Trace element concentrations in patients on home enteral feeding: two cases of severe copper deficiency.
BACKGROUND
Enteral feeding is the fastest growing area of artificial nutrition, with the annual rate of growth being estimated at 20-25% a year. Previous studies have demonstrated trace element deficiencies in patients on long-term home enteral nutrition (HEN).


METHODS
The trace elements zinc, selenium, copper and manganese were measured in blood samples from 37 patients on HEN using atomic absorption spectroscopy.


RESULTS
Plasma zinc concentrations (range 7.4-14.4 micromol/L) were below the reference range (12.6-22.0 micromol/L) in 30 patients, plasma selenium concentrations (range 0.73-1.76 micromol/L) were below the reference range (0.8-2.0 micromol/L) in only one patient. Whole blood manganese (range 74-309 nmol/L) and plasma manganese (range 13-51 nmol/L) were above both respective reference ranges (73-210 nmol/L and 9-24 nmol/L) in four patients. Two patients showed severely low plasma copper concentrations of 2.4 micromol/L and 2.5 micromol/L, and responded to treatment with extra copper supplementation.


CONCLUSIONS
Although enteral feeds contain adequate concentrations of trace elements, problems with bioavailability may occur and patients receiving long-term enteral feeding should be monitored with regard to plasma trace element concentrations.
Oliver
A
A
Department of Clinical Biochemistry, Leeds Teaching Hospitals, Britannia House, Britannia Road, Morley, Leeds LS27 0DQ, UK.
Allen
K R
KR
Taylor
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003300:Copper / Q000172:deficiency*; D004750:Enteral Nutrition / Q000009:adverse effects*; D005260:Female; D006701:Home Nursing; D006801:Humans; D008297:Male; D008345:Manganese / Q000097:blood; D008875:Middle Aged; D012643:Selenium / Q000097:blood; D020521:Stroke / Q000451:nursing; D014131:Trace Elements / Q000097:blood*; D015032:Zinc / Q000097:blood
D014131:Trace Elements; D008345:Manganese; D003300:Copper; D012643:Selenium; D015032:Zinc