SELENIUM DEPLETION IN PATIENTS WITH GASTROINTESTINAL-DISEASES - ARE THERE ANY PREDICTIVE FACTORS

Background: Patients with intestinal disease are at risk of developing selenium deficiency due to impaired intestinal absorption. The aim of the present study was to evaluate selenium status and to identify pre dictive factors of selenium depletion in patients with gastrointestina l disease. Methods: The concentration of selenium and the activity of glutathione peroxidase in plasma and erythrocytes were measured by flu orometry and by spectrophotometry. Eighty-six patients with Crohn's di sease, 40 patients with ulcerative colitis, and 39 patients with vario us other gastrointestinal diseases were studied. Twenty-seven patients (16%) received home parenteral nutrition. Stool mass, faecal fat, and vitamin B-12 absorption were analysed in 100 patients. Results: The p lasma selenium concentration was decreased in 85% of the patients rece iving supplementary parenteral nutrition and in 20% of the patients re ceiving oral nutrition, among them in 26% of the patients with Crohn's disease. Almost all patients with ulcerative colitis had normal selen ium levels. A statistically significant correlation was found between plasma selenium and vitamin B12 absorption, stool mass, faecal fat exc retion, body mass index, P-albumin, P-zinc, and the length of the rema ining small bowel. Stepwise regression analyses showed that the strong est predictors of selenium deficiency were stool mass, vitamin B-12 ab sorption, and the length of the small-bowel resection. Conclusion: Sel enium deficiency is common in patients with severe gastrointestinal di sorders. The deficiency is mainly related to malabsorption, and a low selenium level was almost invariably present in patients who needed pa renteral supplementation due to gut failure.