Factors Affecting Selenium Status in Infants on Parenteral Nutrition Therapy

Area of Science:

• Pediatric Nutrition
• Micronutrient Metabolism
• Clinical Chemistry

Background:

• Selenium is an essential micronutrient vital for infants and young children receiving exclusive parenteral nutrition (PN).
• Adequate selenium status is critical for growth and development in vulnerable pediatric populations.
• Parenteral nutrition (PN) can alter micronutrient levels, necessitating careful monitoring.

Purpose of the Study:

• To investigate selenium status in infants receiving PN.
• To identify clinical factors associated with selenium deficiency in this population.
• To inform optimal monitoring and supplementation strategies for selenium in infants on PN.

Main Methods:

• Retrospective cohort study of pediatric patients on PN with routine selenium monitoring.
• Selenium deficiency diagnosed using age-based plasma selenium norms.
• Analysis of associations between selenium deficiency and birthweight, serum albumin, cholestasis, and enteral feeding.

Main Results:

• High prevalence of selenium deficiency (80%) and albumin deficiency (87.5%) observed in the cohort.
• Significantly higher odds of selenium deficiency in extremely low birthweight (ELBW) and very low birthweight (VLBW) infants compared to normal birthweight (NBW) infants.
• Low serum albumin was strongly associated with increased odds of selenium deficiency (OR=5.33).

Conclusions:

• Hypoalbuminemia and history of ELBW or VLBW are key clinical factors associated with selenium deficiency in infants on PN.
• Dual measurement of serum albumin and serum selenium is recommended for improved interpretation of selenium status.
• This study highlights the need for vigilant selenium monitoring and management in infants receiving PN.