Selenium depletion in patients on home parenteral nutrition

Severe selenium (Se) depletion was found in nine patients receiving long-term home parenteral nutrition because of short bowel syndrome. Plasma Se ranged from 0–0.51 (median 0.21 μmol/L) and erythrocyte Se ranged from 0.7–2.6 (median 1.8 μmol/gHgb), which was significantly lower than in the controls. Glutathione peroxidase (GSHPx) in plasma and erythrocytes was also decreased. After bolus injections with 200 μg Se/d in the form of sodium selenite for 4 mo, followed by 100 μg/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 the controls. Following Se supplementation, plasma and erythrocyte GSHPx did not differ between patients and controls. These data suggest that all patients receiving long-term parenteral nutrition because of short bowel syndrome should receive at least 100 μg sodium selenite/d when given as bolus injections to avoid Se depletion.