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Serum trace elements in dysphagic gastrostomy candidates before endoscopic gastrostomy for long term enteral feeding
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Resumo(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), 21e95 years: HNC-56; ND-90. Low BMI in 78. Low values mostly for Zn
(n ¼ 122) and Fe (n ¼ 69), but less for Se (n ¼ 31), Cu (n ¼ 16), Cr (n ¼ 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 ¼ 2,642, p < 0.01) and a correlation between proteins and TE respectively
albumin and Zn (r ¼ 0.197, p ¼ 0.025), and albumin and Fe (r ¼ 0.415, p ¼ 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.
Descrição
Palavras-chave
Trace elements Dysphagia PEG Gastrostomy Nutrition
Contexto Educativo
Citação
Santos CA, et al., Serum trace elements in dysphagic gastrostomy candidates before endoscopic gastrostomy for long term enteral feeding, Clinical Nutrition (2015), http://dx.doi.org/10.1016/j.clnu.2015.05.006
Editora
Elsevier