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Association between selenium levels and thyroid function in patients with heart disease.

L. F. de Lima,L. M. Watanabe,A. Navarro

Published 2019 in Kardiologia polska

ABSTRACT

657 MI or HF without reduced Se levels. The results showed a high prevalence of patients with low­ er Se concentrations (below the recommended level) when compared with controls. However, the authors did not report a strong relationship between the Se concentration and thyroid func­ tion. Although they revealed variations in thyro­ tropin levels during the acute phase of MI, this finding was no longer observed during follow­ ­up. Thus, the authors concluded that patients with both MI and HF had lower Se levels than controls, but there was no significant correla­ tion between reduced Se levels and either thy­ roid or cardiac function. Patients with heart disease may show inad­ equate food intake, proinflammatory state ac­ tivation, and oxidative stress.6 All these condi­ tions are associated with reduced nutrient ab­ sorption, which may occur due to the presence of abdominal edema as well as increased perme­ ability and chronic inflammation of the muco­ sa, which in turn may alter the intestinal func­ tion and prevent an adequate amount of micro­ and macronutrients from being absorbed.7 Not only the absorption but also the metabolism of some nutrients may be impaired in cardiac pa­ tients, who could have oxidative stress that can alter microelements such as Se and zinc as well as systemic inflammatory response that can modify plasma Se levels.8 Duncan et al9 report­ ed a negative relationship between the plasma Se concentration and the magnitude of the in­ flammatory response assessed by C ­reactive protein concentrations. Selenium, zinc, iodine, and iron participate directly in the formation of thyroid hormones (triiodothyronine, thyrox­ ine).10 Both excess and deficiency of thyroid hor­ mones can lead to thyroid dysfunction. The prev­ alence of thyroid dysfunction in patients with Selenium (Se) is an essential nutritional element, present in nature and in living organisms in or­ ganic and inorganic forms. The main organic forms are selenomethionine and selenocyste­ ine, while the most common inorganic forms are selenite and selenate.1 In human body, Se is largely used to produce the amino acid seleno­ cysteine, which is cotranslationally incorporat­ ed into selenoproteins. Selenoproteins are essen­ tial components of antioxidant defense, and Se bioavailability is a limiting factor in the synthe­ sis of numerous selenoproteins.2 As shown by experimental studies, glutathione peroxidase deficiency may be involved in endothelial dys­ function, cardiac abnormalities, development of atherosclerosis, as well as may adversely af­ fect prognosis in patients with coronary artery disease.2,3 Recent studies have shown that in­ dividuals at risk of cardiovascular disease of­ ten have low plasma Se concentrations, which are associated with increased levels of acute phase proteins such as C ­reactive protein, a phe­ nomenon attributed to the activation of nucle­ ar factor ­kB.2,4 In a recent study by Frączek ­Jucha et al5 pub­ lished in this issue of Kardiologia Polska (Kardiol Pol), the authors investigated Se concen­ trations in patients with myocardial infarction (MI) or heart failure (HF), as well as their rela­ tionship with thyroid hormone levels. A total of 143 participants were divided into 3 groups: MI group (54 patients), HF group (59 patients), and control group (30 healthy volunteers). All groups had blood samples collected for the anal­ ysis of Se concentrations, cardiac function, and thyroid activity. Following this, 4 subgroups were distinguished depending on Se concen­ trations: patients with MI or HF with Se lev­ els below the normal values and patients with Correspondence to: Livia F. de Lima, PhD, Department of Internal Medicine, Medical School of Ribeirão Preto, Avenida Bandeirantes 3900, Monte Alegre, 14049-900, Brasil, phone: +55 1633150000, email: livia.lima@usp.br Received: June 27, 2019. Accepted: June 28, 2019. Published online: August 23, 2019. Kardiol Pol. 2019; 77 (7-8): 657-658 doi:10.33963/KP.14937 Copyright by the Author(s), 2019 E D I T O R I A L

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