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克罗恩病活动与血清硒浓度的相关性。

Correlation Between Crohn's Disease Activity and Serum Selenium Concentration.

机构信息

Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China.

Institute of Drug Metabolism and Pharmaceutical Analysis, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China.

出版信息

Clin Ther. 2022 May;44(5):736-743.e3. doi: 10.1016/j.clinthera.2022.03.005. Epub 2022 Apr 1.

Abstract

PURPOSE

Accurate and reliable evaluation of Crohn's disease (CD) activity is crucial for monitoring and treating the disease; however, it is challenging. There is a high demand for new, reliable, and noninvasive biomarkers for estimating CD activity. Selenium deficiency is common in patients with CD; however, its correlation with disease severity remains unclear. This study aimed to assess the feasibility of using serum selenium concentration as an additional biomarker for determining the severity of CD.

METHODS

This retrospective study included consecutive Asian patients aged 18 to 60 years and hospitalized for CD between May 2020 and December 2020 at the Inflammatory Bowel Disease Center (Hangzhou, China). Patients with a history of extensive small intestinal surgery and/or short bowel syndrome were excluded from analysis. Serum selenium concentration was determined using inductively coupled plasma mass spectrometry. Disease severity was evaluated based on inflammatory markers (simple endoscopic score for CD, CD activity index, Harvey-Bradshaw index, serum C-reactive protein level, erythrocyte sedimentation rate, and platelet count) and markers of nutrition status (body mass index; blood hemoglobin and hematocrit; as well as serum levels of albumin, folic acid, and vitamin D). The correlations between serum selenium level and disease severity-related parameters were analyzed using univariate and multivariate analyses.

FINDINGS

The study included 94 men and 41 women. Serum selenium level was significantly and inversely associated with all tested disease activity-related parameters by univariate analysis (all, P < 0.05). Further multivariate analysis showed that the simple endoscopic score for CD and serum levels of albumin and folic acid were significantly and independently correlated with serum selenium level (all, P < 0.05).

IMPLICATIONS

Serum selenium concentration was inversely correlated with endoscopic disease severity in these Asian patients with CD. It is feasible to use serum selenium level as an additional biomarker for assessing and monitoring disease activity. The present results might have been influenced by geographic region, sample size, and/or dietary factors. Serum selenium level and other indicators of CD activity measured before and after treatment may provide more useful clinical information.

摘要

目的

准确、可靠地评估克罗恩病(CD)的活动度对于监测和治疗疾病至关重要;然而,这是具有挑战性的。人们迫切需要新的、可靠的、非侵入性生物标志物来估计 CD 的活动度。硒缺乏在 CD 患者中很常见;然而,其与疾病严重程度的相关性尚不清楚。本研究旨在评估血清硒浓度作为评估 CD 严重程度的附加生物标志物的可行性。

方法

这是一项回顾性研究,纳入了 2020 年 5 月至 2020 年 12 月在中国杭州炎症性肠病中心住院的年龄在 18 至 60 岁的连续亚洲 CD 患者。排除既往广泛小肠手术和/或短肠综合征的患者。使用电感耦合等离子体质谱法测定血清硒浓度。根据炎症标志物(简单内镜 CD 评分、CD 活动指数、Harvey-Bradshaw 指数、血清 C 反应蛋白水平、红细胞沉降率和血小板计数)和营养状况标志物(体重指数;血红蛋白和血细胞比容;以及血清白蛋白、叶酸和维生素 D 水平)评估疾病严重程度。使用单变量和多变量分析分析血清硒水平与疾病严重程度相关参数之间的相关性。

结果

本研究纳入了 94 名男性和 41 名女性。单变量分析显示,血清硒水平与所有测试的疾病活动相关参数均呈显著负相关(均 P < 0.05)。进一步的多变量分析显示,简单内镜 CD 评分以及血清白蛋白和叶酸水平与血清硒水平显著相关(均 P < 0.05)。

结论

在这些亚洲 CD 患者中,血清硒浓度与内镜疾病严重程度呈负相关。血清硒水平可作为评估和监测疾病活动的附加生物标志物。本研究结果可能受到地理区域、样本量和/或饮食因素的影响。治疗前后血清硒水平和其他 CD 活动度指标的测量可能提供更有用的临床信息。

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