Annals of Clinical Nutrition and Metabolism

Micronutrient deficiencies in copper, zinc, and vitamin D as predictors of clinical outcomes in critically ill surgical patients in Korea: a retrospective cohort study: Jiae Kim, Yanghee Jun, Ye Rim Chang, Jong-Kwan Baek, Hak-Jae Lee, Hyewon Han, Suk-Kyung Hong; Ann Clin Nutr Metab 2024;16(3):158-167. Published online December 1, 2024; DOI: https://doi.org/10.15747/ACNM.2024.16.3.158

Abstract PDF ePub: Purpose: To investigate the prevalence of copper, zinc, and vitamin D deficiencies in surgical intensive care unit (SICU) patients and the associations between those deficiencies and clinical outcomes.
Methods: We conducted a retrospective study of 210 patients admitted to the SICU of Asan Medical Center between June 2020 and June 2022. Micronutrient levels were measured within 7 days of SICU admission. Primary outcomes were the mortality rate, length of SICU stay, hospital stay duration, and mechanical ventilation duration.
Results: Copper deficiency was found in 35% (68/193), zinc deficiency in 52% (100/193), and severe vitamin D deficiency in 46% (82/179) of patients. Copper-deficient patients showed a significantly higher mortality rate (25.0% vs. 12.8%, P=0.044), longer hospital stays (57.8±47.0 vs. 45.2±36.6 days, P=0.041), and extended mechanical ventilation duration (26.9±23.3 vs. 18.8±15.7 days, P=0.012). Zinc deficiency was associated with higher C-reactive protein levels (16.2±9.5 vs. 11.5±8.8 mg/dL, P=0.001) and lower prealbumin levels (6.5±2.8 vs. 9.9±5.6 mg/dL, P<0.001). Severe vitamin D deficiency (<10 ng/mL) was not significantly associated with mortality or other clinical outcomes (mortality: <10 ng/mL vs. ≥10 ng/mL, 13% vs. 18%, P=0.583).
Conclusion: Micronutrient deficiencies are prevalent in SICU patients. Copper deficiency significantly correlated with poor clinical outcomes, and zinc deficiency showed a strong association with inflammatory markers. Early assessment and supplementation of micronutrients could be beneficial for critically ill surgical patients.

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Drug-Induced Vitamin Deficiency: Jung Won Jung, So Young Park, Hyunah Kim; Ann Clin Nutr Metab 2022;14(1):20-31. Published online June 1, 2022; DOI: https://doi.org/10.15747/ACNM.2022.14.1.20

Drug-induced vitamin depletion can occur in hospitalized patients due to the administration of specific medications, which could potentially adversely affect patient outcomes. Signs and symptoms related to vitamin deficiency while taking certain medications should be monitored carefully and managed appropriately if those deficiencies are clinically significant. This article reviews potential drug-induced vitamin depletion and discusses the evidence supporting vitamin deficiency related to the use of specific medications.

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Vitamin D Deficiency is Prevalent in Short Bowel Syndrome Patients on Long-Term Parenteral Nutrition Support: SungHyo An, Sanghoon Lee, Hyun-Jung Kim, Hyo Jung Park, Jeong-Meen Seo; J Clin Nutr 2021;13(1):12-16. Published online June 30, 2021; DOI: https://doi.org/10.15747/jcn.2021.13.1.12

Abstract PDF ePub: Purpose: Short bowel syndrome (SBS) is the most common etiology for intestinal failure (IF) and these patients are at high risk of developing micronutrient deficiencies. This study aimed at assessing the level of vitamins in adult SBS patients at different stages of their disease before the initiation of multidisciplinary intestinal rehabilitation.
Methods: Patient data from November 2015 to March 2017 were retrospectively reviewed. Adult patients who underwent extensive bowel resection and were classified as SBS-IF were selected. Clinical data including age, sex, etiology of IF, biochemical data, nutritional status, nutrition support, and outcome of intestinal rehabilitation were analyzed.
Results: Nine patients with SBS-IF were included in the analysis. There were 6 male patients and 3 female patients, with a median age of 55.0 years. Vitamin levels were analyzed at 306 days (median) after the development of SBS. At the time of vitamin levels screening, 4 patients were receiving daily intravenous vitamin supplementation. Five patients were not receiving vitamin supplementations, either intravenously or orally. Vitamin B12 was within the normal range in 6 patients and higher than normal in 3 patients. Vitamin D was within the normal range in 3 patients and lower than normal in 6 patients. Vitamin E was within the normal range in 7 patients and higher than normal in 2 patients. Folate was within the normal range in 8 patients (not checked in 1 patient). Ambulatory patients had significantly higher vitamin D levels compared to hospitalized patients (P=0.015).
Conclusion: Vitamin D levels had decreased in 67% of patients with SBS in Korea, while vitamin B12, folate, and vitamin E deficiencies were rarely seen.

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Risk Factor of Anemia after a Gastrectomy in Patients with Gastric Cancer: In Jun Yang, Dong-Wook Kim, Ye Seob Jee; Surg Metab Nutr 2019;10(1):15-19. Published online June 30, 2019; DOI: https://doi.org/10.18858/smn.2019.10.1.15

Abstract PDF ePub

Purpose:

In this study, we evaluate hematologic change of iron and vitamin B₁₂ on post-operative anemia after gastrectomy for gastric cancer.

Materials and Methods:

The patients with gastric cancer who underwent gastrectomy between January 2013 and December 2013 in Dankook university hospital were retrospectively reviewed. The 62 patients were followed up for 36 month postoperatively.

Results:

The incidences of anemia in female patients were turned out to be higher than those in male patients but there were no statistical difference; (44.4% vs 40.9%, P=0.399) at 6 month, (33.3% vs 25.0%, P=0.252) at 12 month, (22.2% vs 15.9%, P=0.277) at 18 month, (27.8% vs 15.9%, P=0.142) at 36 month after surgery. Patients with distal gastrectomy after the surgery showed decreasing incidence of anemia while patients with total gastrectomy showed decreasing incidence of anemia until 12 months but increasing incidence after that time.

Conclusion:

Anemia, Vitamin B₁₂ and iron deficiency must be evaluated after surgery for gastric cancer and active treatment is necessary as needed.