Deficiencies in fat-soluble vitamins in long-term users of somatostatin analogue.
BACKGROUND
Somatostatin analogues are administered to control hormone hypersecretion in acromegaly and carcinoid patients. Somatostatin analogues can increase fat in the stools, which can lead to loss of fat-soluble vitamins. The effect of long-term somatostatin analogue use on vitamin levels remains unknown.


OBJECTIVE
To investigate the prevalence of fat-soluble vitamin deficiencies in long-term somatostatin analogue users.


METHODS
All acromegaly and carcinoid patients using somatostatin analogues for ≥ 18 months visiting the University Medical Center Groningen between December 2008 and April 2009 were eligible. Vitamin levels of fat-soluble vitamins in blood, clinical and vitamin-dependent laboratory parameters were collected.


RESULTS
In all, 19 acromegaly and 35 carcinoid patients were included. Twelve patients experienced steatorrhoea; two carcinoid patients experienced night blindness. Forty-two (78%) were deficient for one or more vitamins, and 32% (n = 17) had multiple deficiencies. Deficiencies for vitamin A, D, E, K1 and E in erythrocytes occurred in 6%, 28%, 15%, 63% and 58% of the patients. Prevalence of vitamin D, E and K1 deficiencies was similar in both patient groups. Treatment duration did not influence vitamin levels. The length of intestinal resection and age correlated negatively with vitamin A levels.


CONCLUSIONS
Fat-soluble vitamin deficiencies are frequent during long-term somatostatin analogue treatment. Therefore, fat-soluble vitamins should be monitored in these patients.
Department of Medical Oncology, University Medical Center Groningen, University of Groningen, The Netherlands.
H-B
HB
Fiebrich
G
G
Van Den Berg
I P
IP
Kema
T P
TP
Links
J H
JH
Kleibeuker
A P
AP
Van Beek
A M E
AM
Walenkamp
W J
WJ
Sluiter
E G E
EG
De Vries
D000172:Acromegaly / Q000188:drug therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001361:Avitaminosis / Q000139:chemically induced*; D002276:Carcinoid Tumor / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013004:Somatostatin / Q000009:adverse effects / Q000031:analogs & derivatives*; D013997:Time Factors; D014815:Vitamins / Q000097:blood*
D014815:Vitamins; D013004:Somatostatin