Status de selênio e insuficiência cardíaca: associações com parâmetros clínicos, nutricionais e impacto sobre desfechos clínicos
Selenium deficiency has been a frequent finding in individuals with heart failure (HF), but there are gaps in the literature regarding factors associated with this condition, as well as the impact of selenium status on mortality and hospitalization outcomes. This study aimed to evaluate selenium...
Na minha lista:
| Autor principal: | |
|---|---|
| Outros Autores: | |
| Formato: | Dissertação |
| Idioma: | pt_BR |
| Publicado em: |
Universidade Federal do Rio Grande do Norte
|
| Assuntos: | |
| Endereço do item: | https://repositorio.ufrn.br/handle/123456789/53151 |
| Tags: |
Adicionar Tag
Sem tags, seja o primeiro a adicionar uma tag!
|
| Resumo: | Selenium deficiency has been a frequent finding in individuals with heart
failure (HF), but there are gaps in the literature regarding factors associated with this
condition, as well as the impact of selenium status on mortality and hospitalization
outcomes. This study aimed to evaluate selenium status and its associations with
clinical, nutritional parameters, and clinical outcomes in outpatients with HF. Eighty
individuals with a diagnosis of reduced/slightly reduced HF Ejection Fraction or
preserved HF Ejection Fraction, adults and older people of both sexes, attended the
Interprofessional Heart Failure Outpatient Clinic of the University Hospital Onofre
Lopes, in a follow-up period of up to 36 months, were studied. Plasma selenium levels,
dietary selenium intake, sociodemographic, anthropometric, clinical, and biochemical
parameters, and clinical outcomes (hospitalization and mortality) were evaluated.
Plasma selenium was measured by inductively coupled plasma mass spectrometry
(ICP-MS). Independent variables were analyzed according to tertiles of plasma
selenium concentrations. Multiple linear regression models were run using the
stepwise method to determine associations between plasma selenium and other
variables. Analysis of the Receiver Operating Characteristic Curve (ROC) was
performed to define a cutoff point for plasma selenium values with greater sensitivity
and specificity for the clinical outcomes of mortality and hospitalization. Relationships
between selenium status and clinical outcomes were observed using Cox regression.
Individuals with HF were predominantly male (61.3%) and overweight (52.5%). The
most frequent type of HF was reduced or slightly reduced ejection fraction (HFrEF)
(70.0%), non-ischemic etiology (55.0%), and functional class I (71.2%). A significant
percentage of participants had plasma selenium levels within the reference range
(91.2%) and the prevalence of inadequate selenium intake was 29.12%. Regression
analysis indicated associations between albumin (β=0.113, p<0.001; R²=0.291) and
triglycerides (β=0.0002, p<0.021, R²=0.376) with plasma selenium. Plasma selenium
cutoff ≥ 83.80 µg/L was associated with increased risk of all-cause mortality [HR
=17.085(1.488-196.146); p=0.023)] and hospitalizations [HR=7.596 (1.114-51.808);
p==0.038)]. In conclusion, it was observed that the majority of individuals with HF
treated at the outpatient clinic had plasma selenium levels within the normal range, with albumin and triglycerides as independent predictors of plasma selenium levels. In
addition, plasma selenium cutoff ≥ 83.80µg/L was associated with an increased risk of
unfavorable clinical outcomes in this population. |
|---|