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A Clinical Tool to Predict Low Serum Selenium.pdf (1.44 MB)

A clinical tool to predict low serum selenium in patients with worsening heart failure

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posted on 2021-07-29, 09:46 authored by AA Al-Mubarak, NG Beverborg, SD Anker, NJ Samani, K Dickstein, G Filippatos, DJ van Veldhuisen, AA Voors, N Bomer, P van der Meer
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.

Funding

BIOSTAT-CHF was funded by a grant from the European Commission (FP7-242209-BIOSTAT-CHF).

History

Citation

Al-Mubarak, A.A.; Grote Beverborg, N.; Anker, S.D.; Samani, N.J.; Dickstein, K.; Filippatos, G.; van Veldhuisen, D.J.; Voors, A.A.; Bomer, N.; van der Meer, P. A Clinical Tool to Predict Low Serum Selenium in Patients with Worsening Heart Failure. Nutrients 2020, 12, 2541. https://doi.org/10.3390/nu12092541

Author affiliation

Department of Cardiovascular Sciences

Version

  • VoR (Version of Record)

Published in

Nutrients

Volume

12

Issue

9

Pagination

2541

Publisher

MDPI

issn

2072-6643

eissn

2072-6643

Acceptance date

2020-08-17

Copyright date

2020

Available date

2021-07-29

Spatial coverage

Switzerland

Language

English

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