Parenteral Selenium Supplementation in Extremely Low Birth Weight Infants: Inadequate Dosage But No Correlation With Hypothyroidism

Klinger, G; Shamir, Raanan; Singer, Pierre; Diamond, Eric; Josefsberg, Z; Sirota, Lea

doi:10.1038/sj.jp.7200273

Cited by 20 publications

(17 citation statements)

References 23 publications

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“…In reality, the abnormalities appear to be related to a decrease in peripheral deiodinase activity and therefore to decreased T3 production. Similar results were observed in phenylketonuric subjects, in patients with cystic fibrosis or in subjects nourished exclusively by the parenteral route and who are at a risk of selenium deficiency due to restricted or inadequate protein intake.…”

Section: Selenium and Thyroid Diseasessupporting

confidence: 81%

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Selenium and the thyroid gland: more good news for clinicians

Drutel

Archambeaud

Caron

2013

Clinical Endocrinology

181

137

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SummaryThe thyroid is the organ with the highest selenium content per gram of tissue because it expresses specific selenoproteins. Since the discovery of myxoedematous cretinism and thyroid destruction following selenium repletion in iodine-and seleniumdeficient children, data on links between thyroid metabolism and selenium have multiplied. Although very minor amounts of selenium appear sufficient for adequate activity of deiodinases, thus limiting the impact of its potential deficiency on synthesis of thyroid hormones, selenium status appears to have an impact on the development of thyroid pathologies. The value of selenium supplementation in autoimmune thyroid disorders has been emphasized. Most authors attribute the effect of supplementation on the immune system to the regulation of the production of reactive oxygen species and their metabolites. In patients with Hashimoto's disease and in pregnant women with anti-TPO antibodies, selenium supplementation decreases anti-thyroid antibody levels and improves the ultrasound structure of the thyroid gland. Although clinical applications still need to be defined for Hashimoto's disease, they are very interesting for pregnant women given that supplementation significantly decreases the percentage of postpartum thyroiditis and definitive hypothyroidism. In Graves' disease, selenium supplementation results in euthyroidism being achieved more rapidly and appears to have a beneficial effect on mild inflammatory orbitopathy. A risk of diabetes has been reported following long-term selenium supplementation, but few data are available on the side effects associated with such supplementation and further studies are required.

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Section: Selenium and Thyroid Diseasessupporting

confidence: 81%

“…Selenium supplements between 10 and 300 μg/day were administered on a daily basis to populations in good apparent health over 3 months, 5 months, 6 months or 12 months . In some of the studies, the subjects had selenium deficiencies; while in others, they did not …”

Section: Selenium and Thyroid Diseasesmentioning

confidence: 99%

Selenium and the thyroid gland: more good news for clinicians

Drutel

Archambeaud

Caron

2013

Clinical Endocrinology

181

137

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“…Preterm infants who are born earlier, have less selenium storage in the body and are more likely to be deficient in selenium 11 . ELBWIs have a higher risk of selenium deficiency because they tend to have shorter GA, feeding intolerance, and slow increases in enteral nutrition (EN) 18 . Recently, Rao et al 27 reported that the odds of selenium deficiency were higher in ELBWIs (odds ratio = 17.84, 95% CI [4.04–78.72]; P <.001) compared with reference birth weight infants.…”

Section: Discussionmentioning

confidence: 99%

“…However, several studies indicate that a supply of 2 mcg/kg/day of selenium is insufficient for infants, especially for preterm infants 18,19 . Also, recent guidelines suggest increasing the target supply of selenium 20–22 …”

Section: Introductionmentioning

confidence: 99%

Effect of selenium‐free parenteral nutrition on serum selenium of neonates and infants maintained on long‐term parenteral nutrition

Lee

Shin

Bae

et al. 2021

J Parenter Enteral Nutr

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Background:The risk of selenium deficiency increases for infants receiving long-term parenteral nutrition (PN). This study analyzed selenium deficiency in neonates and infants requiring long-term PN and evaluated the effect of intravenous (IV) selenium provision. Methods:This study was a retrospective study of neonates and infants who were admitted to a neonatal intensive care unit from January 2010 to December 2019, received PN for ≥2 weeks, and had their serum selenium concentration measured.Patients were divided into two groups, depending on their serum selenium concentration, a deficient group (n = 55) and a nondeficient group (n = 47).Results: Of the study participants, 53.9% (55 of 102) were deficient in selenium. No difference in demographic and clinical characteristics existed except bronchopulmonary dysplasia. A subgroup analysis was performed for patients (n = 29). The average dose of IV selenium administered to patients was 2.7 ± 1.0 mcg/kg/day. The average initial serum selenium concentration was 36.5 ± 18.0 mcg/L, and the serum concentration significantly increased to 52.5 ± 19.1 mcg/L after IV selenium administration (P < .001).The correlation between the average IV selenium dose and the change in serum selenium concentrations was statistically significant (r = .423; P = .022). Conclusion:Selenium deficiency is common in neonates and infants receiving longterm PN. Serum selenium concentration increased proportionally as the IV selenium dose increased. Therefore, it is recommended to supply a proper dose of IV selenium depending on the degree of selenium deficiency.

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“…Less than 10 publications regarding Se deficiency and treatment in preterm and extremely preterm populations were identified when performing a literature search for this review and the majority of the identified publications were prospective observational studies performed in countries with low plasma Se concentrations in the general population. Two studies included infants born in the United States 8 , two included extremely premature infants 8, 40 , and one reported data including extremely low birth weight infants 40 . By far the largest study was published by Darlow et al in 2000 and included 534 infants 41 .…”

Section: Studies In Preterm Infantsmentioning

confidence: 99%

Selenium: implications for outcomes in extremely preterm infants

Tindell

Tipple

2018

J Perinatol

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Extremely preterm infants are at high risk for morbidities including bronchopulmonary dysplasia, intraventricular hemorrhage, and retinopathy of prematurity likely related to their exposure to reactive oxygen and nitrogen species early in life. Selenium is a trace mineral contributes to the proper function of multiple systems including immunity, redox regulation, and inflammation via the "selenoenzymes" glutathione peroxidase, thioredoxin reductase, and selenoprotein P. Given that selenium accretion via the placenta occurs primarily during the third trimester, preterm neonates are born selenium deficient. While the role of selenium in animals and adults is better described, publications are lacking in the neonatal population regarding consequences of selenium deficiency or toxicity, accurate monitoring of levels, and proper enteral and parental dosages. This review highlights the role of selenium as it relates to the optimal function of antioxidant systems in extremely preterm infants in order to highlight the gaps in knowledge as it relates to the pathogenesis and prevention of morbidities in this population.

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Parenteral Selenium Supplementation in Extremely Low Birth Weight Infants: Inadequate Dosage But No Correlation With Hypothyroidism

Cited by 20 publications

References 23 publications

Selenium and the thyroid gland: more good news for clinicians

Selenium and the thyroid gland: more good news for clinicians

Effect of selenium‐free parenteral nutrition on serum selenium of neonates and infants maintained on long‐term parenteral nutrition

Selenium: implications for outcomes in extremely preterm infants

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