Manganese intake and cholestatic jaundice in neonates receiving parenteral nutrition: a randomized controlled study
| Autor: | K. K.M. Chui, Pak-Cheung Ng, T. F. Fok, R. Cheung, K. L. Cheung, M. Hjelm |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
medicine.medical_specialty
business.industry chemistry.chemical_element General Medicine Manganese Jaundice medicine.disease Gastroenterology law.invention Surgery Parenteral nutrition Randomized controlled trial chemistry Cholestasis law Interquartile range Internal medicine Statistical significance Pediatrics Perinatology and Child Health medicine medicine.symptom business Complication |
| Zdroj: | Acta Paediatrica. 90:1009-1015 |
| ISSN: | 0803-5253 |
| DOI: | 10.1111/j.1651-2227.2001.tb01356.x |
| Popis: | UNLABELLED Infants requiring parenteral nutrition (n = 244) were randomized to receive either 1 (group 1, n = 121) or 0.0182 micromol/kg/d (group 2, n = 123) of manganese supplementation. The whole-blood manganese and serum direct bilirubin concentrations of the infants were monitored, as was the development of cholestasis (peak serum direct bilirubin concentration >50 micromol/L). Subgroup analysis was carried out on the data of 78 infants in group 1 and 82 in group 2 who had received manganese supplementation and more than three-quarters of their total daily fluid as parenteral nutrition for >14 d. Of all the infants randomized, the high manganese group (group 1) showed a trend towards developing higher peak whole-blood manganese concentration [group 1 versus group 2: median (interquartile range): 606.0 (421.0; 1005.0) vs 566.0 (336.0: 858.0); p=0.061] and higher peak serum direct bilirubin concentration [37.0 (10.5; 122.5) vs 19.0 (8.0; 112.5); p=0.153], but the differences between the 2 groups did not reach statistical significance. The 2 groups did not differ in terms of the occurrence of cholestasis during parenteral nutrition (63/121 vs 57/123; p=0.444). Subgroup analysis of infants who had received more than three-quarters of their total daily fluid as parenteral nutrition showed, however, that the high manganese group developed significantly higher whole-blood manganese concentration [743.5 (498.0; 1211.0) vs 587.0 (438.0; 982.0); p=0.037] and serum direct bilirubin concentration [84.0 (28.0; 170.0) vs 25.5 (9.0; 117.0): p 100 micromol/L (32/78 vs 20/82; p = 0.038). CONCLUSION We conclude that the pathogenesis of parenteral nutrition-related cholestasis is probably multifactorial, and that high manganese intake is a significant contributory factor. |
| Databáze: | OpenAIRE |
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