Lower Serum Selenium Levels Correlated With Crohn Disease Severity

Blood test tubes. Blood samples in a rack. 3d illustration
Investigators sought to assess the potential use of serum selenium concentration as a biomarker for Crohn disease activity.

Serum selenium concentrations were inversely correlated with endoscopic severity among patients with Crohn disease (CD), according to study results published in Clinical Therapeutics.

The retrospective study enrolled consecutive patients hospitalized for CD between May and December 2020 at the Inflammatory Bowel Disease Center in Hangzhou, China. Eligible patients were aged 18 to 60 years and had no history of extensive small intestinal surgery. A serum selenium concentration of 83.78 to 189.47 μg/mL was the reference range used to determine the patients’ selenium status. CD activity was measured using a combination of clinical, laboratory, and endoscopic data.

One gastroenterologist, blinded to serum selenium levels, performed all colonoscopies and graded disease activity using the simple endoscopic score for Crohn disease (SES-CD). Patients were then stratified into 4 categories by disease severity: (1) remission (2) mildly active; (3) moderately active; and (4) severe. Multivariate linear regression was performed to assess the relationship between serum selenium levels and disease activity parameters.

The cohort included 135 patients, among whom 94 (69.6%) were men. Median age at enrollment was 27 years; median disease duration was 23 months. Per endoscopic data, 4 patients (2.9%) were in remission; 32 (23.7%) had mild active disease; 41 (30.4%) had moderate active disease; and 58 (43.0%) had severe active disease. Overall, 57 patients (42.2%) had low selenium levels (<83.78 μg/mL). In univariate models, serum selenium level was significantly inversely associated with all disease activity parameters, including the SES-CD (P =.003), the Crohn Disease Activity Index, the Harvey-Bradshaw Index, C-reactive protein levels, erythrocyte sedimentation rate, and platelet count (all P <.05). Further, in multivariable linear stepwise models, serum selenium levels maintained an independent inverse relationship with SES-CD (P =.003), albumin (P =.011), and folic acid (P <.001).

These results support findings from previous studies, which suggest that selenium deficiency may play a role in the pathogenesis of CD. Limitations of the analysis included the small cohort size and single study site. Additionally, all enrollees had been hospitalized for CD; results may not be generalizable to those with milder disease.

“[Our] results suggest that the serum selenium status is a possible biomarker for assessing and monitoring the activity of CD in addition to the conventionally used assessment tools,” the investigators wrote.


Yan W, Meihao W, Zihan S, et al. Correlation between Crohn disease activity and serum selenium concentration. Clin Ther. Published online March 31, 2022. doi:10.1016/j.clinthera.2022.03.005