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Time course of vitamin E repletion in the premature infant
F J Kelly1, W Rodgers, J Handel
1Department of Human Nutrition, University of Southampton, Bassett Crescent East.
Insights
Preterm infants show delayed vitamin E (tocopherol) uptake compared to term infants, with plasma levels normalizing only after 8 weeks post-term despite adequate intake. Erythrocyte levels improved sooner.
Area of Science:
- Biochemistry
- Neonatal Nutrition
- Pediatric Hematology
Background:
- Vitamin E (tocopherol) is crucial for infant development.
- Premature infants may have altered nutrient absorption and metabolism.
- Establishing adequate vitamin E status is vital for preterm neonates.
Purpose of the Study:
- To assess serial plasma and erythrocyte tocopherol-isomer concentrations in premature infants.
- To compare vitamin E status in preterm infants with term infants and adults.
- To evaluate vitamin E intake and its relation to blood concentrations in neonates.
Main Methods:
- Serial measurements of plasma and erythrocyte tocopherol concentrations.
- Calculation of vitamin E intake from diet and blood transfusions.
- Comparison of preterm infants (25-35 weeks gestation) with term infants and adults.
Main Results:
- Preterm infants had significantly lower initial plasma vitamin E (0.3 mg/l) than term infants (1.9 mg/l).
- Plasma vitamin E levels in preterm infants remained low (0.7 mg/l) by day 8, unlike term infants (8.2 mg/l).
- Erythrocyte vitamin E normalized in preterm infants within 3 weeks, but plasma levels took 8 weeks post-term to reach adult ranges.
Conclusions:
- Premature infants exhibit delayed plasma vitamin E normalization compared to term infants.
- Erythrocyte vitamin E uptake is faster than plasma uptake in preterm neonates.
- Adequate vitamin E intake does not guarantee rapid normalization of plasma vitamin E in preterm infants.
Abstract:
Plasma and erythrocyte (RBC) tocopherol-isomer concentrations were determined serially in forty-two premature infants (25-35 weeks gestation) from birth to 8 weeks of age. For comparison purposes vitamin E status was also determined in six term infants over the first 8 d following birth and in a group of thirteen adult volunteers. Vitamin E intakes in term and preterm infants were calculated from recorded food intakes and blood transfusions. In term infants plasma vitamin E concentration rose from 1.9 mg/l (day 1) to 8.2 mg/l by day 8. In comparison preterm plasma vitamin E concentration, 0.3 mg/l (day 1), did not change appreciably by day 8 (0.7 mg/l). Likewise RBC vitamin E concentration increased in term infants from 1.3 mg/l (day 1) to 2.7 mg/l (day 8), while in preterm infants it remained unchanged, 1.5 mg/1 (day 1) v. 1.3 mg/l (day 8). Over the 3 weeks following birth, RBC vitamin E concentrations in the premature infants increased to adult values, while plasma vitamin E concentration did not reach the adult range until 8 weeks post-term. These slow changes in plasma vitamin E status occurred even though the vitamin E intake of these infants was similar to that proving adequate for term infants.