정맥 영양 사용 신생아에서 혈청 Selenium 결핍 및 Selenium 공급에 따른 농도변화 분석

Abstract

Background: Long-term parenteral nutrition (PN) is associated with a high risk of Se deficiency. This study analyzed the prevalence of Se deficiency, correlations between patient characteristics and Se concentrations, and changes in Se concentrations according to Se supplementation in neonates receiving long-term PN. Methods: Medical records of 36 neonates admitted to the neonatal intensive care unit from March 2012 to May 2024 who received PN for more than two weeks and had their serum Se concentrations measurements were reviewed. Se deficiency was defined as a serum concentration below 57 mcg/L. The prevalence of Se deficiency was assessed. Correlations between Se concentrations and patient characteristics were analyzed using scatter plots and linear regression. In a subgroup of 19 patients, changes in Se concentrations between pre- and post-supplementation were analyzed using the Mann-Whitney U test. Results: The average gestational age was 28.6±3.8 weeks and the average birth weight was 1.2±0.7 kg. Average first serum Se concentration was 19.0±7.7 mcg/L (measured after 36.6±16.5 days of PN). All 36 (100%) patients were found to have Se deficiency. Se concentrations showed negative correlations with NPO duration (p=0.006, r=-0.446) and PN supply (kcal/kg/day, p=0.004, r=-0.463). In the subgroup of 19 patients who received intravenous Se supplementation (3.8±1.3 mcg/kg/day for 30.8±9.6 days), the Mann-Whitney U test showed a statistically significant increase in Se concentration during post-supplementation compared to the concentration during pre-supplementation (U=6.50, p <0.05). Conclusion: All patients receiving PN for more than two weeks showed Se deficiency. Despite intravenous Se supplementation, only 2 in 19 patients reached normal concentration. Therefore, earlier assessment and sufficient intravenous Se supplementation are recommended to prevent Se deficiency in neonates receiving long-term PN.