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

Nutrients

Gerasimos Filippatos¹  Nils Bomer²  AdriaanA. Voors²  DirkJan van Veldhuisen²  Peter van der Meer²  AliA. Al-Mubarak²  Niels Grote Beverborg²  NileshJ. Samani³  StefanD. Anker⁴  Kenneth Dickstein⁵ 

[1] Department of Cardiology, Heart Failure Unit, Athens University Hospital Attikon, 124 06 Athens, Greece;Department of Cardiology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands;Department of Cardiovascular Sciences, University of Leicester, Leicester LE39QP, UK;Innovative Clinical Trials, Department of Cardiology and Pneumology, University Medical Centre Göttingen (UMG), 37075 Göttingen, Germany;Stavanger University Hospital, 4011 Stavanger, Norway;

关键词: selenium;    malnutrition;    heart failure;    albumin;    iron deficiency;   

DOI  :  10.3390/nu12092541

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown