Correlation Between Crohn's Disease Activity and Serum Selenium Concentration

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.

Keywords: Crohn's disease; disease activity; nutrition; serum selenium level.