Micronutrient Profiles and Anxiety in Adolescents with Non-Structural Palpitations: A Case-Control Study.

Metabolic syndrome (MS) is defined as the clustering of cardiovascular risk factors and is associated with increased risk for cardiovascular morbidity and mortality [1, 2]. Oxidative stress has been hypothesized as one of the main mechanisms leading to MS [3]. Since copper, zinc and selenium are cofactors of antioxidant enzymes a lot of studies in different regions have been conducted in order to find possible differences in these trace element levels in subjects with or without MS [4-7]. However, their results were conflicting [4-7]. Therefore, the aim of the present study was to compare serum copper, zinc and selenium levels in subjects with or without MS. A total of 51 subjects (17 males/34 females, mean age ± standard deviation (SD): 69.0 ± 9.4 years, body mass index (BMI) ± SD: 33.8 ± 5.1 Kg/m2) with MS and 54 subjects without MS (22 males/32 females, mean age ± SD: 69.8 ± 9.7 years, BMI ± SD: 29.6 ± 3.7 Kg/m2), consecutively selected from the outpatient clinic of our hospital were enrolled into the study. Subjects having three or more of the criteria according to the NCEP ATP III report [8] were defined as having the MS. A thorough physical examination was performed and a detailed medical history was obtained for each participant. All measurements were performed in the morning, after 10 12 hours fast. Blood samples were drawn for measurement of serum copper, zinc and selenium levels. Serum levels of copper, zinc and selenium were determined by use of atomic mass spectrometry (ZEEnit 700, Analytical Jena, Germany). Trace element levels did not differ between subjects with or without MS: copper levels (120.7 ± 35.5 vs. 117.4 ± 39.2 μm/l, P = 0.65), zinc levels (91.5 ± 28.3 vs. 94.6 ± 23.4 μm/l, P = 0.54) and selenium levels (106.4 ± 33.8 vs. 102.8 ± 28.7 μm/l, P = 0.56). Univariate regression analysis showed that serum copper and selenium levels did not correlate with any of the MS components. Serum zinc levels correlated negatively only with glucose levels (beta = -0.50, P = 0.03) (Table 1). The present study showed that serum copper, zinc and selenium levels are not associated with the presence of MS. The Third National Health and Nutrition Examination Survey showed that serum selenium levels were similar in subjects with or without MS [5]. Furthermore, the Supplementation en Vitamines et Mineraux Antioxydants (SU.VI.MAX) trial [4], showed that serum selenium concentrations were not associated with MS. However, a recent study in Europe showed that only selenium was positively associated with a higher odd of MS in women but not in men. This association was not confirmed between copper or zinc and MS [9]. With regard to zinc the lack of association reported in our study is in accordance with the results of the SU.VI.MAX trial [4]. With regard to zinc and copper the lack of association is in accordance with the results of a study conducted in Iran [7]. In conclusion, the present study showed that serum copper, zinc and selenium levels are not associated with the components or the presence of MS. The only observed association was between serum zinc and glucose levels.

Diabetic patients may have vitamin deficiencies, which are important in the follow-up and complications of diabetes for various reasons. It may be beneficial to include the use of dental prosthesis among the parameters that should be investigated as a cause of vitamin deficiency during the management and follow-up of diabetes mellitus. We aimed to investigate the association between serum vitamin B12, folic acid, 25-hydroxyvitamin D, ferritin, iron, magnesium, and HbA1c levels in diabetic patients with and without removable dental prosthesis and in non-diabetic patients with prosthesis. This study is a single-center case-control study. Participants were classified into the following groups: 1) Diabetic patients (n = 528) with prosthesis, 2) non-diabetic patients with prosthesis (n = 121) and 3) diabetic patients without prosthesis (n = 100). Vitamin B12, 25-hydroxyvitamin D, folic acid, ferritin, iron, magnesium, and HbA1c levels were measured and compared across the groups. A significant difference was observed between the groups with respect to the above parameters. Vitamin B12 levels were determined to be higher in the diabetic group without prosthesis. 25-hydroxyvitamin D levels were found to be significantly higher in the non-diabetic group with a prosthesis than in the other two groups. There was no statistical difference in the iron levels between the groups. Ferritin levels were observed to be significantly higher in the diabetic group with prosthesis compared to the other two groups. Magnesium levels were significantly different between all the three groups. The highest magnesium levels were found in the non-diabetic group with prosthesis. HbA1c levels were found to be higher in the diabetic group with prosthesis. Magnesium levels were correlated with 25-hydroxyvitamin D levels, but a negative correlation was observed between these and HbA1c. Serum vitamin B12 levels were lower in the diabetic and non-diabetic groups with prosthesis compared to the diabetic group without prosthesis. 25-hydroxyvitamin D levels were lower and ferritin was higher in the diabetic groups with and without prosthesis. Magnesium levels were significantly lower in the diabetic group with a prosthesis than in the other two groups. The mean HbA1c level was higher in the diabetic group with prosthesis. The comparison of diabetic patients receiving metformin revealed a higher pronounced vitamin B12 deficiency in the diabetic group with prosthesis. These findings show that those diabetic patients with prosthesis should be evaluated for vitamin B12, 25-hydroxyvitamin D, and magnesium deficiency.

