title: Erythrocyte selenium concentration predicts intensive care unit and hospital mortality in patients with septic shock: a prospective observational study.
abstract: BACKGROUND
  Selenoenzymes can modulate the extent of oxidative stress, which is recognized as a key feature of septic shock. The pathophysiologic role of erythrocyte selenium concentration in patients with septic shock remains unknown. Therefore, the objective of this study was to evaluate the association of erythrocyte selenium concentration with glutathione peroxidase (GPx1) activity, GPx1 polymorphisms and with ICU and hospital mortality in septic shock patients.
  
  
  METHODS
  This prospective study included all patients older than 18 years with septic shock on admission or during their ICU stay, admitted to one of the three ICUs of our institution, from January to August 2012. At the time of the patients' enrollment, demographic information was recorded. Blood samples were taken within the first 72 hours of the patients' admission or within 72 hours of the septic shock diagnosis for determination of selenium status, protein carbonyl concentration, GPx1 activity and GPx1 Pro198Leu polymorphism (rs 1050450) genotyping.
  
  
  RESULTS
  A total of 110 consecutive patients were evaluated. The mean age was 57.6 ± 15.9 years, 63.6% were male. Regarding selenium status, only erythrocyte selenium concentration was lower in patients who died in the ICU. The frequencies for GPx1 Pro198Leu polymorphism were 55%, 38% and 7% for Pro/Pro, Pro/Leu and Leu/Leu, respectively. In the logistic regression models, erythrocyte selenium concentration was associated with ICU and hospital mortality in patients with septic shock even after adjustment for protein carbonyl concentration and acute physiology and chronic health evaluation II score (APACHE II) or sequential organ failure assessment (SOFA).
  
  
  CONCLUSIONS
  Erythrocyte selenium concentration was a predictor of ICU and hospital mortality in patients with septic shock. However, this effect was not due to GPx1 activity or Pro198Leu polymorphism.
authors.forename: Nara Aline
authors.initials: NA
authors.lastname: Costa
authors.forename: Ana Lúcia
authors.initials: AL
authors.lastname: Gut
authors.forename: José Alexandre Coelho
authors.initials: JA
authors.lastname: Pimentel
authors.forename: Silvia Maria Franciscato
authors.initials: SM
authors.lastname: Cozzolino
authors.forename: Paula Schmidt
authors.initials: PS
authors.lastname: Azevedo
authors.forename: Ana Angélica Henrique
authors.initials: AA
authors.lastname: Fernandes
authors.forename: Bertha Furlan
authors.initials: BF
authors.lastname: Polegato
authors.forename: Suzana Erico
authors.initials: SE
authors.lastname: Tanni
authors.forename: Rafael Dezen
authors.initials: RD
authors.lastname: Gaiolla
authors.forename: Leonardo Antonio Mamede
authors.initials: LA
authors.lastname: Zornoff
authors.forename: Sergio Alberto Rupp de
authors.initials: SA
authors.lastname: Paiva
authors.forename: Marcos Ferreira
authors.initials: MF
authors.lastname: Minicucci
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood / Q000378:metabolism; D004912:Erythrocytes / Q000378:metabolism*; D005260:Female; D005979:Glutathione Peroxidase / Q000378:metabolism*; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D007362:Intensive Care Units / Q000639:trends*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012643:Selenium / Q000097:blood*; D012772:Shock, Septic / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D000094765:Glutathione Peroxidase GPX1
chemical_list: D015415:Biomarkers; D005979:Glutathione Peroxidase; D012643:Selenium; D000094765:Glutathione Peroxidase GPX1; C000722067:GPX1 protein, human