Low plasma selenium at the two time points Univariate and multivariate analyses selleckbio of exposure variables for low plasma selenium on admission and day 5 are demonstrated in Table 4. The results are very close to those that were found in the low plasma selenium on admission Inhibitors,Modulators,Libraries analysis. CRP values on admission and malnutrition were significantly associated with low plasma selenium for both evaluation time points. Such as for the analysis of the outcome on admission, there was a significant interaction between CRP concentrations and malnutrition. To better evaluate this result, estimates of the effects of these two variables on patient outcome are presented in Table 5. The effect of CRP concentrations on low plasma selenium was significant in well nourished but not in malnourished patients.
The effect of malnutrition on low plasma selenium also decreased according to the CRP concentration increase and was no longer significant from values 40 mg L. This cutoff value for CRP derived from the statistical interaction between CRP values and malnutrition. Discussion Plasma selenium concentrations were below the normal Inhibitors,Modulators,Libraries range in most patients during the study period. Because infants have a high metabolic rate and faster growth, they are expected to represent a high risk age group for deficiency. Since there are no reference values for plasma selenium in normal Brazilian children, the reference recommended by the laboratory were adopted in our study. The reference values for plasma selenium concentrations must be adjusted for age because serum selenium concentrations in childhood show a significant Inhibitors,Modulators,Libraries age dependency.
We found three studies in the literature that evaluated plasma selenium levels during the systemic inflammatory response in children that had been admitted to the ICU. Plasma selenium concentrations were below the reference values in up to 82% of patients, but no studies considered patient nutritional Inhibitors,Modulators,Libraries status and the magnitude of the Inhibitors,Modulators,Libraries inflammatory response. We did not find correlation between plasma selenium and severity of illness indices. In another pediatric study, weak correlations were found between these variables, suggesting that other factors may affect plasma selenium and severity of illness. Plasma concentration analysis is the most commonly used method for selenium determination.
However, plasma concentrations of some micronutrients may be affected by systemic inflammation, which may confound the low plasma concentrations, which Pacritinib aml indicate deficiency. The main factor responsible for reduced plasma concentrations during the systemic inflammatory response is, hypothetically, selenium redistribution from the circulation to tissues that are involved in immune function. Endothelial injury results in increased vascular permeability favoring transcapillary escape of selenium transporter proteins.