Resumen

MENENDEZ, A. M.ª et al. Influence of zinc administered by total parenteral nutrition on plasmatic zinc levels, on reactive C protein, on serum interleukin-6 and on serum interleukin-6 soluble receptor, in critical patients. Nutr. Hosp. [online]. 2009, vol.24, n.3, pp.340-346. ISSN 1699-5198.

Objectives: To study the interrelationship between serum Interleukin-6 (IL-6), serum Interleukin-6 soluble Receptor (IL-6 sR), C-Reactive Protein (C-RP), plasmatic Zinc levels (PlZn) and their response in relation to Zn administered by TPN, in critical patients. Methods: 17 patients, receiving TPN as a consequence of acute pancreatitis (n = 4) or after a major abdominal surgery due to intestinal cancer (n = 7), intestinal fístula (n = 3), intestinal obstruction (n = 2) or intestinal íleus (n = 1) were studied. At the beginning (To) and at the end of the TPN administration (6-21days) serum IL-6 and IL-6 sR were determined by ELISA; C-RP ultrasensitive (C-RP us) by inmunoturbidimetric method; Zn was determined in TPN and in plasma by Atomic Absorption Spectrometry. Characteristics of the patients were (mean ± SD and ranges): age: 60.6 ± 11.7 (37-77) years; BMI (kg/m²): 26.0 ± 3.4 (19.9-34.0). Results: The results (mean ± standard deviation and ranges) were: Zn provided by TPN (mg/d): 6.1 ± 2.0 (range 2.8 to 10.8). Biochemical levels were, at To and Tf, respectively: (mean±SD and ranges) were at To y Tf, respectively: Zn Pl (μg/dl): 104 ± 46 (35-177); 120 ± 55 (52-229); IL-6 (pg/mL) 93 ± 74 (10-262); 117 ± 180 (7-761); IL6sR (pg/mL): 1,012 ± 322 (589-1855); 1,269 ± 451 (631-2195); C-RP us (mg/L): 71 ± 63 (2-196); 65 ± 43 (0-137). There was no correlation between variations of IL6, IL6sR, C-RP, PlZn levels and the daily amount of Zn administered in the TPN mixtures. Two patients presented a bad evolution; they received 4.2 and 5.2 md/d of Zn and showed an increase of IL6 levels, maintained high levels of IL6sR but C-RP levels decreased. Conclusions: the range of 2.8 to 10.8 mg/d of Zn administered in TPN mixtures did not exacerbate the inflammatory response.

Palabras clave : Zinc; Critically ill patients with parenteral nutrition; Interleukin-6; Soluble receptor of interleukin-6, and C reactive protein.

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