. The outcome variable was ‘low plasma selenium’, which was defined as plasma selenium values below the distribution median during this period. The main explanatory variables were age, malnutrition, sepsis, C-reactive protein (CRP), and clinical severity scores. The data were analyzed using a Binomial Generalized Estimating Equations model, which includes the correlation between admission and 5th day responses.ResultsMalnutrition and CRP were associated with low plasma selenium. The interaction effect between these two variables was significant. When CRP values were less than or equal to 40 mg/L, malnutrition was associated with low plasma selenium levels (odds ratio (OR) = 3.25, 95% confidence interval (CI) 1.39 to 7.63, P = 0.007; OR = 2.98, 95% CI 1.26 to 7.06, P = 0.013; OR = 2.49, 95% CI 1.01 to 6.17, P = 0.049, for CRP = 10, 20 and 40 mg/L, respectively). This effect decreased as CRP concentrations increased and there was loose significance when CRP values were >40 mg/L. Similarly, the effect of CRP on low plasma selenium was significant for well-nourished patients (OR = 1.13; 95% CI 1.06 to 1.22, P <0.001) but not for the malnourished (OR = 1.03; 95% CI 0.99 to 1.08, P = 0.16).ConclusionsThere is a significant interaction between the magnitude of the inflammatory response and malnutrition on low plasma selenium. This interaction should be considered when interpreting plasma concentrations as an index of selenium status in patients with systemic inflammation as well as in the decision on selenium supplementation.

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Pitfalls in the interpretation of blood tests used to assess and monitor micronutrient nutrition status

Berger¹,

Talwar

Shenkin

2022

Nut in Clin Prac

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Assessment of micronutrient (MN) status is of particular importance in patients who require medical nutrition therapy, especially those requiring parenteral nutrition. Blood testing is generally the only tool available in clinical settings to assess MN status. However, using plasma or serum concentration faces pitfalls mainly because of the impact of inflammation that diverts the MNs from the circulating compartment. This review aims to review the blood tests that are useful and provide information about how to integrate functional markers of status to reach a clinically relevant diagnosis. Most impacted, with a significant and proportional decrease in plasma concentrations, are iron, selenium, zinc, thiamin, folic acid, cobalamin, and vitamins A, C, and D; copper is the only MN for which the plasma concentration increases. Therefore, a surrogate marker of inflammation, C‐reactive protein, must always be determined simultaneously. Validated intracellular and functional tests are proposed to improve status assessment. A protocol is suggested for tests required both on commencing and during nutrition support. A timely turnaround of analysis is essential for results to be clinically useful. In some cases, the appropriate provision of MNs should be commenced before results have been obtained to confirm the clinical assessment. Laboratory tests of MN status are an area prone to misuse and misinterpretation. The appropriate use and interpretation of such tests are essential to ensure the correct management of nutrition problems.

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Erythrocyte selenium concentration as a marker of selenium status

Cited by 81 publications

References 33 publications

Erythrocyte selenium concentration predicts intensive care unit and hospital mortality in patients with septic shock: a prospective observational study

Erythrocyte selenium concentration predicts intensive care unit and hospital mortality in patients with septic shock: a prospective observational study

Low plasma selenium concentrations in critically ill children: the interaction effect between inflammation and selenium deficiency

Pitfalls in the interpretation of blood tests used to assess and monitor micronutrient nutrition status

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