Acta Pxdiatr Scand 64: 446448, 1975
PLASMA TOCOPHEROL IN INFANTS AND CHILDREN W. R. McWHIRTER From the. Depurrment of Child Health, University of Dundee, Dundee, Scotland
ABSTRACT. McWhirter, W. R. (Dept. of Child Health, Ninewells Hospital, Dundee, Scotland). Plasma tocopherol in infants and children. Acta Paediatr Scand, 64: 446, 1975.-A study has been made of plasma tocopherol concentrations in normal children and in children with intestinal abnormalities. A positive correlation between plasma tocopherol and age is shown between the ages of 4 months and 10 years. Most patients with cystic fibrosis or coeliac disease were found to have markedly reduced plasma tocopherol concentrations in comparison with the normal children of similar age.
KEY WORDS: Tocopherol, steatorrhoea
Tocopherol (Vitamin E) is a normal constituent of the diet and is found in relatively high concentrations in foods such as cereals and some leafy vegetables, as well as in human colostrum. Its main function after absorption is probably as an anti-oxidant; it is thought to play a part in inhibiting the oxidation of cell membrane lipids by hydrogen peroxide produced by the cell’s metabolism. Deficiency in infancy has been shown to cause haemolytic anaemia ( 1 1). and it is likely that the retinal and neurological abnormalities of a$lipoproteinaemia (10) as well as the ceroid pigmentation in the muscles of patients with cystic fibrosis (7) are related to Vitamin E deficiency. That Vitamin E , a fat soluble vitamin, is poorly absorbed in patients with steatorrhoea has been demonstrated previously (3, 9, 13). There is however comparatively little detailed information on the plasma tocopherol levels found in normal children at different ages. Cord blood concentrations are considerably below those found in normal adults in whom the mean value is around 1 mg/l00 ml (4). It is clear Acta
Piediatr Scand 64
therefore that the plasma tocopherol must rise with age and this has been shown in some earlier studies (3, 14). The present study was undertaken to confirm the trend in plasma tocopherol concentrations in children between the ages of 4 months and 14 years who did not have malabsorption, and t o compare them with those from children with various forms of intes tinal abnormality. MATERIALS AND METHODS The “normal” group consisted of children attending with minor complaints, such as enuresis or upper respiratory tract infection, who had no clinical features suggestive of malabsorption but who required a venepuncture as part of their normal investigations. The abnormal patients included seven with Giardia lamblia infestation (group I ) , nine with cystic fibrosis (group 2). eleven with coeliac disease (group 3), and one with a-P-lipoproteinaemia. Plasma tocopherol was estimated in duplicate on specimens of venous heparinised plasma by the method of Martinek (81, using 0.5 ml plasma. The S.E.M. of the duplicates was 0.017 mg/100 ml. The patients were not fasting at the time the specimens were taken. It was considered that fasting was not necessary since it has been shown that plasma tocopherol teaches a maximum 9 hours after ingestion of a tocopherol load, and only falls gradually thereafter (1).
Plasma tocopherol in infants and children
447
Table 2. Plasrna tocopherol ~ ~ a l u in e s “abnormal” patients 1.2
Diagnosis
..
: I
. .- ..
Age (years)
Plasma toco hero1 (mg/?OO ml)
t-test vs. normals
11/12 15/12 21/12 22/12 2 2 4
0.39 0.45 0.06 0.61 0.85 0.62 0.80
p>.05
3/12 4/12 4/12 9/12 16/12 3 3 4 6
0.43 0.11 0.00 0.08 0.08 0.28 0.25 0.16 0.74
p
PLASMA TOCOPHEROL IN INFANTS AND CHILDREN W. R. McWHIRTER From the. Depurrment of Child Health, University of Dundee, Dundee, Scotland
ABSTRACT. McWhirter, W. R. (Dept. of Child Health, Ninewells Hospital, Dundee, Scotland). Plasma tocopherol in infants and children. Acta Paediatr Scand, 64: 446, 1975.-A study has been made of plasma tocopherol concentrations in normal children and in children with intestinal abnormalities. A positive correlation between plasma tocopherol and age is shown between the ages of 4 months and 10 years. Most patients with cystic fibrosis or coeliac disease were found to have markedly reduced plasma tocopherol concentrations in comparison with the normal children of similar age.
KEY WORDS: Tocopherol, steatorrhoea
Tocopherol (Vitamin E) is a normal constituent of the diet and is found in relatively high concentrations in foods such as cereals and some leafy vegetables, as well as in human colostrum. Its main function after absorption is probably as an anti-oxidant; it is thought to play a part in inhibiting the oxidation of cell membrane lipids by hydrogen peroxide produced by the cell’s metabolism. Deficiency in infancy has been shown to cause haemolytic anaemia ( 1 1). and it is likely that the retinal and neurological abnormalities of a$lipoproteinaemia (10) as well as the ceroid pigmentation in the muscles of patients with cystic fibrosis (7) are related to Vitamin E deficiency. That Vitamin E , a fat soluble vitamin, is poorly absorbed in patients with steatorrhoea has been demonstrated previously (3, 9, 13). There is however comparatively little detailed information on the plasma tocopherol levels found in normal children at different ages. Cord blood concentrations are considerably below those found in normal adults in whom the mean value is around 1 mg/l00 ml (4). It is clear Acta
Piediatr Scand 64
therefore that the plasma tocopherol must rise with age and this has been shown in some earlier studies (3, 14). The present study was undertaken to confirm the trend in plasma tocopherol concentrations in children between the ages of 4 months and 14 years who did not have malabsorption, and t o compare them with those from children with various forms of intes tinal abnormality. MATERIALS AND METHODS The “normal” group consisted of children attending with minor complaints, such as enuresis or upper respiratory tract infection, who had no clinical features suggestive of malabsorption but who required a venepuncture as part of their normal investigations. The abnormal patients included seven with Giardia lamblia infestation (group I ) , nine with cystic fibrosis (group 2). eleven with coeliac disease (group 3), and one with a-P-lipoproteinaemia. Plasma tocopherol was estimated in duplicate on specimens of venous heparinised plasma by the method of Martinek (81, using 0.5 ml plasma. The S.E.M. of the duplicates was 0.017 mg/100 ml. The patients were not fasting at the time the specimens were taken. It was considered that fasting was not necessary since it has been shown that plasma tocopherol teaches a maximum 9 hours after ingestion of a tocopherol load, and only falls gradually thereafter (1).
Plasma tocopherol in infants and children
447
Table 2. Plasrna tocopherol ~ ~ a l u in e s “abnormal” patients 1.2
Diagnosis
..
: I
. .- ..
Age (years)
Plasma toco hero1 (mg/?OO ml)
t-test vs. normals
11/12 15/12 21/12 22/12 2 2 4
0.39 0.45 0.06 0.61 0.85 0.62 0.80
p>.05
3/12 4/12 4/12 9/12 16/12 3 3 4 6
0.43 0.11 0.00 0.08 0.08 0.28 0.25 0.16 0.74
p