SUN-207 MAGNESIUM LEVELS IN DIABETIC PATIENTS WITH END STAGE RENAL DISEASE (ESRD) IN ONE CENTER IN THE UNITED ARAB EMIRATES (UAE)

Micronutrient deficiencies can develop in critically ill patients, arising from factors such as decreased intake, increased losses, drug interactions, and hypermetabolism. These deficiencies may compromise important immune functions, with potential implications for patient outcomes. Alternatively, micronutrient blood levels may become low due to inflammation-driven redistribution rather than consumption. This explorative pilot study investigates blood micronutrient concentrations during the first three weeks of ICU stay in critically ill COVID-19 patients and evaluates the impact of additional micronutrient administration. Moreover, associations between inflammation, disease severity, and micronutrient status were explored. We measured weekly concentrations of vitamins A, B6, D, and E; iron; zinc; copper; selenium; and CRP as a marker of inflammation state and the SOFA score indicating disease severity in 20 critically ill COVID-19 patients during three weeks of ICU stay. Half of the patients received additional (intravenous) micronutrient administration. Data were analyzed with linear mixed models and Pearson’s correlation coefficient. High deficiency rates of vitamins A, B6, and D; zinc; and selenium (50–100%) were found at ICU admission, along with low iron status. After three weeks, vitamins B6 and D deficiencies persisted, and iron status remained low. Plasma levels of vitamins A and E, zinc, and selenium improved. No significant differences in micronutrient levels were found between patient groups. Negative correlations were identified between the CRP level and levels of vitamins A and E, iron, transferrin, zinc, and selenium. SOFA scores negatively correlated with vitamin D and selenium levels. Our findings reveal high micronutrient deficiency rates at ICU admission. Additional micronutrient administration did not enhance levels or expedite their increase. Spontaneous increases in vitamins A and E, zinc, and selenium levels were associated with inflammation resolution, suggesting that observed low levels may be attributed, at least in part, to redistribution rather than true deficiencies.

Selenium, an essential trace element involved in defense against oxidative stress, may prevent cancer and cardiovascular disease. We evaluated the association between selenium levels and all-cause and cause-specific mortality in a representative sample of US adults. Serum selenium levels were measured in 13,887 adult participants in the Third National Health and Nutrition Examination Survey. Study participants were recruited from 1988 to 1994 and followed up for mortality for up to 12 years. The mean serum selenium level was 125.6 ng/mL. The multivariate adjusted hazard ratios comparing the highest (> or = 130.39 ng/mL) with the lowest (< 117.31 ng/mL) serum selenium level tertile were 0.83 (95% confidence interval [CI], 0.72-0.96) for all-cause mortality, 0.69 (95% CI, 0.53-0.90) for cancer mortality, and 0.94 (95% CI, 0.77-1.16) for cardiovascular mortality. However, based on spline regression models, the association between serum selenium levels and all-cause and cancer mortality was nonlinear, with an inverse association at low selenium levels (< 130 ng/mL) and a modest increase in mortality at high selenium levels (> 150 ng/mL). There was no association between serum selenium levels and cardiovascular mortality. In a representative sample of the US population, we found a nonlinear association between serum selenium levels and all-cause and cancer mortality. Increasing serum selenium levels were associated with decreased mortality up to 130 ng/mL. Our study, however, raises the concern that higher serum selenium levels may be associated with increased mortality.

