Mattio Nastasia, Juin Charlotte, Lauverjat Madeleine, Chambrier Cécile, Bergoin Charlotte, Couronne Thomas
Hépato-Gastroentérologie et Assistance Nutritionnelle, Hôpital Lyon Sud, 165 Chemin du Grand Revoyet, 69495 Pierre Bénite CEDEX, France.
Nutrients. 2025 May 6;17(9):1598. doi: 10.3390/nu17091598.
: In short bowel syndrome adults (SBS), about 50% of patients on parenteral support (PS) are weaned off. However, micronutrient deficiency prevalence has never been studied in weaned patients. We aimed to assess the prevalence of micronutrient depletions and potential risk factors, more than a year after PS weaning. : A retrospective study was conducted on our 161 weaned SBS patients between January 2011 and December 2021. Only 42 of them had an assessment of their plasma micronutrient status more than a year after PS weaning. : 40/42 patients had at least one micronutrient depletion, with an average of 4.0 ± 1.9 depletions per patient. Depletions in vitamins D, E, selenium, copper, and zinc were the most frequent, present for >50% of patients. In 75% of cases, patients depleted in vitamin B12 and D were already supplemented. Long-term proton pump inhibitor (PPI) use and duration on PS was associated with ≥ three depletions ( = 0.02). A daily mean of the total energy infused per week > 20 kcal/kg/day at the time of weaning was associated with more depletions (5.8 ± 1.6 vs. 3.7 ± 1.7 depletions, = 0.02). Other factors (digestive anatomy, particularly SBS type, or associated chronic disease) were not predictive of depletion. : Nearly all patients with SBS have at least one micronutrient depletion after PS withdrawal. This study suggests that a long-term monitoring of micronutrients status is needed for SBS patients weaned off PS. A larger-scale study would be necessary to generalize these results.
在短肠综合征成人患者(SBS)中,约50%接受肠外营养支持(PS)的患者可成功脱机。然而,对于已脱机的患者,尚未对微量营养素缺乏的患病率进行研究。我们旨在评估PS脱机一年多后微量营养素缺乏的患病率及潜在危险因素。
对2011年1月至2021年12月期间我院161例已脱机的SBS患者进行了一项回顾性研究。其中只有42例在PS脱机一年多后对其血浆微量营养素状态进行了评估。
42例患者中有40例至少存在一种微量营养素缺乏,平均每位患者有4.0±1.9种缺乏情况。维生素D、E、硒、铜和锌的缺乏最为常见,超过50%的患者存在这些缺乏情况。在75%的病例中,维生素B12和D缺乏的患者已接受补充治疗。长期使用质子泵抑制剂(PPI)和PS治疗时间与≥三种缺乏情况相关(P = 0.02)。脱机时每周平均每日输注的总能量>20 kcal/kg/天与更多的缺乏情况相关(5.8±1.6种缺乏情况与3.7±1.7种缺乏情况相比,P = 0.02)。其他因素(消化解剖结构,特别是SBS类型或相关慢性病)不能预测缺乏情况。
几乎所有SBS患者在PS撤机后都至少存在一种微量营养素缺乏。本研究表明,对于已脱机的SBS患者,需要对微量营养素状态进行长期监测。有必要进行更大规模研究以推广这些结果。