Effect Of Serum Selenium On Left Ventricular Sturcture And Function In Maintenance Hemodialysis Patients

Objective Observation the changes of selenium and oxidative stress index,thyroid hormone(TH),parathyroid hormone(PTH)and C reactive protein(CRP)content in maintenance hemodialysis(MHD)patients’ blood and their left ventricular structure and function,to explore the effects of selenium on left ventricular structure and function in MHD patients and its possible mechanism.Method Detecting plasma selenium,serum thyroxine(TH),parathyroid hormone(PTH),the content of oxidative stress index,respectively in 40 MHD patients,40 cases of non dialysis patients with chronic renal failure(NOHD)patients and 30 normal controls,by mass spectrometry,radioimmunoassay and chemiluminescence method and biochemical colorimetric method;meanwhile detecting serum C reactive protein(CRP),renal function,plasma protein and lipid levels.Using Philips CX50 color ultrasound to measure left ventricular diameter(LVD),left atrial diameter(LAD),left ventricular end diastolic diameter(LVDd),left ventricular posterior wall thickness(LVPWT),interventricular septal thickness(IVST),left ventricular ejection fraction(LVEF);left ventricular mass index(LVMI)was calculated according to Devereux formula.The relationship between blood selenium and other parameters and its influence on the structure and function of the left ventricle were analyzed.Result 1.The level of plasma selenium in patients with MHD was lower than that of the normal control group(P <0.01),and there was no significant statistical difference compared with that of the NOHD group(P > 0.05).2.the content of TT3 and FT3 in the serum of MHD patients was lower than that of the normal control group(P <0.01),and there was no statistical difference compared with that of the NOHD group(P >0.05).The content of TSH in MHD patients was higher than that in normal control group(P > 0.05),which was lower than that in group NOHD(P < 0.05).3.The content of serum PTH in patients with MHD was higher than that of the normal control group(P < 0.01),and there was no significant difference compared with that of the NOHD group(P > 0.05).4.The serum SOD and GSH-px activities in group MHD were lower than those in normal control group(P <0.01),higher than those in NOHD group(P <0.01);MDA was higher than that in normal control group(P < 0.01),which was lower than that in NOHD group(P > 0.05).5.The content of CRP in patients with MHD was higher than that in the normal control group and the NOHD group(P < 0.01).6.Both LAD and LVDd in MHD patients were lower than those in normal control group(P<0.01),while LVPWT and IVST were higher than those in normal control group,but the difference has no statistically significant(P > 0.05);LVMI was higher than that in normal control group(P < 0.01),and the increase in NOHD group was notable than MHD group(< 0.05).7.Bivariate correlation analysis showed that,in chronic kidney disease patients,there was a positive correlation between serum selenium and GSH-Px,TT3,FT3 and SOD(P< 0.01 and P<0.05),and negative correlation with CRP(P<0.01),and negative correlation with MDA(P=0.056);TT3 and FT3 were negatively correlated with LAD,LVMI,LVDd and IVST(P<0.01 and P<0.05);PTH was positively related to LAD,LVDd,IVST and LVMI;CRP was positively correlated with LAD,LVMI,LVDd and IVST(P<0.01 and P<0.05);GSH-Px was negatively correlated with LVDd,LVMI,LAD and IVST(P<0.01 and P<0.05);SOD was negatively correlated with LAD,IVST and LVMI(P<0.01 and P< 0.05);MDA was positively correlated with LAD,LVMI,LVDd and IVST(P <0.01 and P< 0.05).Conclusion Low selenium can reduce the body’s antioxidant capacity,cause TH and PTH metabolic disorders,and increase the inflammatory response,resulting in abnormal left ventricular structure and function in MHD patients.