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Article

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

1
Department of Cardiology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands
2
Innovative Clinical Trials, Department of Cardiology and Pneumology, University Medical Centre Göttingen (UMG), 37075 Göttingen, Germany
3
Department of Cardiovascular Sciences, University of Leicester, Leicester LE39QP, UK
4
NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester LE39QP, UK
5
Stavanger University Hospital, 4011 Stavanger, Norway
6
Department of Clinical Science, University of Bergen, 5007 Bergen, Norway
7
Department of Cardiology, Heart Failure Unit, Athens University Hospital Attikon, 124 06 Athens, Greece
*
Authors to whom correspondence should be addressed.
These authors share senior authorship.
Nutrients 2020, 12(9), 2541; https://doi.org/10.3390/nu12092541
Received: 29 May 2020 / Revised: 15 August 2020 / Accepted: 17 August 2020 / Published: 21 August 2020
(This article belongs to the Special Issue Dietary Minerals and Human Health)
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. View Full-Text
Keywords: selenium; malnutrition; heart failure; albumin; iron deficiency selenium; malnutrition; heart failure; albumin; iron deficiency
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MDPI and ACS Style

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

AMA Style

Al-Mubarak AA, Grote Beverborg N, Anker SD, Samani NJ, Dickstein K, Filippatos G, van Veldhuisen DJ, Voors AA, Bomer N, van der Meer P. A Clinical Tool to Predict Low Serum Selenium in Patients with Worsening Heart Failure. Nutrients. 2020; 12(9):2541. https://doi.org/10.3390/nu12092541

Chicago/Turabian Style

Al-Mubarak, Ali A., Niels Grote Beverborg, Stefan D. Anker, Nilesh J. Samani, Kenneth Dickstein, Gerasimos Filippatos, Dirk J. van Veldhuisen, Adriaan A. Voors, Nils Bomer, and Peter van der Meer. 2020. "A Clinical Tool to Predict Low Serum Selenium in Patients with Worsening Heart Failure" Nutrients 12, no. 9: 2541. https://doi.org/10.3390/nu12092541

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