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[Selenium status and bronchopulmonary dysplasia in premature infants <1,500 g]
1Kinderklinik, RWTH Aachen.
Insights
Preterm infants with bronchopulmonary dysplasia (BPD) had higher initial selenium levels, but levels dropped significantly over four weeks. This suggests early selenium status may influence BPD risk in premature infants.
Area of Science:
- Biochemistry
- Neonatology
- Nutritional Science
Context:
- Selenium is crucial for glutathione peroxidase, an antioxidant enzyme protecting against oxidative stress.
- Preterm infants (<1500g) are at increased risk for selenium deficiency due to inadequate intake.
- Low selenium status and reduced glutathione peroxidase activity may elevate the risk of bronchopulmonary dysplasia (BPD).
Purpose:
- To investigate the association between selenium status and BPD incidence in very low birth weight (VLBW) preterm infants.
- To measure plasma selenium levels in VLBW infants within the first week and at four weeks of life.
Summary:
- A prospective study analyzed 34 VLBW infants (<1500g) receiving parenteral nutrition without specific selenium supplementation.
- Initial plasma selenium levels were higher in infants who later developed BPD (45.0 µg/l) compared to those without BPD (33.2 µg/l).
- However, selenium levels significantly decreased in all infants by four weeks, with no significant difference between BPD and non-BPD groups at this later time point.
Impact:
- Findings suggest that initial selenium levels might be a potential indicator for BPD risk in VLBW infants.
- The study highlights the rapid decline in selenium status in preterm infants on parenteral nutrition.
- Further research is warranted to explore selenium's role in BPD pathogenesis and potential therapeutic interventions.
Abstract:
Selenium is an essential component of the antioxidant enzyme glutathione peroxidase that protects tissues against oxidative injury by detoxifying peroxides. In preterm infants the risk for selenium deficiency is increased due to insufficient selenium uptake. Low selenium uptake and as a consequence decreased glutathione peroxidase activity may result in an elevated risk for the development of bronchopulmonary dysplasia (BPD). The aim of this prospective study was to investigate the relationship between the selenium status of preterm infants < 1500 g and the incidence of BPD. We determined the selenium plasma levels by means of atomic absorption spectrometry in 34 VLBW infants (mean birth weight 1075 +/- 249 g; mean gestational age 28.6 +/- 2.5 weeks) within the first 5 days of life and later in the age of 4 weeks. The infants received mainly parenteral nutrition and were not specifically supplied with selenium. Postnatally, the selenium plasma level was 34.2 micrograms/l (17.3/50) [median (25/75% quantil)] and dropped after 4 weeks to a median value of 16.1 micrograms/l (5.2/38.4) (p < 0.001). In the infants with BPD (n = 12) the selenium concentration within the first week of life was 45.0 micrograms/l (31.5/55.6) versus 33.2 micrograms/l (20.2/42.4) in the infants without BPD. In the age of 4 weeks of life the median selenium level was not significantly different between the infants with and without BPD - 17.2 micrograms/l (10.3/22.5) versus 14.8 micrograms/l (8.8/22.6).