Infants tocopherol levels

Deficiency of vitamin E is characterized by low serum tocopherol levels and a positive hydrogen peroxide hemolysis test. This deficiency is believed to occur in patients with biliary, pancreatic, or intestinal disease that is characterized by excessive steatorrhea. Premature infants with a high intake of fatty acids exhibit a deficiency syndrome characterized by edema, anemia, and low tocopherol levels. This condition is reversed by giving vitamin E. 

The. animal work will be described only sufficiently to allow the reader to appreciate lietter the discussion of the human studies. When it became apparent in 19.55 that the peroxide hemolysis test was dependent not only on the tocopherol level of the blood but also upon the level of linoleic acid (and other autoxidizable components) in the stroma of the erythrocyte, animal experiments were designed to obtain more exact correlations between tocopherol needs and linoleic acid intake. This relationship between linoleic acid content of the diet and the incidence of chick encephalomalacia (Century and Horwitt, 19.58) was not recorded until later (Century et al., 19.59 Century and Horwitt, 19.59) when observation of cerebellar encephalomalacia in an infant that had been fed a commercial cottonseed oil preparation intravenously came to our attention (Horwitt and Bailey, 1959). In the meantime, there had been a number of reports to certify the relationship between linoleic acid consumption and chick encephalomalacia (Dam et al, 19.58 Machlin and Gordon, 1960). With the advent of better gas chromatographic techniques, it was soon possible to show that the linoleic acid content of the cerebellum was diet dependent (Horwitt et al., 1959 Witting et al., 1961). The marked effects of diet on the fatty acids of the mitochondria of chick brains has also been reported (Horwitt, 1981a). The levels of linoleic acid are much lower in brain tissues than in any tissue analyzed to date and this relatively low linoleic acid level may be considered a characteristic of brain tissue. The significance of this difference is not known. It is of interest to note that the current interpretations of the effect of more unsaturated fats on the production of chick encephalomalacia were anticipated by Dam in 1944. 

That one cannot rely on the tocopherol in stored human milk is indicated in Table IV. As can be seen, the mean scrum tocopherol level for a group of infants fed partially skimmed cows milk was 0.17 mg%, and for infants fed stored human milk, which on occasion was reenforced with skimmed lactic acid milk powder, was 0.29 mg%. The difference of 0.12 mg% is not statistically significant (p< 0.05). The tocopherol level in the group of premature infants fed stored human milk is only approximately 40 % that of full-term infants nursed by their mothers. This may be due to loss of vitamin E in storage of human milk (Harris et al., 1952) diminished fat absorption (Gordon and McNamara, 1941) or a combination of both factors and cannot be judged from our data. In contrast, the... 

Serum Tocopherol Levels of Prematurely Born Infants Fed Different... 

Between 1944 and 1956 there were several determinations of plasma tocopherol levels in disorders of fat absorption Minot (1944) in a child suffering from celiac disease Darby el al. (1946) in 20 patients with sprue Filer et al. (1951) in three children with fibrocystic disease, of one with celiac disease, and of one with sprue Woodruff (1956a, b) in 28 nutritional disorders (many of these had been considered elsewhere Darby el al., 1954). Two of the 28 patients had celiac disease, one Whipple s disease, one xanthomatous biliary cirrhosis of 10 years duration, and the remainder sprue Gordon and Nitowsky (1956) and Nitowsky et al. (1956b, c) in 31 infants and children with steatorrhoea due to proved cystic fibrosis of the pancreas or biliary atresia. 

Vitamin E is widespread in foods and is stored in the body so that deficiency states are very rare. A possible exception may be premature infants with very low fat stores. The concentration of a-tocopherol in cows milk ranges from 3.0 to 5.0 mg/L and is present at about the same level in human milk. While vitamin E has been shown to be essential for normal fertility in rats and other animals, it has never been proven to be necessary for human fertility. However, in recent years there has been renewed interest in the antioxidant function of vitamin E [e.g., in protecting the cardiovascular system (Sytkowski et al., 1990 Gurr, 1994)]. 

Vitamin K is a fat-soluble vitamin. The RDA for the adult man is 10 mg of a-loeophenol, or its biological equivalent. The RDA for infants should also be mentioned, as vitamin E deficiency, when it occurs, tends to strike this population. The RDA for the newborn is 5 mg of a-tocopherol, or its equivalent. The vitamin needs of the infant have been expressed in terms of the amount of polyunsaturated faltj acids (as fats and oils) in the diet, for example, 0,7 mg of a-tocopherol per gram of linoleic acid. A common level of dietary intake is about 10 mg per day. A deficiency iit the vitamin is quite rare. 

We are thus forced to make an estimate concerning the need for tocopherol supplementation from inadequate data. In the case of the full-term infant, there would seem to be no need for supplementation of the diet, since on ordinary cows milk mixtures within 6 months the level of tocopherol is above that at which hemolysis of erythrocytes occurs in hydrogen peroxide in vitro. This level is reached in the first week by babies fed breast... 

The low levels of tocopherol found at birth in normal infants on a full milk diet show a steady rise so that they rapidly reach a level above 0.5 mg/100 ml. 

On the basis of the various studies undertaken, the postnatal fall in the serum level may represent the effect on the premature infant of three unrelated factors (1) an inadequate supply of tocopherol in artificial formula feed. (2) excessive demand for tocopherol represented by the marked increase in body mass of the premature infant during the first several months of extrauterine life. (3) possible redistribution due to a rapidly expanded blood volume and accumulation of adipose tissue. 

Antioxidant levels (ubiquinone-10, ubiquinol-10, a- and y-tocopherol) in neonate and infant plasma were determined using a Cjg column (electrochemical detector, electrode 1 = — 150my electrode 2 = -1-600 mV) and an 800/180/65 metha-nol/ethanol/IPA with 31.7mM ammonium formate mobile phase [337]. Elution was complete in 30 min. A standard solution containing 1-35 pmol of each material gave readily detected peaks. 

The levels of retinol, a-tocopherol, and retinyl palmitate in infant plasma samples were determined using a C g column (2 = 305 nm) and a 100/0 -> 40/60 (at 9min hold 6min) (90/10 acetonitrile/water)/(10/90 IPA/ethyl acetate) gradient [860]. Excellent separation and peaks shapes were obtained. All compounds eluted within 12min. Detection limits were reported as O.I-I.Opg/mL (S/N = 3). The resulting working curve was linear up to 8 pg/mL. 

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