Kuroki Fumitoshi, Matsumoto Takayuki, Iida Mitsuo
Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Higashiku, Fukuoka City, Japan.
Dig Dis. 2003;21(3):266-70. doi: 10.1159/000073346.
BACKGROUND/AIMS: [corrected] Selenium is an important trace element and its deficiency has been reported to be associated with cardiomyopathy or gastrointestinal cancer. The aim of this study is to clarify the selenium status in Crohn's disease (CD) on enteral nutrition.
We measured serum selenium concentrations in 53 patients with CD and compared them with those in 21 healthy controls. Twenty-nine patients were under the treatment by enteral nutrition (EN group), and the remaining 24 patients were free from formulated enteral nutrition (non-EN group).
While the serum selenium concentration in the non-EN group was not decreased when compared to controls, the value in the EN group was significantly lower than those in the non-EN group and in controls. Clinical manifestations of selenium deficiency were found in a patient on exclusive enteral nutrition. In the EN group, the serum selenium concentration showed an inverse correlation with the duration and the daily dose of enteral nutrition. In the non-EN group, the serum selenium concentrations were inversely correlated with the Crohn's disease activity index.
These findings suggest that patients with CD on enteral nutrition are at risk for selenium deficiency and that even patients without enteral nutrition may develop selenium deficiency at the active phase of the disease.
背景/目的：[已修正] 硒是一种重要的微量元素，据报道其缺乏与心肌病或胃肠道癌症有关。本研究的目的是阐明克罗恩病（CD）患者接受肠内营养时的硒状态。
我们测量了53例CD患者的血清硒浓度，并将其与21例健康对照者的血清硒浓度进行比较。29例患者接受肠内营养治疗（EN组），其余24例患者未接受配制肠内营养（非EN组）。
与对照组相比，非EN组的血清硒浓度未降低，但EN组的值显著低于非EN组和对照组。在一名接受全肠内营养的患者中发现了硒缺乏的临床表现。在EN组中，血清硒浓度与肠内营养的持续时间和每日剂量呈负相关。在非EN组中，血清硒浓度与克罗恩病活动指数呈负相关。
这些发现表明，接受肠内营养的CD患者有硒缺乏的风险，而且即使未接受肠内营养的患者在疾病活动期也可能出现硒缺乏。