Background. An integral part of a child’s physical and mental development is a balanced diet. Insufficient or inadequate for a child developing organism’s needs nutrition in preschool age leads to a delay in physical, cognitive, and mental development. The study was aimed to assess the macro-and micronutrient provision status of preschool children with psychomotor developmental delay, identify the presence of macro- and micronutrient deficiencies, define the connection between macro- and micronutrient levels in patient’s serum and psychomotor developmental disorders. Materials and methods. The study analyzed the results of biochemical blood tests of blood serum samples for total calcium, magnesium, and iron level in 30 preschool children with psychomotor developmental disorders. Results. Mental retardation was observed in 53.33 % of examined children, autism spectrum disorders — in 20 % of examined children; minimal brain dysfunction — in 13.33 %, attention deficit hyperactivity disorder (ADHD) — in 13.33 %. 93.33 % of examined children had a deficiency of total calcium, magnesium — in 63.33 %, iron — in 20 %. Ten percent of patients had a deficiency of both total calcium, magnesium, and iron; one child (3.33 %) had no deficits. The most common deficiency in almost all subgroups of examined children was a combined deficiency of total calcium and magnesium. Only in the minimal brain dysfunction subgroup, in 50 % of cases, there was a combined deficiency of total calcium and magnesium, and in other 50 % of cases — an isolated deficiency of total calcium. This study identified a reliable inverse correlation of moderate strength between the level of total calcium and psychomotor development disorders and between the level of magnesium and the hyperexcitability syndrome. This study detected a weak unreliable correlation between the levels of magnesium and neurological disorders; an inverse unreliable weak correlation was found between iron and psychomotor developmental disorders. Conclusions. The most common deficiency in almost all subgroups of examined children was a combined deficiency of total calcium and magnesium. This study identified a reliable inverse correlation of moderate strength between the level of total calcium and psychomotor developmental disorders and between the level of magnesium and the hyperexcitability syndrome. There is also a weak direct unreliable correlation between magnesium level and psychomotor disorders. An inverse unreliable weak correlation was detected between the concentration of iron and psychomotor disorders.

Gestational hyperglycemia, zinc, selenium, and antioxidant vitamins

Adequate maternal selenium level is essential for immune response and healthy pregnancy. This study aimed to shed light on the selenium status of pregnant women with COVID‐19 and the effects of potential deficiency in serum selenium levels. Totally 141 pregnant women, 71 of them were COVID‐19 patients, in different trimesters were included in the study. Maternal serum selenium levels, demographic and clinical parameters were determined. Serum selenium levels of pregnant women in the second (p: .0003) and third (p: .001) trimesters with COVID‐19 were significantly lower than in the healthy group. Maternal selenium level was found to be negatively correlated with gestational week (p < .0001, r: −.541), D‐dimer (p: .0002, r: −.363) and interleukin‐6 (IL‐6) level (p: .02, r: −.243). In the second trimester, serum selenium level positively correlated with white blood cell (p: .002, r: .424), neutrophil (p: .006, r: .39), lymphocyte (p: .004, r: .410) count and hemoglobin (p: .02, r: .323), hematocrit (p: .008, r: .38) status. In the third trimester, it was found that maternal selenium level positively correlated with monocyte (p: .04, r: .353) and negatively correlated with C‐reactive protein level (p: .03, r: −.384). Serum selenium level was gradually decreased during the pregnancy period, however, this natural decrease was enhanced together with COVID‐19 infection. The reason might be increased selenium needs depended on the immune response against infection. The decrease in maternal selenium level was found to be related to IL‐6 and D‐dimer levels, which indicate selenium's role in disease progression.

