Selenium Status in Patients Receiving Short-Term Parenteral Nutrition: Frequency of Deficiency and Response to a Standard Supplementation Regimen

Author:

Walsh Julia1,Karanjia Nariman D.2,Taylor Andrew34ORCID,Livingstone Callum3

Affiliation:

1. Department of Chemical Pathology, Royal Gwent Hospital, Cardiff Road, Newport, Gwent NP20 2UB, UK

2. Department of Surgery, Royal Surrey County Hospital NHS Foundation Trust, Egerton Road, Guildford, Surrey GU2 7XX, UK

3. Department of Clinical Biochemistry, Royal Surrey County Hospital NHS Foundation Trust, Egerton Road, Guildford, Surrey GU2 7XX, UK

4. Trace Elements Supraregional Assay Service (SAS), Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH, UK

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±0.22μmol/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.

Publisher

Hindawi Limited

Subject

General Earth and Planetary Sciences,General Environmental Science

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