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The micronutrient status of patients with phenylketonuria on dietary treatment: an ongoing challenge.
[phenylketonuria]
In
phenylketonuria
(
PKU
)
,
phenylalanine-free
L-
amino
acid
supplements
are
the
major
source
of
dietary
micronutrients
.
Four
hundred
fifty-
two
retrospective
annual
/
bi
-annual
non-fasting
blood
samples
for
nutritional
markers
(
plasma
zinc
,
selenium
,
and
serum
folate
)
from
78
subjects
aged
1
-
16
years
(
median
number
of
blood
samples
:
6
,
range
1
-
14
)
were
analysed
over
12
years
.
Longitudinal
blood
result
data
were
available
for
51
subjects
(
65
%
)
.
The
dietary
intake
from
supplements
was
calculated
.
The
median
intakes
of
all
of
the
micronutrients
studied
were
>
200
%
of
the
reference
nutrient
intakes
(
RNI
)
.
There
was
no
statistical
correlation
between
dietary
intake
and
nutritional
markers
outside
of
the
normal
reference
range
(
RR
)
except
for
selenium
,
but
there
was
a
correlation
between
a
lower
plasma
zinc
,
plasma
selenium
and
haemoglobin
status
and
better
blood
phenylalanine
control
in
1
-
to
4
-
year
-old
children
.
On
at
least
one
occasion
,
the
individual
plasma
concentrations
of
zinc
(
71
%
,
n
=
54
/
76
)
and
selenium
(
21
%
,
n
=
16
/
75
)
were
below
the
RR
;
however
,
the
concentrations
of
selenium
(
41
%
,
n
=
31
/
75
)
and
serum
folate
(
83
%
,
n
=
34
/
41
)
were
also
above
the
RR
.
Dietary
intakes
exceeded
the
upper
tolerable
intakes
for
zinc
and
copper
(
32
%
,
n
=
25
)
and
folate
(
65
%
,
n
=
51
)
.
Individual
longitudinal
data
demonstrated
little
change
in
micronutrient
status
over
time
.
In
PKU
,
biochemical
micronutrient
deficiencies
are
common
despite
micronutrient
intakes
above
the
RNI
.
Further
study
of
the
nutritional
profiling
of
L-
amino
acid
supplements
in
PKU
is
needed
.
©
2014
S
.
Karger
AG
,
Basel
.
Diseases
Validation
Diseases presenting
"blood phenylalanine control"
symptom
phenylketonuria
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