Utility of Breath Ethane as a Noninvasive Biomarker of Vitamin E Status in Children

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Abstract
The purpose of our study was to determine if the ethane content of expired air could be a useful index of vitamin E status in children. Eight children with vitamin E deficiency secondary to chronic severe liver disease were studied: six of these children were treated with parenteral vitamin E (2–5 mg/kg/dose every 4–7 d). Measures of vitamin E status pre- and posttherapy were: serum vitamin E, 2 ± 1 versus 7 ± 1 μg/mL (p < 0.001); serum vitamin E:total lipids, 0.3 ± 0.1 versus 1.0 ± 0.1 mg/g (p < 0.001); and erythrocyte peroxide hemolysis test, 80 ± 10 versus 6 ± 12% (p < 0.001). Fasting breath ethane in the patients pre- and posttherapy was 78 ± 10 versus 31 ± 11 pmol/kg/min (p < 0.001). Breath ethane correlated negatively with serum vitamin E (p < 0.042) and serum E:total lipids (p < 0.004) and positively with the erythrocyte peroxide hemolysis test (p < 0.003). Values for treated patients did not differ from those for fasted sibling controls (34 ± 12 pmol/kg/min), postprandial sibling controls (31 ± 12 pmol/kg/min), and healthy children sampled randomly, in the nonfasted state (21 ± 14 pmol/kg/min). Breath ethane production in one patient (up to 168 pmol/kg/min) did not normalize after treatment of vitamin E deficiency until her selenium deficiency was corrected as well. We conclude that this noninvasive test can be useful as a screen for vitamin E deficiency in children and for ascertaining response to therapy. The presence of high concentrations of ethane in expired air in vitamin E-sufficient subjects may indicate deficiencies of other antioxidants such as selenium.

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