title: Vitamin E intake, α-tocopherol levels and pulmonary function in children and adolescents with cystic fibrosis.
abstract: Pancreatic insufficiency cystic fibrosis (CF) patients receive vitamin E supplementation according to CF-specific recommendations in order to prevent deficiencies. It has been suggested that higher serum α-tocopherol levels could have protective effects on pulmonary function (PF) in patients with CF. Whether current recommendations are indeed optimal for preventing deficiency and whether vitamin E has therapeutic benefits are subjects of debate. Therefore, we studied vitamin E intake as well as the long-term effects of vitamin E intake, the coefficient of fat absorption (CFA) and IgG on α-tocopherol levels. We also examined the long-term effects of serum α-tocopherol and serum IgG on forced expiratory volume in 1 s expressed as percentage of predicted (FEV₁% pred.) in paediatric CF patients during a 7-year follow-up period. We found that CF patients failed to meet the CF-specific vitamin E recommendations, but serum α-tocopherol below the 2·5th percentile was found in only twenty-three of the 1022 measurements (2 %). Furthermore, no clear effect of vitamin E intake or the CFA on serum α-tocopherol was found (both P≥ 0·103). FEV₁% pred. was longitudinally inversely associated with age (P< 0·001) and serum IgG (P= 0·003), but it was not related to serum α-tocopherol levels. We concluded that in the present large sample of children and adolescents with CF, vitamin E intake was lower than recommended, but serum α-tocopherol deficiency was rare. We found no evidence that higher serum α-tocopherol levels had protective effects on PF. Adjustment of the recommendations to the real-life intake of these patients may be considered.
authors.affiliation: Internal Medicine and Dermatology, Dietetics and, Cystic Fibrosis Centre Utrecht, University Medical Centre Utrecht,Internal Address KH.01.419.0, PO Box 85500,3508GAUtrecht,The Netherlands.
authors.forename: Janna W
authors.initials: JW
authors.lastname: Woestenenk
authors.affiliation: Department of Paediatric Pulmonology and, Cystic Fibrosis Centre Utrecht,University Medical Centre Utrecht,Internal Address KH.01.419.0, PO Box 85500,3508GAUtrecht,The Netherlands.
authors.forename: Nancy
authors.initials: N
authors.lastname: Broos
authors.affiliation: Department of Biostatistics, Julius Centre,University Medical Centre Utrecht,Internal Address STR.7.125, PO Box 85500,3508GAUtrecht,The Netherlands.
authors.forename: Rebecca K
authors.initials: RK
authors.lastname: Stellato
authors.affiliation: Department of Paediatric Pulmonology and, Cystic Fibrosis Centre Utrecht,University Medical Centre Utrecht,Internal Address KH.01.419.0, PO Box 85500,3508GAUtrecht,The Netherlands.
authors.forename: Hubertus G M
authors.initials: HG
authors.lastname: Arets
authors.affiliation: Department of Paediatric Pulmonology and, Cystic Fibrosis Centre Utrecht,University Medical Centre Utrecht,Internal Address KH.01.419.0, PO Box 85500,3508GAUtrecht,The Netherlands.
authors.forename: Cornelis K
authors.initials: CK
authors.lastname: van der Ent
authors.affiliation: Department of Paediatric Gastroenterology and Cystic Fibrosis Centre,University Medical Centre Utrecht,Internal Address KE.04.133.1, PO Box 85500,3508GAUtrecht,The Netherlands.
authors.forename: Roderick H J
authors.initials: RH
authors.lastname: Houwen
mesh_terms: D000293:Adolescent; D041923:Adolescent Development; D002648:Child; D002657:Child Development; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D015331:Cohort Studies; D003550:Cystic Fibrosis / Q000097:blood / Q000178:diet therapy* / Q000503:physiopathology; D004032:Diet / Q000009:adverse effects; D019587:Dietary Supplements; D018450:Disease Progression; D005260:Female; D006801:Humans; D007223:Infant; D007408:Intestinal Absorption; D008137:Longitudinal Studies; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D010349:Patient Compliance; D017410:Practice Guidelines as Topic; D012137:Respiratory System / Q000503:physiopathology*; D012189:Retrospective Studies; D014810:Vitamin E / Q000008:administration & dosage / Q000378:metabolism / Q000627:therapeutic use*; D014811:Vitamin E Deficiency / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D024502:alpha-Tocopherol / Q000097:blood* / Q000378:metabolism
chemical_list: D014810:Vitamin E; D024502:alpha-Tocopherol
keywords: IgG