Document Detail


Copper supplementation in parenteral nutrition of cholestatic infants.
MedLine Citation:
PMID:  20400915     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: Conventional practice is to reduce or eliminate copper (Cu) supplementation in the parenteral nutrition of infants with cholestasis because of the increased risk of hepatotoxicity. However, there are reports of Cu deficiency in cholestatic infants because of Cu reduction in their parenteral nutrition. The objectives of the present study are to determine the proportion of cholestatic infants who develop elevated serum Cu while receiving a nonreduced dose of parenteral Cu, to evaluate potential clinical factors that affect serum Cu in cholestatic infants, and to evaluate the impact of serum Cu on liver disease.
PATIENTS AND METHODS: This is a retrospective review of 28 cholestatic infants receiving 20 microg x kg(-1) x day(-1) of Cu via parenteral nutrition. Age-adjusted references were used to determine normality of serum Cu levels. Multiple linear regression analyses were performed to determine predictors of serum Cu and alanine aminotransferase (ALT).
RESULTS: Serum Cu levels were elevated in 2 infants (7%). On average, infants received 80% of their energy intake from parenteral nutrition for 3 months. Intestinal failure was present in 50% of the patients. Birth weight, gestational age, and ALT were identified as predictors of serum Cu (R2 = 0.53; P = 0.0001). Serum Cu, gestational age, and total bilirubin were associated with serum ALT (R2 = 0.43; P = 0.001).
CONCLUSIONS: Supplementation of parenteral Cu at 20 microg x kg(-1) x day(-1) does not lead to a significant increase in Cu toxicity or worsening of liver disease in cholestatic infants.
Authors:
Juliana Frem; Yvonne Sarson; Tom Sternberg; Conrad R Cole
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of pediatric gastroenterology and nutrition     Volume:  50     ISSN:  1536-4801     ISO Abbreviation:  J. Pediatr. Gastroenterol. Nutr.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-26     Completed Date:  2010-11-23     Revised Date:  2014-09-08    
Medline Journal Info:
Nlm Unique ID:  8211545     Medline TA:  J Pediatr Gastroenterol Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  650-4     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Alanine Transaminase / blood
Bilirubin / blood
Birth Weight
Cholestasis / blood*
Copper / administration & dosage,  adverse effects*,  blood
Dietary Supplements*
Energy Intake
Gestational Age
Humans
Infant
Intestinal Diseases
Liver Diseases / blood*
Parenteral Nutrition / methods*
Regression Analysis
Retrospective Studies
Grant Support
ID/Acronym/Agency:
1KL2RR025009/RR/NCRR NIH HHS; 5K12RR017643/RR/NCRR NIH HHS; M01 RR000039/RR/NCRR NIH HHS; M01 RR000039-475518/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
789U1901C5/Copper; EC 2.6.1.2/Alanine Transaminase; RFM9X3LJ49/Bilirubin
Comments/Corrections

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