Banca de DEFESA: ISABELLI LUARA COSTA DA SILVA

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : ISABELLI LUARA COSTA DA SILVA
DATE: 29/03/2023
TIME: 09:00
LOCAL: Sessão pública realizada por meio de vídeo conferência
TITLE:

Selenium status and heart failure: associations with clinical and nutritional parameters and impact on clinical outcomes

KEY WORDS:

Heart Failure; Selenium; Biomarkers; Survival analysis.

PAGES: 107
BIG AREA: Ciências da Saúde
AREA: Nutrição
SUMMARY:

Selenium deficiency has been a frequent finding in individuals with heart failure (HF), but there are gaps in the literature regarding factors associated with this condition, as well as the impact of selenium status on mortality and hospitalization outcomes. This study aimed to evaluate selenium status and its associations with clinical, nutritional parameters, and clinical outcomes in outpatients with reduced or slightly reduced HF Ejection Fraction or preserved HF Ejection Fraction. Eighty individuals with a diagnosis of HF, adults and elderly of both sexes, attended the Interprofessional Heart Failure Outpatient Clinic of the University Hospital Onofre Lopes, in a follow-up period of up to 36 months, were studied. Plasma selenium concentrations, dietary selenium intake, sociodemographic, anthropometric, clinical, and biochemical parameters, and clinical outcomes (hospitalization and mortality) were evaluated. Plasma selenium was measured by inductively coupled plasma mass spectrometry (ICP-MS). Independent variables were analyzed according to tertiles of plasma selenium concentrations. Multiple linear regression models were run using the stepwise method to determine associations between plasma selenium and other variables. Analysis of the Receiver Operating Characteristic Curve (ROC) was performed to define a cutoff point for plasma selenium values with greater sensitivity and specificity for the clinical outcomes of mortality and hospitalization. Relationships between selenium status and clinical outcomes were observed using Cox regression. Individuals with HF were predominantly male (61.3%) and overweight (52.5%). The most frequent type of HF was reduced or slightly reduced ejection fraction (HFrEF) (70.0%), non-ischemic etiology (55.0%), and functional class I (71.2%). A significant percentage of participants had plasma selenium concentrations within the reference range (91.2%) and the prevalence of inadequate consumption of the element was 29.12%. Regression analysis indicated associations between albumin (β=0.113, p<0.001; R²=0.291) and triglycerides (β=0.0002, p<0.021, R²=0.376) with plasma selenium. Plasma selenium cutoff ≥ 83.80 µg/L was associated with increased risk of all-cause mortality [HR =17.085(1.488-196.146); p=0.023)] and hospitalizations [HR=7.596 (1.114-51.808); p==0.038)]. In conclusion, it was observed that the majority of individuals with HF treated at the outpatient clinic had plasma selenium values within the normal range, with albumin and triglycerides standing out as independent predictors of this variable. In addition, plasma selenium cutoff ≥ 83.80µg/L was associated with an increased risk of unfavorable clinical outcomes in this population. 

COMMITTEE MEMBERS:
Interna - 3218336 - BRUNA ZAVARIZE REIS
Externa à Instituição - Graziela Biude Silva Duarte - USP
Presidente - 2306763 - KARINE CAVALCANTI MAURICIO DE SENA EVANGELISTA
Externo à Instituição - MARCOS FERREIRA MINICUCCI - UNESP