Background. This study aimed to determine the prevalence and correlates of Se deficiency in patients referred for parenteral nutrition (PN) and to assess the response to a standard supplementation regimen. Methods. Adult patients (53) were recruited prior to commencing a PN regimen delivering 32？μg (0.4？μmol) Se per 24–36？h. Serum Se concentrations were measured before and daily during PN. Results. At baseline 49 (92%) patients had serum Se concentrations below the reference range (0.9–1.65？μmol/L). Se concentrations climbed during PN from (mean ± SD) to ？μmol/L ( ), but in 48 (91%) patients the concentrations remained low at post-PN. Taking a Se concentration below 0.6？μmol/L as indicative of depletion in the presence of an acute phase response (APR), 37 (70%) patients had Se depletion at baseline and in 27 (51%), levels remained low at post-PN. Baseline serum Se predicted the length of hospital stay ( , ). Increased “malnutrition universal screening tool” score predicted low Se ( , ). Conclusions. Patients referred for PN have a high prevalence of Se deficiency, even when the APR is taken into account. Se supplementation of 32？μg Se per 24–36？h is insufficient for most patients. Baseline serum Se may have prognostic value. 1. Introduction Selenium (Se) is a trace element essential to human health [1]. It is present within selenoproteins which include glutathione peroxidase (GPx), a family of enzymes which catalyse the reduction of hydrogen peroxide to water. GPx accounts for 10–16% of serum Se [2, 3]. The UK Reference Nutrient Intake (RNI) is 75？μg (0.96？μmol) Se per day for males and 60？μg (0.77？μmol) per day for females. This intake is required to maximize plasma GPx activity which occurs at a Se concentration of 89–114？μg/L (1.14–1.46？μmol/L) [4]. Concentrations lower than this are thought to compromise the activity of Se dependent enzymes. Studies of European populations have shown intakes to be considerably less than the RNI [5]. There is ongoing debate about how best to assess Se status, but serum Se is the most commonly used test, its concentrations being thought to reflect short-term changes in dietary intake [6]. Concentrations less than 0.8？μmol/L correlate with dietary Se intake but at higher concentrations tissue selenoproteins plateau as requirements have been met [7]. Serum GPx has also been proposed as a measure of Se status [6]. It responds promptly to changes in intake, being thought to reflect relatively short-term Se status. Its activity correlates with plasma Se and falls in established Se deficiency [8]. In hospitalized patients
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