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Author Notes:

Correspondence: Thomas R. Ziegler, Suite GG-23, General Clinical Research Center, Emory University Hospital, 1364 Clifton Road, Atlanta, GA 30322; Phone: (404) 727-7351; Fax: (404) 727-5563; Email: tzieg01@emory.edu

Authors' Contributions: TRZ, JRG, and LML designed the study.

JRG and TRZ enrolled subjects.

ML, CFE and NB carried out the clinical protocol and collected samples.

ML, CFE and TRZ analyzed the data and prepared the manuscript, which was reviewed by all authors.

RLS provided HPLC data for the study.

Disclosures: None of the authors had a financial or personal conflict of interest.

Subject:

Research Funding:

The study was supported by the National Institutes of Health grants R01 DK55850 (to TRZ) and General Clinical Research Center grant M01 RR00039.

Keywords:

  • short bowel syndrome
  • carotenoids
  • vitamin A
  • tocopherols
  • parenteral nutrition

Prospective analysis of serum carotenoids, vitamin A and tocopherols in adults with short bowel syndrome undergoing intestinal rehabilitation 1

Tools:

Journal Title:

Nutrition

Volume:

Volume 25, Number 4

Publisher:

, Pages 400-407

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Carotenoids, vitamin A and tocopherols serve important roles in many key body functions. However, availability of these compounds may be decreased in patients with short bowel syndrome (SBS) due to decreased oral intake of fruits and vegetables and/or decreased intestinal absorption. Little information is available on serum concentrations of carotenoids, vitamin A and tocopherols during chronic parenteral nutrition (PN) or during PN weaning. The aim of this study was to prospectively examine serum concentrations of a wide variety of carotenoids, vitamin A and tocopherols in SBS patients undergoing an intensive 12-week intestinal rehabilitation program. Twenty-one PN-dependent adult SBS patients were enrolled in a 12-week intestinal rehabilitation program, which included individualized dietary modification, multivitamin supplementation, and randomization to receive either s.c. placebo (n=9) or human growth hormone (GH, 0.1 mg/kg/day). PN weaning was initiated after week 4 and advanced as tolerated. Serum concentrations of carotenoids, vitamin A and tocopherols were determined at baseline and at weeks 4 and 12. Results showed that a significant % of subjects exhibited low serum concentrations for carotenoids and α-tocopherol at study entry, while a few subjects had low concentrations of retinol (5%). Serum α-tocopherol concentration was negatively associated with PN lipid dose (r = - 0.34, p < 0.008). We conclude that SBS patients are depleted in diet-derived carotenoids despite oral and intravenous multivitamin supplementation and dietary adjustment during intestinal rehabilitation and PN weaning. Reduction of PN lipid infusion may improve serum α-tocopherol concentrations.

Copyright information:

© 2009 Elsevier Inc. All rights reserved.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommerical-NoDerivs 3.0 Unported License (http://creativecommons.org/licenses/by-nc-nd/3.0/).

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