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Serum Trace Elements in Dysphagic Gastrostomy Candidates Before Endoscopic Gastrostomy for Long Term Enteral Feeding
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Abstract(s)
BACKGROUND & AIMS: Patients who underwent endoscopic gastrostomy (PEG) present protein-energy malnutrition, but little is known about Trace Elements (TE), Zinc (Zn), Copper (Cu), Selenium (Se), Iron (Fe), Chromium (Cr). Our aim was the evaluation of serum TE in patients who underwent PEG and its relationship with serum proteins, BMI and nature of underlying disorder.
METHODS: A prospective observational study was performed collecting: patient's age, gender, underlying disorder, NRS-2002, BMI, serum albumin, transferrin and TE concentration. We used ferrozine colorimetric method for Fe; Inductively Coupled Plasma-Atomic Emission Spectroscopy for Zn/Cu; Furnace Atomic Absorption Spectroscopy for Se/Cr. The patients were divided into head and neck cancer (HNC) and neurological dysphagia (ND).
RESULTS: 146 patients (89 males), 21-95 years: HNC-56; ND-90. Low BMI in 78. Low values mostly for Zn (n = 122) and Fe (n = 69), but less for Se (n = 31), Cu (n = 16), Cr (n = 7); low albumin in 77, low transferrin in 94 and 66 with both proteins low. Significant differences between the groups of underlying disease only for Zn (t140.326 = -2,642, p < 0.01) and a correlation between proteins and TE respectively albumin and Zn (r = 0.197, p = 0.025), and albumin and Fe (r = 0.415, p = 0.000).
CONCLUSIONS: When gastrostomy was performed, patients display low serum TE namely Zn, but also Fe, less striking regarding others TE. It was related with prolonged fasting, whatever the underlying disease. Low proteins were associated with low TE. Teams taking care of PEG-patients should use Zn supplementation and include other TE evaluation as part of the nutritional assessment of PEG candidates.
Description
Keywords
HSM MED Biomarkers/blood Combined Modality Therapy Deficiency Diseases/diagnosis Deficiency Diseases/epidemiology Deficiency Diseases/etiology Deficiency Diseases/prevention & control Deglutition Disorders/blood Deglutition Disorders/physiopathology Deglutition Disorders/surgery Deglutition Disorders/therapy Enteral Nutrition Gastrostomy Nutrition Assessment Nutritional Status Portugal/epidemiology Prospective Studies Protein-Energy Malnutrition/diagnosis Protein-Energy Malnutrition/epidemiology Protein-Energy Malnutrition/etiology Protein-Energy Malnutrition/prevention & control Risk Spectrophotometry, Atomic Trace Elements/blood Trace Elements/deficiency
Citation
Clin Nutr. 2016 Jun;35(3):718-23