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Correlation Between Crohn's Disease Activity and Serum Selenium Concentration

      Highlights

      • Noninvasive biomarkers for estimating Crohn's disease activity are needed.
      • Selenium deficiency is common in patients with Crohn's disease.
      • Serum selenium level was inversely correlated with Crohn's disease activity.
      • Serum selenium level may serve as a biomarker to assess Crohn's disease activity.

      Abstract

      Purpose

      Accurate and reliable evaluation of Crohn's disease (CD) activity is crucial for monitoring and treating the disease; however, it is challenging. There is a high demand for new, reliable, and noninvasive biomarkers for estimating CD activity. Selenium deficiency is common in patients with CD; however, its correlation with disease severity remains unclear. This study aimed to assess the feasibility of using serum selenium concentration as an additional biomarker for determining the severity of CD.

      Methods

      This retrospective study included consecutive Asian patients aged 18 to 60 years and hospitalized for CD between May 2020 and December 2020 at the Inflammatory Bowel Disease Center (Hangzhou, China). Patients with a history of extensive small intestinal surgery and/or short bowel syndrome were excluded from analysis. Serum selenium concentration was determined using inductively coupled plasma mass spectrometry. Disease severity was evaluated based on inflammatory markers (simple endoscopic score for CD, CD activity index, Harvey-Bradshaw index, serum C-reactive protein level, erythrocyte sedimentation rate, and platelet count) and markers of nutrition status (body mass index; blood hemoglobin and hematocrit; as well as serum levels of albumin, folic acid, and vitamin D). The correlations between serum selenium level and disease severity–related parameters were analyzed using univariate and multivariate analyses.

      Findings

      The study included 94 men and 41 women. Serum selenium level was significantly and inversely associated with all tested disease activity–related parameters by univariate analysis (all, P < 0.05). Further multivariate analysis showed that the simple endoscopic score for CD and serum levels of albumin and folic acid were significantly and independently correlated with serum selenium level (all, P < 0.05).

      Implications

      Serum selenium concentration was inversely correlated with endoscopic disease severity in these Asian patients with CD. It is feasible to use serum selenium level as an additional biomarker for assessing and monitoring disease activity. The present results might have been influenced by geographic region, sample size, and/or dietary factors. Serum selenium level and other indicators of CD activity measured before and after treatment may provide more useful clinical information.

