硒蛋白 P 浓度低与住院心力衰竭患者贫血的相关性。
Association between low selenoprotein P concentrations and anaemia in hospitalized heart failure patients.
机构信息
Department of Clinical Sciences, Lund University, Malmö, Sweden.
Department of Cardiology, Lund University, Skane University Hospital, Malmö, Sweden.
出版信息
ESC Heart Fail. 2024 Apr;11(2):877-882. doi: 10.1002/ehf2.14651. Epub 2024 Jan 10.
AIMS
Heart failure (HF) patients with anaemia tend to have a worse outcome, with increased hospitalization rates, decreased exercise tolerance, and higher mortality compared to those without anaemia. Limited research exists on the association between selenium deficiency and anaemia specifically in HF patients, despite previous findings of a correlation in different populations. The BIOSTAT-CHF study demonstrated that higher selenium levels in HF patients were associated to a lower risk of anaemia and iron deficiency. This study investigates the relationship between selenoprotein P (SELENOP) concentrations, a major contributor and functional biomarker of selenium transport, and anaemia, Hb levels, and iron status in hospitalized HF patients.
METHODS AND RESULTS
SELENOP was analysed in 320 hospitalized HF subjects, with complete data available for 310 subjects. The relationships between continuous SELENOP concentrations and 1) Hb concentrations, 2) anaemia (Hb < 115 g/L (women), <130 g/L (men)), and 3) iron status (as measured by transferrin receptor 1 (TfR1) which increases in iron deficiency) were evaluated using multivariable logistic and linear regression models. Additionally, SELENOP concentrations in the lowest quartile were related to anaemia, haemoglobin, and iron state in multivariable logistic and linear models. The mean age of the study population was 75.0 ± 11.6 years, and 30% were women. Anaemia was present in 133 subjects (42.9%). SELENOP concentrations were positively correlated with haemoglobin concentrations (0.238; P < 0.001) and negatively with TfR1 concentrations (-0.238, P < 0.001). In multivariable regression models, higher SELENOP concentrations were associated with higher Hb concentrations (B = 3.23; P = 0.002) and lower TfR1 concentrations (B = -0.20; P < 0.001). Furthermore, SELENOP deficiency was associated with lower Hb concentrations (B = -7.64: P = 0.001), higher TfR1 concentrations (B = 0.31; P = 0.003), and higher odds of anaemia in HF patients (odds ratio 2.17; 95% confidence interval 1.23-3.82; P = 0.008).
CONCLUSIONS
In hospitalized heart failure patients, lower concentrations of SELENOP were associated with higher prevalence of anaemia.
目的
与非贫血心力衰竭（HF）患者相比，贫血 HF 患者的预后更差，住院率更高，运动耐量降低，死亡率更高。尽管在不同人群中发现了相关性，但关于硒缺乏与 HF 患者贫血之间的关联的研究有限。BIOSTAT-CHF 研究表明，HF 患者的硒水平较高与贫血和缺铁的风险降低相关。本研究调查了在住院 HF 患者中，硒蛋白 P（SELENOP）浓度与贫血、Hb 水平和铁状态之间的关系，SELENOP 是硒转运的主要贡献者和功能生物标志物。
方法和结果
分析了 320 名住院 HF 患者的 SELENOP，其中 310 名患者的数据完整。使用多变量逻辑和线性回归模型评估连续 SELENOP 浓度与 1）Hb 浓度、2）贫血（女性 <115g/L，男性 <130g/L）和 3）铁状态（由缺铁时增加的转铁蛋白受体 1（TfR1）测量）之间的关系。此外，在多变量逻辑和线性模型中，SELENOP 浓度最低的四分位数与贫血、血红蛋白和铁状态有关。研究人群的平均年龄为 75.0±11.6 岁，30%为女性。133 名患者（42.9%）存在贫血。SELENOP 浓度与血红蛋白浓度呈正相关（0.238；P<0.001），与 TfR1 浓度呈负相关（-0.238，P<0.001）。在多变量回归模型中，较高的 SELENOP 浓度与较高的 Hb 浓度（B=3.23；P=0.002）和较低的 TfR1 浓度（B=-0.20；P<0.001）相关。此外，SELENOP 缺乏与较低的 Hb 浓度（B=-7.64：P=0.001）、较高的 TfR1 浓度（B=0.31；P=0.003）和 HF 患者贫血的更高几率相关（比值比 2.17；95%置信区间 1.23-3.82；P=0.008）。
结论
在住院 HF 患者中，较低的 SELENOP 浓度与更高的贫血患病率相关。
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