Oxidative stress: The link between selenium deficiency and peripartum cardiomyopathy among ethnic Hausa–Fulani patients

BACKGROUND: Peripartum cardiomyopathy (PPCM) is an idiopathic cardiomyopathy characterized by left ventricular systolic dysfunction occurring during the puerperium. It is a significant cause of morbidity and mortality, especially in Northern Nigeria. Its incidence shows geographic and ethnic variation, with the highest burden being among ethnic Hausa/Fulani of northern Nigeria. The etiology of PPCM is poorly understood. Several hypotheses, including nutritional deficiencies and oxidative stress, have been proposed. OBJECTIVES: This study aims to determine the link between selenium deficiency and PPCM among ethnic Hausa and Fulani. METHODS: Patients with PPCM and controls who met the inclusion criteria were recruited using simple random sampling. Sociodemographic and clinical data were obtained from the participants using a structured questionnaire. Blood sample was taken to determine serum levels of selenium and oxidative stress markers (catalase, glutathione peroxidase [GPX], superoxide dismutase [SOD], and malondialdehyde [MDA]) for both PPCM patients and controls. RESULTS: The majority of PPCM patients had selenium deficiency. There was a statistically significant higher frequency of deficiencies of serum selenium (82%) among patients compared to the controls. There was low activity of SOD (56%), GPX (64%), and higher serum MDA (16%) among PPCM patients compared to the controls. There was no significant difference in serum catalase levels between PPCM patients compared to the controls. SOD and GPX were modestly correlated with serum selenium. There was a strong positive correlation between catalase activity, red blood cell count, and packed cell volume among the PPCM group. CONCLUSION: This study demonstrated that the link between selenium deficiency and PPCM is likely oxidative stress.