Selenium in total parenteral nutrition

  • H. B. von Stockhausen
Article

Abstract

In clinical practice, selenium deficiency may arise under conditions of chronic malnutrition and especially after long-term total parenteral nutrition (TPN). In infants receiving long-term TPN, we observed plasma selenium levels as low as those previously reported in Chinese children with Keshan disease. Low plasma selenium levels were also usually associated with very low activities of glutathione peroxidase. Although clinical symptoms of selenium deficiency did not occur in our patients, several cases have been described in the literature, indicating the need for supplementation in TPN. In order to derive at the appropriate dosage, it is proposed to correlate it with the total protein supply. According to our present knowledge, .5–1.0 μg selenium/g of protein appears to be adequate to keep patients in Se balance. For Se repletion of body stores, this dosage has been increased up to 3 μg of Se/g of protein. Advantages and disadvantages of selenite and of selenomethionine as possible supplemental forms of Se for TPN solutions are discussed.

Index Entries

Parenteral nutrition selenium deficiency glutathione peroxidase selenium substitution selenite selenomethionine 

References

  1. 1.
    J. T. Rotruck, A. L. Pope, H. E. Ganther, D. G. Hafeman, and W. G. Hoekstra,Science 179, 588 (1973).PubMedCrossRefGoogle Scholar
  2. 2.
    F. Mazead, J. Maral, and A. M. Michelson,Biochem. Biophys. Res. Commun. 86, 1161 (1979).CrossRefGoogle Scholar
  3. 3.
    K. Schwarz and C. M. Foltz,J. Am. Chem. Soc. 79, 3292 (1957).CrossRefGoogle Scholar
  4. 4.
    I. S. Jamall and J. C. Smith, inCadmium. E. C. Foulkes, ed., Springer, Berlin, Heidelberg, New York, 1986, pp. 351–361.Google Scholar
  5. 5.
    S. T. Omaye, K. A. Reddy, and C. E. Cross,Toxicol. Appl. Pharmacol. 43, 237 (1979).CrossRefGoogle Scholar
  6. 6.
    J. M. McKenzie, H. M. Rea, A. M. van Rij, and M. F. Robinson,Proc. Univ. Otago Med. School 54, 25 (1976).Google Scholar
  7. 7.
    A. M. van Rij, C. D. Thomson, J. M. McKenzie, and M. F. Robinson,Am. J. Clin. Nutr. 32, 2076 (1979).PubMedGoogle Scholar
  8. 8.
    S. Amin, C. P. J. Collip, M. Castro Magana, V. T. Maddaiah, and S. W. Klein,Nutr. Metab. 24, 331 (1980).PubMedCrossRefGoogle Scholar
  9. 9.
    R. A. Johnson, S. S. Baker, J. T. Fallon, E. P. Maynard, J. N. Ruskin, Z. Wen, K. Ge, and H. J. Cohen,N. Engl. J. Med. 304, 1210 (1981).PubMedGoogle Scholar
  10. 10.
    R. G. Kay and G. S. Knight,Selenium in human nutrition. New Zealand Workshop on Trace Elements in New Zealand, Univ. Otago, Dunedin, 1981.Google Scholar
  11. 11.
    C. R. Fleming, J. T. Lie, J. T. McCall, J. F. O’Brien, E. E. Baillie, and J. L. Thistle,Gastroenterology,83, 689 (1982).PubMedGoogle Scholar
  12. 12.
    H. W. Lane, A. O. Barroso, D. Englert, S. J. Dudrick, and B. G. MacFadyen,J. Paren. Ent. Nutr. 6, 426 (1982).CrossRefGoogle Scholar
  13. 13.
    C. L. Kien and H. E. Ganther,Am. J. Clin. Nutr. 37, 319 (1983).PubMedGoogle Scholar
  14. 14.
    J. Néve, F. Vertongen, N. Thonnart, and Y. A. Carpentier, inTrace Elements Analytical Chemistry in Medicine and Biology, vol. 3, P. Brätter and P. Schramel, eds., de Gruyter, Berlin, New York, 1984, pp. 139–149.Google Scholar
  15. 15.
    R. Baptista, B. Bistrian, and G. Blackburn,Am. J. Clin. Nutr. 39, 816 (1984).PubMedGoogle Scholar
  16. 16.
    H. B. v. Stockhausen, V. E. Negretti, and P. Brätter,Monatsschr. Kinderheilkd. 132, 727, 1984.Google Scholar
  17. 17.
    C. D. McGee, M. J. Ostro, R. Kurian, and K. N. Jeejeebhoy,Am. J. Clin. Nutr. 42, 432 (1985).PubMedGoogle Scholar
  18. 18.
    J. Néve, F. Vertongen, N. Thonnart, Y. A. Carpentier, Y. Gréggoire, and L. Molle,Acta Pharmacol. Toxicol. 59 Suppl. 7, 166 (1986).Google Scholar
  19. 19.
    I. Lombeck, K. Kasparek, H. D. Harbisch, L. E. Feinendegen, and H. J. Bremer,Eur. J. Pediatr. 125, 81 (1977).PubMedCrossRefGoogle Scholar
  20. 20.
    J. Néve, F. Vertongen, and L. Molle,Clin. Endocrinol. Metab. 14, 629 (1985).PubMedCrossRefGoogle Scholar
  21. 21.
    I. Lombeck, H. Menzel, G. Steiner, and K. Kasparek,Klin. Pädiatr. 194, 303 (1982).PubMedCrossRefGoogle Scholar
  22. 22.
    P. D. Whanger,J. Amer. Coll. of Toxicol. 5, 101 (1986).Google Scholar

Copyright information

© Humana Press Inc. 1988

Authors and Affiliations

  • H. B. von Stockhausen
    • 1
  1. 1.Universitaets-KinderklinikUniversity of WuerzburgWuerzburgFederal Republic of Germany

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