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Serum selenium and glutathione peroxidase-3 activity: biomarkers of systemic inflammation in the critically ill?

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Abstract

Objectives

To confirm the influence of systemic inflammatory response syndrome (SIRS) on selenium (Se) levels and prospectively evaluate the relationship between serum Se concentration [Se], glutathione peroxidase activity [GPx-3] and injury severity in patients at the time of intensive care unit (ICU) admission.

Design

Prospective, observational study.

Setting

Multidisciplinary University Hospital ICU.

Patients and participants

A total of 36 ICU patients and 23 healthy volunteer subjects (HVS).

Measurements and results

Healthy volunteer subjects were designated as controls (Group 1). ICU patients were divided into three groups: without SIRS (Group 2); with SIRS (Group 3); with SIRS and multiple organ dysfunction syndrome (MODS) (Group 4). The latter groups had APACHE II scores >15. [GPx-3] and [Se] were determined by standard methods within the first 48 h of admission to ICU. Kruskal–Wallis and Mann–Whitney U test were used for analysis of non-parametric continuous variables. The predictive value of [Se] and [GPx-3] for SIRS was calculated using a receiver operating characteristics (ROC) analysis. In SIRS and MODS patients [GPx-3] and [Se] decreased significantly (P = 0.0001 and P = 0.002, respectively). After ICU admission [GPx-3] and [Se] had a predictive value for SIRS ([GPx-3] sensitivity: 90%, specificity: 86.2% (cut-off value: 0.5 U/mL); [Se]: sensitivity 90%, specificity 72.4% (cut-off value: 60 μg/L). [Se] had predictive value for ICU mortality (P = 0.034).

Conclusions

Systemic inflammatory response syndrome and MODS were associated with early decreases in [Se] and [GPx-3]. Low [Se] and [GPx-3] after ICU admission had a predictive value for SIRS, which may aid future selection of patients who could benefit from Se supplementation.

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Acknowledgments

We are indebted to Alejandro Ferreiro, MD for his collaboration in the data analysis. This project was supported by grants from the Comisión Sectorial para la Investigación Científica (CSIC), UDELAR and the Fondo Clemente Estable 2004/10.072, DICyT. Ministerio de Educación y Cultura, Uruguay.

Conflict of interest statement

All authors have no competing interests to declare.

Author information

Authors and Affiliations

  1. Department of Critical Care Medicine, School of Medicine, Hospital de Clínicas (University Hospital), UDELAR, Montevideo, Uruguay

    William Manzanares, Alberto Biestro, Federico Galusso & Gustavo Pittini

  2. Department of Inorganic Chemistry, Faculty of Chemistry, UDELAR, Montevideo, Uruguay

    Maria H. Torre & Gianella Facchin

  3. Department of Toxicology, Faculty of Chemistry, UDELAR, Montevideo, Uruguay

    Nelly Mañay

  4. Institute of Food, Nutrition and Human Health, Massey University, Auckland, New Zealand

    Gil Hardy

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  1. William Manzanares
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  2. Alberto Biestro
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  3. Federico Galusso
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  7. Gianella Facchin
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  8. Gil Hardy
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Correspondence to William Manzanares.

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Manzanares, W., Biestro, A., Galusso, F. et al. Serum selenium and glutathione peroxidase-3 activity: biomarkers of systemic inflammation in the critically ill?. Intensive Care Med 35, 882–889 (2009). https://doi.org/10.1007/s00134-008-1356-5

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  • DOI: https://doi.org/10.1007/s00134-008-1356-5

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