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Selenium supplementation in low-birthweight premature infants: relationship to trace metals and antioxidant enzymes
R K Huston1, B J Jelen, J Vidgoff
1Department of Pediatrics, Emanuel Hospital and Health Center, Portland, Oregon 97227.
Insights
Selenium supplementation in premature infants did not improve outcomes and may negatively impact copper metabolism. The study suggests the tested selenium dose was inadequate for these vulnerable infants.
Area of Science:
- Neonatal nutrition
- Trace element metabolism
Background:
- Low-birthweight infants (<1000g) have altered trace metal metabolism.
- Parenteral nutrition (TPN) is common in these infants, necessitating careful nutrient management.
- The role of selenium in neonatal trace metal homeostasis requires further investigation.
Purpose of the Study:
- To evaluate the effect of selenium supplementation on trace metal metabolism in very low-birthweight infants.
- To assess the adequacy of a specific selenium dosage (1.34 µg/kg/day) in TPN.
- To examine the impact of selenium on copper, zinc, and antioxidant enzyme activities.
Main Methods:
- A randomized controlled trial comparing selenium-supplemented TPN (Group S) versus standard TPN (Group C).
- Measurement of serum selenium, copper, zinc, and white blood cell glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) activities at three time points.
- Infants were assessed at TPN initiation, enteral nutrition initiation, and TPN discontinuation.
Main Results:
- Selenium levels were higher in Group S at enteral nutrition initiation but declined equally in both groups by TPN discontinuation.
- Group S showed increased GSH-Px activity initially, while Group C had a significant decrease by TPN discontinuation.
- Serum copper levels significantly declined in Group S but not in Group C, despite identical copper intake.
Conclusions:
- The supplemental selenium dose of 1.34 µg/kg/day appears inadequate for very low-birthweight infants.
- Selenium supplementation may interfere with copper metabolism in this population.
- Further research is needed to determine optimal selenium dosages and its interactions with other trace elements in neonates.
Abstract:
We attempted to study the effect of selenium supplementation upon trace metal metabolism in low-birthweight infants less than 1000 g birthweight. Serum levels of the trace metals copper, zinc, and selenium; and white blood cell glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) activities were measured in conjunction with the trace metals when parenteral nutrition (TPN) was begun (sample A), at the initiation of enteral nutrition (sample B), and when TPN was discontinued (sample C). Two randomly selected groups of infants were evaluated: group S received selenium supplementation (1.34 micrograms/kg per d) in their parenteral nutrition solutions; group C was a control which did not receive selenium supplementation. Selenium levels declined to equally low levels in both groups by sample C, but were significantly higher in group S at sample B. GSH-Px activities demonstrated a significant increase at sample B in group S and then tended to decrease. In group C, GSH-Px tended to increase, then decreased significantly by sample C. Both groups received 20 micrograms/kg per d of copper in TPN, however, serum copper declined significantly at sample B in group S whereas there were no significant changes in group C. There were no significant changes in zinc and SOD levels. There were no significant differences between groups in clinical characteristics or outcome. This study suggests that a dose of supplemental selenium of 1.34 micrograms/kg per d in TPN is inadequate for low-birthweight premature infants. Selenium supplementation may also affect copper metabolism.