Selenium plasma levels in hemodialysis patients: Comparison between North and Southeast of Brazil

Introduction: Patients with chronic kidney disease present selenium (Se) plasma deficiency which is an essential trace element with important biological functions and, the best known biological role is attributed to its presence in the antioxidant enzyme, glutathione peroxidase (GPx). The Se content of foods depends on soil and some authors have suggested that Amazon soil (North Brazilian region) has high Se concentrations when compared to other regions of Brazil. Objective: The objective of this work was to compare the Se status in hemodialysis (HD) patients from North and Southeast of Brazil. Methods: Thirty-eight patients from Southeast region (22 men and 16 women, 15% diabetic, 53.5 ± 26.4 yrs) were compared to 40 patients from North region (28 men and 12 women, 22.5% diabetic, 63.5 ± 11.9 yrs). Se in plasma was determined through atomic absorption spectrophotometry with hydride generation. Results: The plasma Se levels in patients from Southeast region were significantly lower (17.5 ± 11.9 μg/L) when compared to patients from the North (37.1 ± 15.8 μg/L) (p < 0.001). However, both patient groups presented low Se plasma levels when compared to recommended values (60- 120 μg/L). There was no correlation between plasma Se levels and analyzed parameters. Conclusion: We concluded that patients from North (Amazon) region present higher plasma Se levels when compared to the patients from Southeast of Brazil. However, independently of the region, HD patients presented Se deficiency.

引言：慢性肾脏病患者存在血浆硒（selenium, Se）缺乏：硒是一种具有重要生物学功能的必需微量元素，其最为人熟知的生物学作用体现于抗氧化酶谷胱甘肽过氧化物酶（glutathione peroxidase, GPx）的组成成分中。食物中的硒含量取决于土壤环境，有学者提出，巴西北部亚马逊地区的土壤硒浓度高于巴西其他区域。
研究目的：本研究旨在对比巴西北部与东南部地区血液透析（hemodialysis, HD）患者的硒营养状况。
研究方法：本研究纳入巴西东南部地区患者38例（男性22例、女性16例，糖尿病患病率15%，年龄53.5±26.4岁），并与北部地区患者40例（男性28例、女性12例，糖尿病患病率22.5%，年龄63.5±11.9岁）进行对照；采用氢化物发生-原子吸收分光光度法检测血浆硒水平。
研究结果：结果显示，东南部地区患者的血浆硒水平（17.5±11.9 μg/L）显著低于北部地区患者（37.1±15.8 μg/L，p<0.001）。但与推荐的正常参考值范围（60~120 μg/L）相比，两组患者的血浆硒水平均处于偏低状态。此外，血浆硒水平与本次分析的各项参数均无相关性。
研究结论：本研究结论为：巴西北部（亚马逊地区）血液透析患者的血浆硒水平高于东南部地区患者。但无论来自哪个区域，血液透析患者均存在硒缺乏情况。