# Study of element concentrations in blood serum of patients receiving parenteral nutrition using total reflection X-ray fluorescence analysis

**Authors:** Monika Pierzak-Stępień, Aldona Kubala-Kukuś, Dariusz Banaś, Ilona Stabrawa, Jolanta Wudarczyk-Moćko, Karol Szary, Monika Biernacka, Milena Piotrowska, Dariusz Pasieka, Natalia Wojtaś, Andrzej Dąbrowski, Stanisław Głuszek, Satish Rojekar, Satish Rojekar, Satish Rojekar

PMC · DOI: 10.1371/journal.pone.0341090 · PLOS One · 2026-02-02

## TL;DR

This study used X-ray fluorescence to measure element concentrations in blood serum of patients receiving parenteral nutrition and compared them to a control group.

## Contribution

The study identifies significant changes in element concentrations due to parenteral nutrition and explores correlations between elements.

## Key findings

- Parenteral nutrition caused a significant increase in selenium and decrease in copper concentrations.
- Differences in element concentrations were observed between the studied and control groups for several elements.
- Positive correlations were found between sulfur and calcium, and between zinc and selenium in all groups.

## Abstract

Total reflection X-ray fluorescence (TXRF) analysis was used to determine element concentrations in blood serum samples of patients receiving parenteral nutrition. The concentrations of elements were measured in the serum samples two times, namely in the first day (measurement I) of the treatment and on the seventh day (measurement II) after nutrient supplementation. For comparison purposes, also serum samples of 50 patients without nutritional disorders, admitted to a planned cholecystectomy (surgical procedure of the gall bladder removal), were analyzed and treated as the control group. Descriptive statistics of measured concentrations of P, S, Cl, K, Ca, Cr, Fe, Cu, Zn, Se, and Br were determined both for the studied and control groups. Statistical analysis of the results concentrates on verifying the type of element concentration distributions. Next, the comparison of element concentration between groups of women and men was done. Parenteral nutrition resulted in a significant increase in supplemented Se and a decrease in Cu concentrations between measurement I and II. Parametric as well as nonparametric approaches were applied to verify the hypothesis. Additionally, it was found out that for some elements differences between the studied and control groups can be observed (P, S, Ca, Fe, Cu, Zn, Se, Br). The analyses were also performed taking into account the gender of the patients. Correlation coefficients were calculated for the studied and control groups as regards the determined elements. It was observed that in all groups positive correlations were obtained between S and Ca, and for Zn and Se. In studied and control groups a negative correlation between Ca and Cr was obtained. This paper discusses also prediction of trace element concentrations following seven days of parenteral nutrition therapy, based on the knowledge of various anthropometric, biochemical and immunological parameters describing the patient’s condition. The procedure is discussed for Br concentration.

## Linked entities

- **Chemicals:** Se (PubChem CID 5460640), Cu (PubChem CID 23978), P (PubChem CID 139579), S (PubChem CID 3015009), Cl (PubChem CID 312), K (PubChem CID 813), Ca (PubChem CID 271), Cr (PubChem CID 23976), Fe (PubChem CID 23925), Zn (PubChem CID 23994), Br (PubChem CID 259)

## Full-text entities

- **Genes:** UQCC6 (ubiquinol-cytochrome c reductase complex assembly factor 6) [NCBI Gene 728568] {aka BR, BRAWNIN, C12orf73}, CP (ceruloplasmin) [NCBI Gene 1356] {aka AB073614, CP-2}, CRP (C-reactive protein) [NCBI Gene 1401] {aka PTX1}, USB1 (U6 snRNA biogenesis phosphodiesterase 1) [NCBI Gene 79650] {aka C16orf57, HVSL1, Mpn1, PN, hMpn1, hUsb1}, HAMP (hepcidin antimicrobial peptide) [NCBI Gene 57817] {aka HEPC, HFE2B, LEAP1, PLTR}, ALB (albumin) [NCBI Gene 213] {aka FDAHT, HSA, PRO0883, PRO0903, PRO1341}
- **Diseases:** cholecystitis (MESH:D002764), micronutrient deficiencies (MESH:D007153), anorexia (MESH:D000855), cholecystectomy (MESH:D017562), inflammatory (MESH:D007249), refeeding syndrome (MESH:D055677), burns (MESH:D002056), nutritional disorders (MESH:D009748), intestinal obstruction (MESH:D007415), malnutrition (MESH:D044342), dehydration (MESH:D003681), coma (MESH:D003128), weight loss (MESH:D015431), acute pancreatitis (MESH:D010195), Hodgkin's lymphoma (MESH:D006689), malabsorption syndromes (MESH:D008286), hemorrhages (MESH:D006470), hemolysis (MESH:D006461), ketosis (MESH:D007662), Cancer (MESH:D009369), PN (MESH:C565820), bulimia (MESH:D002032), bladder (MESH:D001745), anemia (MESH:D000740), eating disorders (MESH:D001068), body mass loss (MESH:C536030)
- **Chemicals:** Water (MESH:D014867), Br (MESH:D001966), folic acid (MESH:D005492), Se (MESH:D012643), Sr (MESH:D013324), selenite (MESH:D020887), F (MESH:D005461), Mn (MESH:D008345), Pb (MESH:D007854), I (MESH:D007455), Copper (MESH:D003300), Rb (MESH:D012413), urea (MESH:D014508), Carbohydrates (MESH:D002241), sorbitol (MESH:D013012), K (MESH:D011188), Mo (MESH:D008982), xylitol (MESH:D014993), silicon (MESH:D012825), phosphates (MESH:D010710), C (MESH:D002244), Zinc (MESH:D015032), Ni (MESH:D009532), P (MESH:D010758), Fe (MESH:D007501), Chromium (MESH:D002857), S (MESH:D013455), cysteine (MESH:D003545), sulfur amino acids (MESH:D000603), Na (MESH:D012964), methionine (MESH:D008715), Addamel (-), Cl (MESH:D002713), amino acids (MESH:D000596), sodium selenite (MESH:D018038), Mg (MESH:D008274), Ga (MESH:D005708), Glucose (MESH:D005947), sugars (MESH:D000073893), nitrogen (MESH:D009584), quartz (MESH:D011791), Lipid (MESH:D008055), Ca (MESH:D002118)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## References

26 references — full list in the complete paper: https://tomesphere.com/paper/PMC12863542/full.md

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Source: https://tomesphere.com/paper/PMC12863542