Saint-Georges M D, Bonnefont D J, Bourely B A, Jaudon M C, Cereze P, Chaumeil P, Gard C, D'Auzac C L
Department of Nephrology-Dialysis, Hôpital National, Saint-Maurice, France.
Kidney Int Suppl. 1989 Nov;27:S274-7.
Selenium is an essential trace element important for glutathione peroxidase activity. Selenium deficiency has been found in association with skeletal and cardiac myopathy and may increase the risk for cardiovascular diseases and for cancer. We studied 39 hemodialysis patients and 15 control subjects. Plasma selenium, plasma glutathione peroxidase activity and erythrocyte glutathione peroxidase activity were lower than in controls (38 +/- 14 vs. 88 +/- 17 micrograms/liter (P less than 0.01); 153 +/- 32 vs. 334 +/- 41 IU/liter (P less than 0.01), 19 +/- 4 vs. 26 +/- 4 IU/g Hb (P less than 0.01), respectively). Plasma selenium and plasma glutathione peroxidase activity were strongly correlated with duration of dialysis. There was no correlation between plasma selenium and protein or calorie intakes. Plasma selenium was lower in patients dialyzed with highly permeable membranes (P less than 0.01). The total muscle mass, assessed by anthropometry, was lower in the patients who had the lowest plasma selenium (P less than 0.01) and plasma glutathione peroxidase activity (P less than 0.05). Interventricular septum hypertrophy, documented by echocardiography, was greater in patients with the lowest plasma selenium and plasma glutathione peroxidase activity (P less than 0.01). Twenty hemodialysis patients had oral supplementation of 500 micrograms/day of sodium selenite for three months, and then, 200 micrograms/day for the next three months. Plasma selenium increased as early as the first week and reached a plateau similar to the control levels after three weeks. Plasma glutathione peroxidase activity increased after two months but remained below controls. Erythrocyte glutathione peroxidase activity reached a higher value than controls after one month.(ABSTRACT TRUNCATED AT 250 WORDS)
硒是一种对谷胱甘肽过氧化物酶活性至关重要的必需微量元素。已发现硒缺乏与骨骼肌和心肌病有关，可能会增加患心血管疾病和癌症的风险。我们研究了39名血液透析患者和15名对照受试者。血液透析患者的血浆硒、血浆谷胱甘肽过氧化物酶活性和红细胞谷胱甘肽过氧化物酶活性均低于对照组（分别为38±14微克/升 vs. 88±17微克/升，P＜0.01；153±32国际单位/升 vs. 334±41国际单位/升，P＜0.01；19±4国际单位/克血红蛋白 vs. 26±4国际单位/克血红蛋白，P＜0.01）。血浆硒和血浆谷胱甘肽过氧化物酶活性与透析时间密切相关。血浆硒与蛋白质或热量摄入量之间无相关性。使用高通透性膜进行透析的患者血浆硒水平较低（P＜0.01）。通过人体测量评估，血浆硒水平最低的患者总肌肉量较低（P＜0.01），血浆谷胱甘肽过氧化物酶活性最低的患者总肌肉量也较低（P＜0.05）。超声心动图显示，血浆硒和血浆谷胱甘肽过氧化物酶活性最低的患者室间隔肥厚更明显（P＜0.01）。20名血液透析患者口服补充亚硒酸钠，前三个月每天500微克，接下来三个月每天200微克。血浆硒早在第一周就开始升高，三周后达到与对照组水平相似的平台期。血浆谷胱甘肽过氧化物酶活性在两个月后升高，但仍低于对照组。红细胞谷胱甘肽过氧化物酶活性在一个月后高于对照组。（摘要截短至250字）
