Effects of trace elements supplementation for parenteral nutrition on serum trace element levels in preterm low birth weight infants

GU Ying-fen; FU Huan-huan; JIA Xue-qi; PAN Li-ya

doi:10.20251/j.cnki.1003-3734.2025.04.011

Abstract：Objective:To evaluate the efficacy and safety of multi-trace element injection I[MTEI-(I)]for parenteral nutrition in preterm low birth weight(LBW)infants.Methods:From March 2020 to August 2020,infants with GA<37 weeks and BW<2500 g admitted to NICU within 24 hours after birth were included.PN with MTEI-(I)at 1 mL·kg-1·d-1 was administered to the infants.The serum trace element levels were detected by ICP-MS pre-and post-supplementation.The body weight was daily measured.The body length,head circumference,pre-albumin(pre-ALB),albumin(ALB),C-reactive protein(CRP),procalcitonin(PCT),routine blood tests,liver and kidney functions and adverse drug reactions(ADR)were monitored.Results:A total of 43 preterm infants were enrolled,including 22 male infants(51.2% )and 21 female infants(48.8% )with GA of(31.4±2.4)weeks and BW of 1430(1 200,1830)g.Administration of MTEI-(I)in parenteral nutrition was initiated 2(1,2)days after birth,and continued for 11(9,17)days.Serum Cu and Se levels were significantly higher than those pre-parenteral nutrition(P<0.05),whereas serum Mn levels were significantly lower than those before(P<0.05).No significant differences were observed in serum Zn levels(P>0.05).A significant positive correlation between serum Zn levels after supplementation and weight growth velocity in hospitalized preterm LBW infants was found(P<0.05).Serum Se levels were positively correlated with weight and weight-for-age z scores at discharge(P<0.05).After MTEI-(I)was administered,PCT,aspartate transaminase(AST),gamma glutamyl-transferase(GGT),total bilirubin(TB),and blood urea nitrogen(BUN)were significantly lower(P<0.05),while pre-ALB,alkaline phosphatase(ALP),direct bilirubin(DB),and creatinine(Cr)were significantly higher(P<0.05).No significant ADR were observed except for one infant with parenteral nutrition-associated cholestasis(PNAC).Conclusion:Parenteral supplementation of MTEI-(I)at 1 mL·kg-1·d-1 is safe for preterm LBW infants and might increase serum Cu levels,maintain the levels of serum Zn and Se,and improve serum Mn levels.