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Vitamin E Status of Patients Receiving Long-Term Parenteral Nutrition: Is Vitamin E Supplementation Adequate?

GI-Nutrition Service Department of Medicine, Memorial Sloan-Kettering Cancer Center, Cornell University Medical College

Maret G. Traber, PHD

Department of Medicine, New York University School of Medicine, New York

Yasushi Ito, MD

GI-Nutrition Service Department of Medicine, Memorial Sloan-Kettering Cancer Center, Cornell University Medical College

Lynn Hornsby Lewis, MD

GI-Nutrition Service Department of Medicine, Memorial Sloan-Kettering Cancer Center, Cornell University Medical College

Herbert J. Kayden, MD

Department of Medicine, New York University School of Medicine, New York

Moshe Shike, MD

GI-Nutrition Service Department of Medicine, Memorial Sloan-Kettering Cancer Center, Cornell University Medical College

Vitamin E status of eight patients receiving total parenteral nutrition (TPN), including 10 IU of all-racemic -tocopheryl acetate daily and Intralipid 20% (500 mL; 12 mg of RRR-- and 92 mg of RRR--tocopherols) two to three times per week for 69 ± 45 (mean ± SD) months was assessed by measuring plasma and adipose tissue tocopherol concentrations. Plasma -tocopherols of TPN patients were similar to controls (17.5 ± 6.6 µmol/L vs 22.4 ± 5.1), whereas -tocopherols were significantly reduced (6.0 ± 3.1 vs 11.2 ± 3.6, p < 0.03). The adipose tissue - and -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 µmol/mmol vs 5.1 ± 3.5, p < 0.05), suggesting that adipose tissue was relatively TGdepleted and tocopherol/cholesterol measurements better reflect vitamin E status. The mean -tocopherol/cholesterol ratios were significantly lower in the TPN patients than the controls (55 ± 36 vs 106 ± 63, p < 0.04). Thus, current vitamin E supplementation of TPN patients seems insufficient for maintenance of adequate tissue stores. (Journal of Parenteral and Enteral Nutrition 15:647-652, 1991)

Journal of Parenteral and Enteral Nutrition, Vol. 15, No. 6, 647-652 (1991)
DOI: 10.1177/0148607191015006647


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