Vitamin E status of patients receiving long-term parenteral nutrition: is vitamin E supplementation adequate?
Vitamin E status of eight patients receiving total parenteral nutrition (TPN), including 10 IU of all-racemic alpha-tocopheryl acetate daily and Intralipid 20% (500 mL; 12 mg of RRR-alpha- and 92 mg of RRR-gamma-tocopherols) two to three times per week for 69 +/- 45 (mean +/- SD) months was assessed by measuring plasma and adipose tissue tocopherol concentrations. Plasma alpha-tocopherols of TPN patients were similar to controls (17.5 +/- 6.6 mumol/L vs 22.4 +/- 5.1), whereas gamma-tocopherols were significantly reduced (6.0 +/- 3.1 vs 11.2 +/- 3.6, p less than 0.03). The adipose tissue alpha- and gamma-tocopherol/triglycerides (TG) were similar (369 +/- 215 nmol/mmol vs 452 +/- 228, and 125 +/- 102 vs 140 +/- 130, respectively), but cholesterol/TG were increased in the TPN patients (7.8 +/- 2.5 mumol/mmol vs 5.1 +/- 3.5, p less than 0.05), suggesting that adipose tissue was relatively TG-depleted and tocopherol/cholesterol measurements better reflect vitamin E status. The mean alpha-tocopherol/cholesterol ratios were significantly lower in the TPN patients than the controls (55 +/- 36 vs 106 +/- 63, p less than 0.04). Thus, current vitamin E supplementation of TPN patients seems insufficient for maintenance of adequate tissue stores.
Steephen
A C
AC
GI-Nutrition Service Department of Medicine, Memorial Sloan-Kettering Cancer Center, Cornell University Medical College, NY 10021.
Traber
M G
MG
Ito
Y
Y
Lewis
L H
LH
Kayden
H J
HJ
Shike
M
M
D000273:Adipose Tissue / Q000737:chemistry; D000328:Adult; D000368:Aged; D002784:Cholesterol / Q000032:analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010289:Parenteral Nutrition, Total / Q000592:standards*; D014280:Triglycerides / Q000032:analysis; D014810:Vitamin E / Q000008:administration & dosage* / Q000032:analysis / Q000097:blood
D014280:Triglycerides; D014810:Vitamin E; D002784:Cholesterol