The evaluation of α-tocopherol concentration instead of α-tocopherol:cholesterol ratio in adult cystic fibrosis patients results in the overestimation of vitamin E deficiency

Ewa Sapiejka; Patrycja Krzyżanowska-Jankowska; Dariusz Walkowiak; Szymon Kurek; Jarosław Walkowiak

doi:10.20883/jms.313

Authors

Ewa Sapiejka The Specialist Centre for Medical Care of Mother and Child, Gdansk, Poland https://orcid.org/0000-0003-0867-1717
Patrycja Krzyżanowska-Jankowska Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland https://orcid.org/0000-0001-8676-9803
Dariusz Walkowiak Department of Organization and Management in Health Care, Poznan, Poland https://orcid.org/0000-0001-8874-2401
Szymon Kurek Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland https://orcid.org/0000-0002-1409-2933
Jarosław Walkowiak Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland https://orcid.org/0000-0001-5813-5707

DOI:

https://doi.org/10.20883/jms.313

Keywords:

fat-soluble vitamins, gastrointestinal diseases, pancreatitis, high-performance liquid chromatography

Abstract

Introduction. It has been suggested that serum vitamin E concentrations in CF patients may not properly reflect the body resources of vitamin E. Therefore, we aimed to assess vitamin E status in CF adults relating it to reference values for healthy subjects, also taking into account the α‑tocopherol:cholesterol ratio.
Material and Methods. The study group was composed of 33 CF patients − 18 (54.5%) females and 15 (45.5%) males − aged from 18 to 47 years. In all CF patients nutritional status and clinical expression of disease − lung function; Pseudomonas aeruginosa colonization; diabetes; cirrhosis; exocrine pancreatic function and vitamin E supplementation were analyzed. Vitamin E (α‑tocopherol) concentration was assessed by high‑performance liquid chromatography (HPLC).
Resuls. CF adults have lower vitamin E concentrations (median: 830 µg/dl vs. 1132 µg/dl, p = 0.00174) and higher vitamin E: cholesterol ratio (median: 7.2 mg/g vs. 6.7 mg/g, p < 0.00001) than healthy subjects. The underlying factor that determines this phenomenon is related to low cholesterol levels observed in CF patients. The percentage of low vitamin E concentrations defined in comparison to healthy Polish peers is considerably higher than low vitamin E:cholesterol ratios (39.4% vs. 21.2%, p = 0.0011).
Conclusions. The evaluation of α‑tocopherol concentration instead of α‑tocopherol:cholesterol ratio in CF adults results in the overestimation of vitamin E deficiency. Moreover, there is also potentially a large percentage of individuals with excessive vitamin E body resources. However, this aspect demands further studies.

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