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Vitamins and trace elements in home parenteral nutrition patients
J M Reimund1, Y Arondel, B Duclos
1Service d'Hèpato-Gastroentèrologie et d'Assistance Nutritive, Centre Agrèè de Nutrition Parentèrale á Domicile, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, 67098 Strasbourg Cedex, France.
Aims:
to study the micronutrient status in home parenteral nutrition (HPN) patients and its relationship to inflammatory markers, and clinical outcome.
Methods:
Vitamins (A, 25OH D3, E, B12), serum folic acid, as well as trace elements (selenium, zinc, copper, iron and manganese) were measured in 22 adult HPN patients and 14 controls. They were compared to serum malondialdehyde (MDA) concentration (as a marker of lipid peroxidation), erythrocyte superoxide dismutase (SOD) and gluthatione peroxidase (GSHPx), inflammatory markers, and clinical outcome.
Results:
In HPN patients MDA concentration was increased whereas vitamin E concentrations were decreased, and significantly negatively correlated to MDA. Erythrocyte GSHPx and plasma selenium were decreased in the patients and positively correlated to each other. By contrast, manganese concentration was significantly increased in HPN patients and correlated to inflammatory markers.
Conclusions:
Adult HPN patients showed increased lipid peroxidation. This seems principally the result of low vitamin E status. In addition, these patients presented often a decrease in plasma selenium responsible for low GSHPx activity. These combined antioxidant system deficiencies contribute probably to peroxidative damage in HPN patients. Increased manganese concentrations, in view of their potential neurotoxicity have to be closely surveyed. In HPN patients micronutrient status needs regular monitoring in regard to the possibility of vitamin and/or trace element abnormalities.