Dworkin B, Newman L J, Berezin S, Rosenthal W S, Schwarz S M, Weiss L
JPEN J Parenter Enteral Nutr. 1987 Jan-Feb;11(1):38-41. doi: 10.1177/014860718701100138.
Frank clinical selenium deficiency has been described in cystic fibrosis (CF), and a relative deficiency has been proposed as contributing to the pathogenesis of the disease. Because of these possibilities, we investigated the relationship between overall nutritional status in CF with measures of selenium nutriture. Fifteen stable outpatients with CF (group I) were compared to 13 age-matched controls (group II) and 27 healthy adults (group III). Whole blood, plasma, and red blood cell selenium levels were reduced by 31%, 29%, and 33%, respectively, in CF patients vs controls (all p less than 0.001). In addition, both groups I and II showed significantly lower blood selenium levels than healthy adults (p less than 0.005). Nutritional assessment revealed CF patients to be undernourished, with significant decreases in serum albumin (p less than 0.025), weight-for-height deficit (p less than 0.01), and weight-for-age (p less than 0.025) vs controls. However, only the triceps skinfold (TSF) measurement correlated significantly with selenium status (r = 0.56: p less than 0.05 for whole blood selenium vs TSF). We conclude, based on the magnitude of decrement in blood selenium, that it is unlikely that selenium plays a significant primary pathogenic role in cystic fibrosis. However, these patients are at high risk for developing clinical selenium deficiencies. The measurement of blood selenium levels using appropriate age-matched normal standards should be mandatory in all CF patients with malnutrition, or in those requiring parenteral nutritional support.
临床上已描述了囊性纤维化(CF)患者存在明显的硒缺乏,并且有人提出相对缺乏的硒可能与该疾病的发病机制有关。鉴于这些可能性,我们研究了CF患者的总体营养状况与硒营养指标之间的关系。将15名稳定的CF门诊患者(I组)与13名年龄匹配的对照组(II组)以及27名健康成年人(III组)进行比较。与对照组相比,CF患者的全血、血浆和红细胞硒水平分别降低了31%、29%和33%(所有p值均小于0.001)。此外,I组和II组的血硒水平均显著低于健康成年人(p值小于0.005)。营养评估显示,与对照组相比,CF患者存在营养不良,血清白蛋白显著降低(p值小于0.025),身高体重比不足(p值小于0.01),年龄体重比降低(p值小于0.025)。然而,只有肱三头肌皮褶厚度(TSF)测量值与硒状态显著相关(r = 0.56:全血硒与TSF相比,p值小于0.05)。基于血硒降低的幅度,我们得出结论,硒在囊性纤维化中不太可能发挥显著的原发性致病作用。然而,这些患者发生临床硒缺乏的风险很高。对于所有营养不良的CF患者或需要肠外营养支持的患者,应强制使用适当的年龄匹配正常标准来测量血硒水平。