title: Serum selenium and glutathione peroxidase-3 activity: biomarkers of systemic inflammation in the critically ill?
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Prospective, observational study.
  
  
  METHODS
  Multidisciplinary University Hospital ICU.
  
  
  METHODS
  A total of 36 ICU patients and 23 healthy volunteer subjects (HVS).
  
  
  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 microg/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.
authors.affiliation: Department of Critical Care Medicine, School of Medicine, Hospital de Clínicas (University Hospital), UDELAR, Montevideo, Uruguay. wmanzanares@adinet.com.uy
authors.forename: William
authors.initials: W
authors.lastname: Manzanares
authors.forename: Alberto
authors.initials: A
authors.lastname: Biestro
authors.forename: Federico
authors.initials: F
authors.lastname: Galusso
authors.forename: Maria H
authors.initials: MH
authors.lastname: Torre
authors.forename: Nelly
authors.initials: N
authors.lastname: Mañay
authors.forename: Gustavo
authors.initials: G
authors.lastname: Pittini
authors.forename: Gianella
authors.initials: G
authors.lastname: Facchin
authors.forename: Gil
authors.initials: G
authors.lastname: Hardy
mesh_terms: D000328:Adult; D015415:Biomarkers; D016638:Critical Illness / Q000453:epidemiology*; D005260:Female; D005979:Glutathione Peroxidase / Q000097:blood*; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D012643:Selenium / Q000097:blood* / Q000172:deficiency; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood* / Q000453:epidemiology
chemical_list: D015415:Biomarkers; C486484:GPX3 protein, human; D005979:Glutathione Peroxidase; D012643:Selenium