Abstract
Background. This study aimed to determine the prevalence and correlates of Se deficiency in patients referred for parenteral nutrition (PN) and to assess the response to a standard supplementation regimen. Methods. Adult patients (53) were recruited prior to commencing a PN regimen delivering 32 µg (0.4 µmol) Se per 24–36 h. Serum Se concentrations were measured before and daily during PN. Results. At baseline 49 (92%) patients had serum Se concentrations below the reference range (0.9–1.65 μmol/L). Se concentrations climbed during PN from 0.49±0.23 (mean ± SD) to 0.57±0.22 μmol/L (P<0.05), but in 48 (91%) patients the concentrations remained low at post-PN. Taking a Se concentration below 0.6 μmol/L as indicative of depletion in the presence of an acute phase response (APR), 37 (70%) patients had Se depletion at baseline and in 27 (51%), levels remained low at post-PN. Baseline serum Se predicted the length of hospital stay (r=-0.36, P<0.05). Increased “malnutrition universal screening tool” score predicted low Se (r=-0.93, P<0.05). Conclusions. Patients referred for PN have a high prevalence of Se deficiency, even when the APR is taken into account. Se supplementation of 32 µg Se per 24–36 h is insufficient for most patients. Baseline serum Se may have prognostic value.
Highlights
Selenium (Se) is a trace element essential to human health [1]
In an effort to account for the acute phase response (APR), the authors of this study suggested that, in the presence of inflammation, as indicated by an elevated C-reactive protein (CRP) level, Se concentrations below 0.6 μmol/L (46.9 μg/L) indicate true Se deficiency
70% of patients were Se depleted at baseline and 51% had levels which remained low at post-parenteral nutrition (PN)
Summary
Selenium (Se) is a trace element essential to human health [1]. It is present within selenoproteins which include glutathione peroxidase (GPx), a family of enzymes which catalyse the reduction of hydrogen peroxide to water. The UK Reference Nutrient Intake (RNI) is 75 μg (0.96 μmol) Se per day for males and 60 μg (0.77 μmol) per day for females. This intake is required to maximize plasma GPx activity which occurs at a Se concentration of 89–114 μg/L (1.14–1.46 μmol/L) [4]. At baseline 49 (92%) patients had serum Se concentrations below the reference range (0.9–1.65 μmol/L). Taking a Se concentration below 0.6 μmol/L as indicative of depletion in the presence of an acute phase response (APR), 37 (70%) patients had Se depletion at baseline and in 27 (51%), levels remained low at post-PN.
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