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Serum alpha-tocopherol concentrations in preterm infants receiving less than 25 mg/kg/day alpha-tocopherol acetate
C A Friedman1, D F Wender, D M Temple
1Hinds General Hospital, Mississippi Baptist Medical Center, Jackson.
Insights
High alpha-tocopherol (aT) levels in preterm infants were linked to necrotizing enterocolitis. Low aT concentrations were also observed, showing significant variability in preterm infants receiving supplements.
Area of Science:
- Neonatal Medicine
- Nutritional Science
- Biochemistry
Background:
- Preterm infants often require nutritional support, including vitamin E (alpha-tocopherol).
- Supplementation of alpha-tocopherol acetate (aTA) is common in neonatal intensive care units.
- Variability in vitamin E status can impact infant health outcomes.
Purpose of the Study:
- To determine alpha-tocopherol (aT) concentrations in preterm infants receiving aTA supplements.
- To investigate the relationship between aT levels and the incidence of necrotizing enterocolitis (NEC).
- To explore factors influencing serum tocopherol variability.
Main Methods:
- Serum aT concentrations were measured in 52 preterm infants receiving less than 25 mg/kg/day of aTA.
- Infants received supplements via intravenous hyperalimentation, lipids, and oral aTA.
- Correlation analysis was performed with serum lipid content and plasma aTA hydrolysis activity.
Main Results:
- One-fourth of infants exhibited aT concentrations >3.5 mg/dl, associated with increased NEC risk.
- Another one-fourth had aT concentrations <0.5 mg/dl during the first postnatal week.
- Serum tocopherol concentrations showed high variability, correlating with total serum lipid content.
Conclusions:
- Elevated alpha-tocopherol levels may be associated with adverse outcomes like necrotizing enterocolitis in preterm infants.
- Significant variability in vitamin E status exists in supplemented preterm infants.
- Further research is needed to optimize alpha-tocopherol supplementation strategies in neonates.
Abstract:
Alpha-tocopherol (aT) concentrations were determined in 52 preterm infants receiving less than 25 mg/kg/day alpha-tocopherol acetate (aTA) supplements through intravenous hyperalimentation solutions, lipid, and oral aTA. One fourth of the study infants had aT concentrations greater than 3.5 mg/dl at least once, and an association between concentrations greater than 3.5 mg/dl and necrotizing enterocolitis was demonstrated. In contrast, another one fourth of the infants' concentrations remained less than 0.5 mg/dl through the first postnatal week. The highly variable serum tocopherol concentrations correlated with total serum lipid content but not with plasma aTA hydrolysis activity.