Response to a single oral dose of all-rac-alpha-tocopheryl acetate in patients with cystic fibrosis and in healthy individuals.
Biochemical vitamin E deficiency and low plasma lipids are frequent findings in patients with cystic fibrosis (CF). The response to a single oral dose of all-rac-alpha-tocopheryl acetate [100 IU (100 mg)/kg body wt] was studied over 24 h in 25 CF patients with exocrine pancreatic insufficiency and in 23 healthy individuals. Patients received pancreatic enzymes together with the vitamin E test dose. At baseline, plasma alpha-tocopherol concentrations correlated with cholesterol concentrations; both were lower in patients than in control subjects, as were erythrocyte alpha-tocopherol concentrations (all P < 0.0001). Plasma and erythrocyte alpha-tocopherol concentrations were significantly higher than baseline concentrations from 3 and 6 h onward, respectively, and peaked most frequently at 6 and 12 h, respectively, in both patients and control subjects. Maximum increases and areas under the concentration time curves for plasma alpha-tocopherol concentrations were smaller in patients than in control subjects (P < 0.0001). When ratios of plasma alpha-tocopherol to cholesterol (to correct for differences in cholesterol concentrations) or erythrocyte alpha-tocopherol concentrations were applied, patients were shown to respond as efficiently as control subjects. On the basis of these results, we recommend vitamin E supplements in doses high enough to achieve vitamin E status in CF patients well within the range of healthy individuals; these supplements should be given with appropriate amounts of pancreatic enzymes. However, for long-term supplementation much lower doses than those used in this test situation may be sufficient.
Winklhofer-Roob
B M
BM
Division of Gastroenterology and Nutrition, Department of Pediatrics, University of Zurich, Switzerland.
Tuchschmid
P E
PE
Molinari
L
L
Shmerling
D H
DH
D000042:Absorption; D000284:Administration, Oral; D000328:Adult; D000975:Antioxidants / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000627:therapeutic use; D001692:Biological Transport; D002648:Child; D002784:Cholesterol / Q000097:blood*; D003550:Cystic Fibrosis / Q000097:blood* / Q000150:complications / Q000378:metabolism; D004305:Dose-Response Relationship, Drug; D004912:Erythrocytes / Q000378:metabolism; D005260:Female; D006801:Humans; D008049:Lipase / Q000627:therapeutic use; D008055:Lipids / Q000097:blood; D008297:Male; D010184:Pancreatic Extracts / Q000627:therapeutic use; D020799:Pancrelipase; D024505:Tocopherols; D014810:Vitamin E / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000097:blood* / Q000493:pharmacokinetics / Q000627:therapeutic use; D014811:Vitamin E Deficiency / Q000097:blood / Q000188:drug therapy / Q000209:etiology; D024502:alpha-Tocopherol / Q000031:analogs & derivatives*
D000975:Antioxidants; D008055:Lipids; D010184:Pancreatic Extracts; D014810:Vitamin E; D020799:Pancrelipase; D002784:Cholesterol; D008049:Lipase; D024502:alpha-Tocopherol; D024505:Tocopherols