      Key words

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      References

        • Gecse KB
        • Vermeire S.
        Differential diagnosis of inflammatory bowel disease: imitations and complications.
        Lancet Gastroenterol Hepatol. 2018; 3: 644-653
        • Nocerino A
        • Nguyen A
        • Agrawal M
        • et al.
        Fatigue in inflammatory bowel diseases: etiologies and management.
        Adv Ther. 2020; 37: 97-112
        • Jeong DY
        • Kim S
        • Son MJ
        • et al.
        Induction and maintenance treatment of inflammatory bowel disease: a comprehensive review.
        Autoimmun Rev. 2019; 18: 439-454
        • Misselwitz B
        • Juillerat P
        • Sulz M C
        • et al.
        Emerging treatment options in inflammatory bowel disease: janus kinases, stem cells, and more.
        Digestion. 2020; 101: 69-82
        • Gomollon F
        • Dignass A
        • Annese 3rd, V.
        European Evidence-based Consensus on the Diagnosis and Management of Crohn's Disease 2016.
        J Crohns Colitis. 2017; 11: 3-25
        • Spiceland CM
        • Lodhia N.
        Endoscopy in inflammatory bowel disease: role in diagnosis, management, and treatment.
        World J Gastroenterol. 2018; 24: 4014-4020
        • Papay P
        • Ignjatovic A
        • Karmiris K
        • et al.
        Optimising monitoring in the management of Crohn's disease: a physician's perspective.
        J Crohns Colitis. 2013; 7: 653-669
        • Gajendran M
        • Loganathan P
        • Catinella AP
        • et al.
        A comprehensive review and update on Crohn's disease.
        Dis Mon. 2018; 64: 20-57
        • Chang S
        • Malter L
        • Hudesman D.
        Disease monitoring in inflammatory bowel disease.
        World J Gastroenterol. 2015; 21: 11246-11259
        • Mitselos IV
        • Fousekis FS
        • Lamouri C
        • et al.
        Current noninvasive modalities in Crohn's disease monitoring.
        Ann Gastroenterol. 2021; 34: 770-780
        • Kopylov U
        • Rosenfeld G
        • Bressler B
        • et al.
        Clinical utility of fecal biomarkers for the diagnosis and management of inflammatory bowel disease.
        Inflamm Bowel Dis. 2014; 20: 742-756
        • Kyle BD
        • Agbor TA
        • Sharif S
        • et al.
        Fecal calprotectin, CRP and leucocytes in IBD patients: comparison of biomarkers with biopsy results.
        J Can Assoc Gastroenterol. 2021; 4: 84-90
        • Kielczykowska M
        • Kocot J
        • Pazdzior M
        • et al.
        Selenium—a fascinating antioxidant of protective properties.
        Adv Clin Exp Med. 2018; 27: 245-255
        • Avery JC
        • Hoffmann PR.
        Selenium, selenoproteins, and immunity.
        Nutrients. 2018; 10: 1203
        • Hariharan S
        • Dharmaraj S.
        Selenium and selenoproteins: its role in regulation of inflammation.
        Inflammopharmacology. 2020; 28: 667-695
        • Gentschew L
        • Bishop KS
        • Han DY
        • et al.
        Selenium, selenoprotein genes and Crohn's disease in a case-control population from Auckland, New Zealand.
        Nutrients. 2012; 4: 1247-1259
        • Gilca-Blanariu GE
        • Diaconescu S
        • Ciocoiu M
        • et al.
        New insights into the role of trace elements in IBD.
        Biomed Res Int. 2018; 20181813047
        • Han YM
        • Yoon H
        • Lim S
        • et al.
        Risk factors for vitamin D, zinc, and selenium deficiencies in Korean patients with inflammatory bowel disease.
        Gut Liver. 2017; 11: 363-369
        • Huang LJ
        • Mao XT
        • Li YY
        • et al.
        Multiomics analyses reveal a critical role of selenium in controlling T cell differentiation in Crohn's disease.
        Immunity. 2021; 54: 1728-1744
        • Jarmakiewicz-Czaja S
        • Piatek D
        • Filip R.
        The influence of nutrients on inflammatory bowel diseases.
        J Nutr Metab. 2020; 20202894169
        • Short SP
        • et al.
        Colonic epithelial-derived selenoprotein P is the source for antioxidant-mediated protection in colitis-associated cancer.
        Gastroenterology. 2021; 160 (1694-1708.e3)
        • Liu X
        • Wang Y
        • Han S
        • et al.
        A spatial ecological study on serum selenium and Keshan disease in Heilongjiang Province.
        China. Biol Trace Elem Res. 2021; 199: 3253-3261
        • Ojuawo A
        • Keith L.
        The serum concentrations of zinc, copper and selenium in children with inflammatory bowel disease.
        Cent Afr J Med. 2002; 48: 116-119
        • Castro AT
        • Navarro-Alarcon M
        • Quesada GJ
        • et al.
        Ulcerative colitis and Crohn's disease are associated with decreased serum selenium concentrations and increased cardiovascular risk.
        Nutrients. 2016; 8: 780
        • Koutroumpakis E
        • Katsanos KH.
        Implementation of the simple endoscopic activity score in Crohn's disease.
        Saudi J Gastroenterol. 2016; 22: 183-191
        • Khanna R
        • Nelson SA
        • Feagan BG
        • et al.
        Endoscopic scoring indices for evaluation of disease activity in Crohn's disease.
        Cochrane Database Syst Rev. 2016; : D10642
        • Vermeire S
        • Schreiber S
        • Sandborn WJ
        • et al.
        Correlation between the Crohn's disease activity and Harvey-Bradshaw indices in assessing Crohn's disease severity.
        Clin Gastroenterol Hepatol. 2010; 8: 357-363
        • Zittan E
        • Kabakchiev B
        • Kelly OB
        • et al.
        Development of the Harvey-Bradshaw Index-pro (HBI-PRO) score to assess endoscopic disease activity in Crohn's disease.
        J Crohns Colitis. 2017; 11: 543-548
        • MacMaster MJ
        • Damianopoulou S
        • Thomson C
        • et al.
        A prospective analysis of micronutrient status in quiescent inflammatory bowel disease.
        Clin Nutr. 2021; 40: 327-331
        • Wendland BE
        • Aghdassi E
        • Tam C
        • et al.
        Lipid peroxidation and plasma antioxidant micronutrients in Crohn's disease.
        Am J Clin Nutr. 2001; 74: 259-264
        • Sands BE.
        Biomarkers of inflammation in inflammatory bowel disease.
        Gastroenterology. 2015; 149: 1275-1285
        • Ozturk ZA
        • Dag MS
        • Kuyumcu ME
        • et al.
        Could platelet indices be new biomarkers for inflammatory bowel diseases?.
        Eur Rev Med Pharmacol Sci. 2013; 17: 334-341
        • Vaghari-Tabari M
        • Jafari-Gharabaghlou D
        • Sadeghsoltani F
        • et al.
        Zinc and selenium in inflammatory bowel disease: trace elements with key roles?.
        Biol Trace Elem Res. 2021; 199: 3190-3204
        • Barnett M
        • Bermingham E
        • McNabb W
        • et al.
        Investigating micronutrients and epigenetic mechanisms in relation to inflammatory bowel disease.
        Mutat Res. 2010; 690: 71-80
        • Mijac DD
        • Jankovic GL
        • Jorga J
        • et al.
        Nutritional status in patients with active inflammatory bowel disease: prevalence of malnutrition and methods for routine nutritional assessment.
        Eur J Intern Med. 2010; 21: 315-319
        • Kim S
        • McClave SA
        • Martindale RG
        • et al.
        Hypoalbuminemia and clinical outcomes: what is the mechanism behind the relationship?.
        Am Surg. 2017; 83: 1220-1227
        • Nogales F
        • Ojeda ML
        • Delgado MJ
        • et al.
        Effects of antioxidant supplementation on duodenal Se-Met absorption in ethanol-exposed rat offspring in vivo.
        J Reprod Dev. 2011; 57: 708-714