Copper Supplement with Cocoa for Copper Deficiency in Patients with Long-Term Enteral Nutrition.

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  • 長期経腸栄養患者の銅欠乏に対する，ココアによる銅補充及び維持療法の検討
  • チョウキ ケイチョウ エイヨウ カンジャ ノ ドウ ケツボウ ニ タイスル ココア ニ ヨル ドウ ホジュウ オヨビ イジ リョウホウ ノ ケントウ

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Abstract

Copper deficiency (normal serum copper level: 78-136μg/dl) has been reported in patients with long-term enteral nutrition, caused by a copper deficit in enteral nutrition. Occasionally, this leads to anemia and leukopenia. We used Hersheys' pure cocoa that is rich in copper (content 3.8mg/cocoa 100g) for copper deficiency. A total of 86 (40 men and 46 women, mean age 69 years) patients on enteral nutrition were studied. The primary diseases were cerebral vascular disease in 71 patients, neurological disease in 5 and others in 10. Those who showed serum copper levels of 20μg/dl or less (N=8) were given 30-45g of cocoa (copper content 1.14-1.71mg) per day for about 40 days. Among them, two patients could not continue because of vomiting and diarrhea and were excluded from this study. Mean serum copper levels increased from 8.7±6.2 to 99.0±25.4μg/dl (N=6). Those who showed serum copper levels 20-77mg/dl (N=31) were given 10g of cocoa (copper content 0.38mg) per day for about 40 days. When mean serum copper levels increased from 50.5±19.3 to 89.0±12.9μg/dl with cocoa administration, anemia and neutropenia caused by copper deficiency showed a tendency to improve. After completing the study period, cocoa was reduced to 5g (copper content 0.19mg) per day in 23 patients. The mean serum copper levels increased from 90.7±10.4 to 100.6±17.1μg/dl for about 100 days. Recently, the amount of daily copper requirement for adults has been reported to be 1.28-2.5mg per day. We showed that 10g of cocoa (0.6mg total copper: 0.38mg in cocoa and 0.22mg in other nutrients) is sufficient to treat copper deficiency, and 5g of cocoa (0.37mg total copper: 0.19mg in cocoa and 0.18mg in other nutrients) is enough to maintain the normal level of serum copper in patients with long-term enteral nutrition.

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