title: Serum vitamins in adult patients with short bowel syndrome receiving intermittent parenteral nutrition.
abstract: BACKGROUND
  Short bowel syndrome (SBS) occurs after massive intestinal resection, and parenteral nutrition (PN) therapy may be necessary even after a period of adaptation. The purpose of this study was to determine the vitamin status in adults with SBS receiving intermittent PN.
  
  
  METHODS
  The study was conducted on hospitalized adults with SBS who were receiving intermittent PN therapy (n = 8). Nine healthy volunteers, paired by age and sex, served as controls. Food ingestion, anthropometry, plasma folic acid, and vitamins B(12), C, A, D, E, and K were evaluated.
  
  
  RESULTS
  The levels of vitamins A, D, and B(12) in both groups were similar. SBS patients presented higher values of folic acid (21.3 ± 4.4 vs 14.4 ± 5.2, P = .01) and lower values of vitamin C (0.9 ± 0.4 vs 1.2 ± 0.3 mg/dL, P = .03), α-tocopherol (16.3 ± 3.4 vs 24.1 ± 2.7 µmol/L, P < .001), and phylloquinone (0.6 ± 0.2 vs 1.0 ± 0.5 nmol/L, P < .03). Eight-seven percent of patients had vitamin D deficiency, and all patients presented with serum vitamin E levels below reference values.
  
  
  CONCLUSIONS
  Despite all efforts to offer all the nutrients mentioned above, SBS patients had lower serum levels of vitamins C, E, and K, similar to those observed in patients on home PN. These findings suggest that the administered vitamins were not sufficient for the intermittent PN scheme and that individual adjustments are needed depending on the patient's vitamin status.
authors.affiliation: Department of Internal Medicine, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil.
authors.forename: Camila Bitu Moreno
authors.initials: CB
authors.lastname: Braga
authors.forename: Helio
authors.initials: H
authors.lastname: Vannucchi
authors.forename: Cristiana Maria Murbach
authors.initials: CM
authors.lastname: Freire
authors.forename: Júlio Sérgio
authors.initials: JS
authors.lastname: Marchini
authors.forename: Alceu Afonso
authors.initials: AA
authors.lastname: Jordão
authors.forename: Selma Freire de Carvalho
authors.initials: SF
authors.lastname: da Cunha
mesh_terms: D000328:Adult; D000368:Aged; D001205:Ascorbic Acid / Q000008:administration & dosage / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D010288:Parenteral Nutrition / Q000379:methods*; D012778:Short Bowel Syndrome / Q000473:pathology / Q000628:therapy*; D014808:Vitamin D Deficiency / Q000097:blood / Q000453:epidemiology; D014810:Vitamin E / Q000008:administration & dosage / Q000097:blood; D014811:Vitamin E Deficiency / Q000097:blood / Q000453:epidemiology; D010837:Vitamin K 1 / Q000008:administration & dosage / Q000097:blood; D014815:Vitamins / Q000008:administration & dosage / Q000097:blood*; D024502:alpha-Tocopherol / Q000008:administration & dosage / Q000097:blood
chemical_list: D014815:Vitamins; D014810:Vitamin E; D010837:Vitamin K 1; D005492:Folic Acid; D024502:alpha-Tocopherol; D001205:Ascorbic Acid