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Selenium status of infants on nutritional support
Insights
Parenteral nutrition in infants can lead to a significant drop in selenium levels, potentially causing deficiency. Ensuring adequate selenium intake during total parenteral nutrition (TPN) is crucial for infant health.
Area of Science:
- Nutritional biochemistry
- Pediatric nutrition
- Clinical chemistry
Background:
- Infants receiving nutritional support require careful monitoring of micronutrient status.
- Parenteral nutrition (PN) bypasses normal digestive processes, potentially altering nutrient absorption and utilization.
- Selenium is an essential trace element vital for antioxidant defense and overall health.
Purpose of the Study:
- To investigate the selenium status of infants receiving nutritional support.
- To determine if parenteral nutrition meets the selenium requirements of infants.
- To assess the clinical implications of altered selenium levels during nutritional support.
Main Methods:
- Plasma selenium concentrations were measured in 5 infants before and during parenteral nutrition.
- Red blood cell-glutathione peroxidase activity was monitored.
- Selenium levels were reassessed after the reintroduction of enteral feeding.
Main Results:
- A significant decrease in plasma selenium concentrations was observed after 4 weeks of parenteral nutrition (0.8 +/- 0.5 micrograms/dl vs. normal 3.6 +/- 0.9 micrograms/dl).
- One infant showed a concurrent rise in transaminases, and 3 patients exhibited decreased glutathione peroxidase activity.
- Selenium levels normalized after reintroducing enteral nutrition, indicating inadequate selenium provision during parenteral nutrition.
Conclusions:
- Long-term parenteral nutrition may not adequately meet the selenium requirements of infants.
- Progressive selenium deficiency can develop in infants on parenteral nutrition.
- Physiological amounts of selenium should be provided to long-term parenteral nutrition patients to prevent deficiency.
Abstract:
We investigated the selenium status of 5 infants while on nutritional support. After 4 weeks of parenteral nutrition a significant fall in plasma selenium concentrations was observed (mean +/- SD: 0.8 +/- 0.5 micrograms/dl; normal for this age: 3.6 +/- 0.9 micrograms/dl). In 1 infant the decline in selenium value occurred simultaneously with a transient rise in transaminases. A parallel but delayed decrease in red blood cell-glutathione peroxidase activity was seen in 3 patients. After reintroduction of enteral foods, the selenium levels increased progressively to and reached control values after 6 weeks, 4 and 5 months respectively in 3 patients, suggesting that the selenium requirement on TPN was not met. We consider it essential to provide longterm TPN patients with physiological amounts of selenium in order to prevent the progressive development of a deficiency state.