SELENIUM DEPLETION IN PATIENTS ON HOME PARENTERAL-NUTRITION - THE EFFECT OF SELENIUM SUPPLEMENTATION

Severe selenium (Se) depletion was found in nine patients receiving lo ng-term home parenteral nutrition because of short bowel syndrome. Pla sma Se ranged from 0-0.51 (median 0.21 mumol/L), and erythrocyte Se ra nged from 0.7-2.6 (median 1.8 mumol/gHgb), which was significantly low er than in the controls. Glutathione peroxidase (GSHPx) in plasma and erythrocytes was also decreased. After bolus injections with 200 mug S e/d in the form of sodium selenite for 4 mo, followed by 100 mug/d for 8 mo, plasma Se increased to values slightly but significantly higher than in the controls. Erythrocyte Se reached normal levels in most of the patients after 4 mo substitution, but it remained lower than in t he controls. Following Se supplementation, plasma and erythrocyte GSHP x did not differ between patients and controls. These data suggest tha t all patients receiving long-term parenteral nutrition because of sho rt bowel syndrome should receive at least 100 mug sodium selenite/d wh en given as bolus injections to avoid Se depletion.