Introduction: Chronic kidney disease (CKD) is described by structural or functional defects staying for three months. End-stage kidney disease (ESKD) patients undergoing renal replacement therapy (RRT) face complications and increased susceptibility to infections due to their compromised immune system. In addition, malnutrition and chronic inflammatory conditions are prevalent in CKD patients. Selenium, an essential trace element, plays a crucial role as a cofactor in antioxidant enzymes like glutathione peroxidase (GPX), contributing to vascular endothelial function. Selenium deficiency in patients with ESKD may intensify oxidative stress, increase susceptibility to cardiovascular complications, and impact mortality rates. Despite the significance of selenium in this context, studies on its levels in children undergoing hemodialysis (HD) are limited. Objectives: This study assessed serum selenium levels in children undergoing HD, compared with healthy children. Furthermore, we sought to establish correlations between selenium levels and inflammatory profiles in the HD group. Patients and Methods: An observational cross-sectional study was conducted with 30 pediatric patients with ESKD undergoing HD (HD group) and 50 healthy children (control group) in Tehran, Iran. Blood samples were collected from both groups, and serum selenium levels along with inflammatory markers were analyzed. The inclusion criteria encompassed pediatric ESKD patients undergoing HD for at least six months without recent inflammation or infections. The exclusion criteria comprised active infections, immunodeficiency syndromes, and corticosteroid therapy. Statistical analyses were performed using SPSS statistics. Results: Significant differences were observed in serum selenium levels between the HD and control groups (P=0.039). Correlation analysis disclosed a direct relationship among selenium levels and participant age (r = 0.235, P=0.036), with no significant difference between genders. Notably, significant correlations were found between selenium levels and erythrocyte sedimentation rate (ESR) and platelet-to-lymphocyte ratio (PLR). In contrast, no significant correlation between selenium levels and other inflammatory profiles was established. Conclusion: This study underscores the importance of assessing serum selenium levels in pediatric ESKD patients undergoing HD. Understanding the interplay between selenium deficiency and inflammatory profiles can inform interventions aimed at improving outcomes and reducing complications in this vulnerable population. Further researches are necessary to explain these associations and to explore possible therapeutic interventions.

BackgroundIn critically ill patients, there are reduced stores of antioxidants, which are associated with increased organ failure and even higher mortality. Trace elements, especially zinc and selenium, are the cornerstone of the antioxidant defense in acute systemic inflammatory response syndrome. Prolactin (PRL) is the counterregulatory stress hormone that prevents cortisol/stress-induced lymphocyte apoptosis. The aim of our study is to detect the serum levels of zinc, selenium, and PRL hormone as important immunomodulators in critically ill children and to investigate the relationship between these immunomodulators and the severity of illness.Subjects and methodsThis was a prospective study that included two groups; group 1: 50 critically ill children within 72 hours of intensive care unit admission, and group 2: 30 healthy children as controls. Blood samples were collected from the two groups for zinc, selenium, and PRL level measurement.ResultsZinc and PRL levels were found to be decreased in critically ill children compared to control group, and these levels were inversely correlated with organ failure index and pediatric logistic organ dysfunction scores. Selenium levels were decreased in patients with sepsis and in patients with multiple organ failure.ConclusionSerum concentrations of zinc and PRL are generally low in critically ill children, with a greater decrease in patients with sepsis and in the presence of multiple organ failure. The levels of zinc and PRL are inversely correlated with severity of illness. Selenium levels were decreased in patients with sepsis and in patients with multiple organ failure.

The present study was conducted to evaluate the serum selenium levels in first-degree relatives of diabetic patients (FDR) according to controls. Insulin resistance, serum lipid levels, inflammation markers, and blood pressure were also studied in these patients. Serum levels of selenium in FDR were significantly lower than control group (74.65 +/- 5.9 vs 88.7 +/- 8.7 microg/dl, p < 0.0001). HsCRP, HOMA-IR, insulin, homocysteine levels were significantly higher in FDR according to the control group (1.32 +/- 0.9 vs 0.63 +/- 0.4 mg/dL, p < 0.0001; 2.07 +/- 0.84 vs 1.51 +/- 0.69, p < 0.0001; 9.26 +/- 3.8 vs 6.8 +/- 2.98 microU/MI, p < 0.0001; 15.7 +/- 7.4 vs 11.5 +/- 5.1 micromol/L, p < 0.0001, respectively). There was significant correlation between selenium levels and hsCRP (r = - 0.450, p < 0.0001). There was also weak significant correlation also between HOMA-IR and selenium levels (r = -0.227, p = 0.003). There was a correlation between systolic blood pressure and BMI (r = 0.365, p < 0.0001). But there was no correlation between selenium levels and blood pressure or other parameters. HsCRP, HOMA-IR, homocysteine levels in individuals with selenium levels < 80 microg/L (n = 78) was significantly higher than hsCRP HOMA-IR, homocysteine levels in individuals with selenium levels >or= 80 (n = 91; 1.23 +/- 0.98 vs 0.81 +/- 0.76 mg/dL, p < 0.003; 1.99 +/- 0.88 vs 1.64 +/- 0.74, p < 0.005; 15.0 +/- 7.6 vs 12.9 +/- 5.7 micromol/L, p < 0.049, respectively). Selenium deficiency may contribute to cardiovascular disease risk in FDR.

