title: Antioxidant trace elements serum levels in long-term parenteral nutrition (PN): Prevalence and infectious risk associated with deficiencies, a retrospective study from a tertiary home-PN center.
abstract: Antioxidants essential trace elements (TEs), selenium (Se), zinc (Zn) and copper (Cu) are key dietary components and their supplementation in parenteral nutrition (PN) is recommended. However, the frequency of marginal deficiencies and related clinical outcomes remain poorly known in patients receiving long-term PN.
  
  
  
  We conducted a retrospective observational study whose aim was to determine in a cohort of patients (n = 73) with chronic intestinal failure (CIF) enrolled in a tertiary home PN center and receiving long-term PN with systematic multi-TE supplementation, the prevalence of low serum TEs levels. The goal was also to assess mid-term incidence of serious infection and its associated factors.
  
  
  
  Among the 73 studied patients, 21.9%, 13.9% and 21.1% had low serum Se (<0.9 μmol/l), Cu (<12.7 μmol/l) and Zn (<12.5 μmol/l) levels, respectively. There was no difference between short bowel syndrome (SBS) and non-SBS patients. 30 patients had at least one of the three serum TEs levels under the cut-off values of deficiency. No specific disease and/or underlying intestinal anatomy were associated with low serum TEs concentration. Cumulative incidence rates of serious infection were 11.1% 95CI[5.7-21.0] and 19.5% 95CI[12.0-30.7] at 6 months and 1 year, respectively. Central venous catheter-related bloodstream infection was the most common infection. Low serum Se was independently associated with a higher risk to develop serious infection (HR 2.65 95CI[1.01-6.97]).
  
  
  
  Low serum TEs concentration is a frequent condition in patients with CIF even with systematic multi-TE supplementations. Se deficiency exposes to a greater risk of serious infection. This suggests that frequent TEs dosage in this population as well as individually tailored supplementation may be beneficial.
authors.affiliation: Department of Gastroenterology and Nutritional Support, Beaujon Hospital, Assistance Publique des Hôpitaux de Paris, Université Paris VII, Clichy, France. Electronic address: mathieuuzzan@gmail.com.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Uzzan
authors.affiliation: Department of Gastroenterology, Saint-Antoine Hospital, Assistance Publique des Hôpitaux de Paris, Université Paris VI, Paris, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Kirchgesner
authors.affiliation: Department of Biological Toxicology, University Hospital Lariboisière, APHP, Université Paris VII, Paris, France.
authors.forename: Joël
authors.initials: J
authors.lastname: Poupon
authors.affiliation: Department of Gastroenterology and Nutritional Support, Beaujon Hospital, Assistance Publique des Hôpitaux de Paris, Université Paris VII, Clichy, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Corcos
authors.affiliation: Department of Gastroenterology and Nutritional Support, Beaujon Hospital, Assistance Publique des Hôpitaux de Paris, Université Paris VII, Clichy, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Pingenot
authors.affiliation: Department of Gastroenterology and Nutritional Support, Beaujon Hospital, Assistance Publique des Hôpitaux de Paris, Université Paris VII, Clichy, France; Gastrointestinal and Metabolic Dysfunctions in Nutritional Pathologies, Inserm UMR 1149, Centre de Recherche sur l'Inflammation Paris Montmartre, UFR de Médecine Paris Diderot 16 rue Henri Huchard, 75890 Paris Cedex 18, France.
authors.forename: Francisca
authors.initials: F
authors.lastname: Joly
mesh_terms: D000328:Adult; D000368:Aged; D000975:Antioxidants / Q000008:administration & dosage*; D062905:Central Venous Catheters / Q000009:adverse effects / Q000382:microbiology; D003141:Communicable Diseases / Q000188:drug therapy / Q000453:epidemiology*; D003300:Copper / Q000008:administration & dosage / Q000097:blood / Q000172:deficiency; D005260:Female; D005500:Follow-Up Studies; D006090:Gram-Negative Bacteria; D006801:Humans; D015994:Incidence; D007410:Intestinal Diseases / Q000097:blood / Q000382:microbiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D016331:Parenteral Nutrition, Home; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012643:Selenium / Q000008:administration & dosage / Q000097:blood / Q000172:deficiency; D012778:Short Bowel Syndrome / Q000097:blood / Q000382:microbiology / Q000628:therapy; D014131:Trace Elements / Q000008:administration & dosage* / Q000097:blood / Q000172:deficiency; D015032:Zinc / Q000008:administration & dosage / Q000097:blood / Q000172:deficiency
chemical_list: D000975:Antioxidants; D014131:Trace Elements; D003300:Copper; D012643:Selenium; D015032:Zinc
keywords: Copper; Parenteral nutrition; Selenium; Serious infection; Trace elements; Zinc