Selenium status of seven chronic intravenous hyperalimentation patients

Selenium status was determined on seven patients receiving long-term intravenous hyperalimentation (IVH) and they were followed monthly for 4 to 17 months. Analysis of the IVH solutions for selenium revealed no detectable amounts. The selenium indices measures were (1) erythrocyte selenium levels, (2) erythrocyte glutathione peroxidase activities (GSH-Px), and (3) plasma selenium levels. In general, the IVH population had significantly lower values (p less than 0.001) for these selenium indices than a healthy population (n = 275). The plasma selenium levels decreased to below the normal range within one to two months after initiation of IVH. The below normal ranges varied by patient: three patients by three months, one patient by nine months, and three patients had low and normal values throughout the study. No consistent correlation of individual patient's erythrocyte GSH-Px activities and erythrocyte selenium levels existed, but a positive correlation (r = 0.51, p less than 0.01) occurred between plasma selenium levels and erythrocyte GSH-Px activities. Thus, erythrocyte GSH-Px activities decrease parallel to decreases in plasma selenium levels but not with changes in erythrocyte selenium levels. These data suggest that some of these IVH patients may be at risk for selenium deficiency and that selenium supplementation of IVH solutions may be required. Furthermore, these data suggest that the measurement of erythrocyte GSH-Px activity or selenium levels in some IVH patients may not be related to available body selenium.