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硒,一种显著的微量营养素:肾衰竭全因长期死亡率背景下的关键元素。

Selenium, a Notable Micronutrient: A Crucial Element in the Context of All-Cause Long-Term Mortality in Renal Failure.

作者信息

Tutan Duygu, Ulfberg Jan, Aydemir Nihal, Eser Barış, Doğan İbrahim

机构信息

Department of Internal Medicine, Faculty of Medicine, Hitit University, Çorum, Turkey.

Circad Health, Nora, Sweden.

出版信息

Biol Trace Elem Res. 2025 Jul;203(7):3685-3693. doi: 10.1007/s12011-024-04460-6. Epub 2024 Nov 26.

Abstract

Selenium is a trace element involved in crucial antioxidative and anti-inflammatory processes in the body. Low selenium status has been linked to increased mortality due to compromised immune function and heightened risk of cardiovascular events. Patients with chronic kidney disease (CKD) face elevated mortality risks, prompting the need for strategies to mitigate these events. Selenium deficiency is prevalent among CKD patients, yet the long-term implications and its association with mortality in this population remain unclear. This study assessed seventy-five CKD patients' serum selenium levels (SSL) between January and February 2020. The objective was to investigate the correlation between SSL and 36-month all-cause mortality in CKD patients. Baseline laboratory values, dialysis adequacy, Charlson comorbidity index (CCI), serum selenium status, and all-cause mortality at 36 months were subjected to statistical analysis. Significance level was set at p < 0.05. Significant differences were observed in CCI between surviving and deceased groups, with deceased patients being older and afflicted with more comorbidities. SSL also exhibited a significant difference between the groups, with levels in the mortality group significantly lower than those in other patients, suggesting a potential role of selenium in predicting patient outcomes. SSL equal to or lower than 66.35 were associated with approximately 5 times higher likelihood of mortality within three years of follow-up. Our study highlights the significant association between low serum selenium levels and survival in patients with chronic kidney disease, underscoring the potential importance of selenium monitoring in this population. These findings emphasize the need for further research to elucidate the underlying mechanisms and to explore potential interventions aimed at improving outcomes in CKD patients.

摘要

硒是一种微量元素,参与人体关键的抗氧化和抗炎过程。低硒状态与免疫功能受损导致的死亡率增加以及心血管事件风险升高有关。慢性肾脏病(CKD)患者面临更高的死亡风险,因此需要采取策略来减轻这些事件。硒缺乏在CKD患者中普遍存在,但该人群中硒缺乏的长期影响及其与死亡率的关联仍不清楚。本研究评估了2020年1月至2月期间75例CKD患者的血清硒水平(SSL)。目的是研究CKD患者SSL与36个月全因死亡率之间的相关性。对基线实验室值、透析充分性、Charlson合并症指数(CCI)、血清硒状态以及36个月时的全因死亡率进行了统计分析。显著性水平设定为p < 0.05。存活组和死亡组之间的CCI存在显著差异,死亡患者年龄更大且合并症更多。两组之间的SSL也存在显著差异,死亡组的水平显著低于其他患者,这表明硒在预测患者预后方面可能发挥作用。SSL等于或低于66.35与随访三年内死亡可能性高出约5倍相关。我们的研究强调了慢性肾脏病患者低血清硒水平与生存之间的显著关联,突出了在该人群中监测硒的潜在重要性。这些发现强调需要进一步研究以阐明潜在机制,并探索旨在改善CKD患者预后的潜在干预措施。

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