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Vitamin E administration and reversal of neurological deficits in protein-energy malnutrition
V Kalra1, J K Grover, G K Ahuja
1Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India. vkalra@medinst.ernet.in
Insights
Vitamin E deficiency is linked to neurological issues in children with protein-energy malnutrition (PEM). Supplementing with vitamin E improved neurological signs and normalized vitamin levels in these children.
Area of Science:
- Nutritional Neuroscience
- Pediatric Nutrition
- Biochemistry
Background:
- Neurological deficits, including posterior column, spinocerebellar, retinal, and peripheral nerve issues, are increasingly associated with vitamin E deficiency.
- Children with protein-energy malnutrition (PEM) exhibit significantly lower serum alpha-tocopherol levels and characteristic signs of tocopherol deficiency.
Purpose of the Study:
- To investigate the therapeutic effects of oral vitamin E supplementation in children with moderate protein-energy malnutrition (PEM).
- To assess the impact of vitamin E on serum alpha-tocopherol levels, lipid ratios, creatine phosphokinase, and neurological function in PEM subjects.
Main Methods:
- A prospective therapeutic intervention study involving moderate PEM subjects.
- Administration of aqueous oral vitamin E supplementation for 6 weeks to the intervention group, compared with a control PEM group.
- Evaluation of pre- and post-therapy serum alpha-tocopherol, alpha-tocopherol lipid ratio, lipid profile, creatine phosphokinase, and electroneurophysiological studies.
Main Results:
- Vitamin E supplementation significantly normalized serum alpha-tocopherol levels (p < 0.001) and the alpha-tocopherol lipid ratio (p < 0.001).
- Supplementation led to a reduction in creatine phosphokinase levels (p < 0.01) and a significant decrease in neurological signs (p < 0.001) in PEM subjects.
- Observed improvements in neurological dysfunction among PEM subjects receiving vitamin E.
Conclusions:
- Oral vitamin E supplementation is effective in normalizing vitamin E status and improving neurological dysfunction in children with protein-energy malnutrition.
- The findings highlight the importance of vitamin E administration in managing PEM, particularly in developing countries.
- Further larger-scale studies are recommended to confirm these therapeutic benefits.
Abstract:
Neurological signs including posterior column, spinocerebellar, retinal, and peripheral nerve deficits are being increasingly recognized in vitamin E deficiency states. Children suffering from protein-energy malnutrition (PEM) revealed significantly reduced serum alpha-tocopherol levels compared to age-matched normal children, the deficient subjects also exhibited the widely recognized signs of tocopherol deficiency. In this prospective therapeutic intervention study moderate PEM subjects were administered aqueous oral vitamin E supplementation for 6 weeks and compared with control PEM subjects. The parameters studied included pre- and post-therapy serum alpha-tocopherol levels, alpha-tocopherol lipid ratio, lipid profile, creatine phosphokinase levels, and electroneurophysiological studies. Vitamin E supplementation normalized serum alpha-tocopherol levels (p < 0.001), alpha-tocopherol lipid ratio (p < 0.001), reduced creatine phosphokinase levels (p < 0.01), and reduced neurological signs in PEM subjects (p < 0.001). The observed improvement in neurological dysfunction among PEM subjects is of great interest, especially in developing countries. While larger studies are recommended, the importance of vitamin E administration in PEM is being reported.