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

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Abstract
Vitamin E status of eight patients receiving total parenteral nutrition (TPN), including 10 IU of all-racemic α-tocopheryl acetate daily and Intralipid 20% (500 mL; 12 mg of RRR-α- and 92 mg of RRR-γ-tocopherols) two to three times per week for 69 ± 45 (mean ± SD) months was assessed by measuring plasma and adipose tissue tocopherol concentrations. Plasma α-tocopherols of TPN patients were similar to controls (17.5 ± 6.6 μmol/L vs 22.4 ± 5.1), whereas γ-tocopherols were significantly reduced (6.0 ± 3.1 vs 11.2 ± 3.6, p < 0.03). The adipose tissue α- and γ-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 α-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)