Background: Psoriasis is an inflammatory skin disease that is associated to a number of clinical conditions. It results from a combination of genetic predisposition and environmental factors, which together provoke sensitization of the immune system. We aim to explore the status of serum vitamin D, selenium and CRP levels in patients with psoriasis and their association with the severity of the disease. Materials and Methods: There were 50 psoriasis cases and 47 healthy people in this hospital-based case-control research. The levels of serum VD, selenium, and CRP were measured, as well as the general demographic data. Results: VD levels are considerably lower in psoriasis (p&lt; 0.005) according to statistical analyses. Obesity was found to be more common among psoriasis patients than controls in the demographic factors.The levels of selenium and CRP in the serum did not differ significantly between the two groups. Conclusion: We conclude that vitamin D deficiency is strongly associated with psoriasis. Vitamin D supplementation can help with psoriasis management as well as obesity reduction. Serum selenium and CRP levels have shown very little significance in our study.

The selenium status of women with a history of recurrent miscarriage

Objective Selenium is effective in improving quality of life and reducing the progression of active Graves’ orbitopathy. The effect of correcting relative selenium deficiency on improving Graves’ orbitopathy is unknown, as baseline selenium levels have not previously been measured. The study aims to determine whether serum selenium levels are reduced in patients with Graves’ disease with orbitopathy (GO) compared with without orbitopathy (GD). Design A prospective, case–control study performed between 2019 and 2021 at endocrine and ophthalmology clinics in Ain SHams University, Cairo. Subjects A total of 75 subjects, 25 as control and a total of 50 patients with Graves’ disease participated in the study: 25 with Graves’ orbitopathy and 25 without Graves’ orbitopathy. Measurements Serum selenium levels in all groups. Results Mean serum selenium levels were significantly lower in GO (16.6 +- 7.5 ng/ml) than in GD (42.9 +- 8.2 ng/ml) with (P &amp;lt; 0.001). Mean selenium levels appeared to decrease in parallel with increasing severity of GO; selenium level was 30-55 ng/ml in GD, 21-28ng/ml in mild GO, 18-22 ng/ml in moderate GO and 5-16 ng/ml in severe GO (P &amp;lt; 0.001). Conclusion Serum selenium levels are lower in patients with GO compared with GD in an Egyptian study population with marginal selenium status. selenium deficiency may be an risk factor for orbitopathy in patients with Graves’ disease.

Introduction: Pregnancy is dynamic anabolic state in women’s life. During pregnancy women undergo profound hormonal, metabolic and physical changes. Aim of the present study was to compare the serum level of selenium and iron between pregnant and non-pregnant women. Materials and Methods: The present study was carried out in 50 first trimester pregnant women and 50 non pregnant women at tertiary care hospital in Surat, in age group of 30 years and in BMI groups of Blood was collected and serum was analyzed for selenium and iron concentration in atomic absorption spectrophotometry (AAS).We have also measured anthropological parameter like height, weight and based on this BMI calculated. SPSS software used for statistical analysis. Result: There was a significant lower level of serum selenium (p found in 1st trimester pregnant women compared to non-pregnant women. There was a significant decreased in selenium level in all BMI group in pregnant women except in 30 kg/m2 group and there was a decreased in serum iron level in all BMI group in pregnant women compared to non-pregnant women. Conclusion: There was a significant decrease in serum selenium and iron level in 1st trimester of pregnant women com pared to non- pregnant women, which indicate that during pregnancy requirement of trace elements increase to meet demand for fetus growth. A reduction in maternal selenium concentration during pregnancy can lead to various disorders such as miscarriage, premature birth, preeclampsia, pregnancy include hypertension, low birth weight, retinopathy of prematurity etc. Keywords: Selenium, Iron, Atomic absorption spectrophotometry.