Intestinal malabsorption of vitamin E in primary biliary cirrhosis.
Intestinal malabsorption of vitamin E in primary biliary cirrhosis.
复制标题
原发性胆汁性肝硬化中维生素 E 的肠道吸收不良。
DOI：
10.1016/0016-5085(89)91574-6
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发表时间：
1989
期刊：
影响因子：
29.4
通讯作者：
Balistreri,WF
中科院分区：
文献类型：
--
作者：
Sokol,RJ;Kim,YS;Hoofnagle,JH;Heubi,JE;Jones,EA;Balistreri,WF
我们研究了 26 名患有原发性胆汁性肝硬化 (PBC) 的成年人和 6 名对照受试者的肠道吸收维生素 E 的情况。根据血清维生素 E 与血清总脂质浓度的比率，七名 (27%) PBC 患者缺乏维生素 E。使用 2000 IU α-生育酚乙酸酯的负荷剂量对所有患者和对照受试者进行口服维生素 E 耐受性测试，并测量 24 小时内的连续血清维生素 E 浓度。维生素 E 吸收量表示为血清维生素 E 高于基线的最大上升量、口服耐受试验曲线下面积，并将这两个值除以空腹总血清脂质浓度。与对照受试者相比，所有 PBC 患者、维生素 E 缺乏与维生素 E 充足的 PBC 患者（p < 0.05 至 p < 0.01）以及血清维生素 E 水平低于 10 μg/ml 的 PBC 患者与血清维生素 E 水平高于 10 μg/ml 的 PBC 患者相比，维生素 E 的吸收均显着受损（p < 0.01）。维生素E吸收与PBC分期、血清胆甘氨酸、总胆红素、胆固醇、碱性磷酸酶、天冬氨酸转氨酶和凝血酶原时间呈负相关。血清维生素E低于10μg/ml、血清总胆红素高于3mg/dl、血清胆甘氨酸高于600μg/dl或血清碱性磷酸酶高于1000IU/L的患者维生素E严重吸收不良，发生维生素E缺乏的风险较高。因此，不仅对于存在明显维生素 E 缺乏的患者，而且对于符合这些标准的 PBC 患者，都应考虑补充维生素 E。
We studied intestinal absorption of vitamin E in 26 adults with primary biliary cirrhosis (PBC) and 6 control subjects. Seven (27%) PBC patients were vitamin E-deficient based on the ratio of serum vitamin E to serum total lipid concentrations. An oral vitamin E tolerance test was performed in all patients and control subjects using a loading dose of 2000 IU α-tocopheryl acetate with measurement of serial serum vitamin E concentrations over 24 h. Vitamin E absorption was expressed as the maximal rise in serum vitamin E above baseline, the area under the oral tolerance test curve, and these two values divided by the fasting total serum lipid concentration. Absorption of vitamin E was significantly impaired in all PBC patients vs. control subjects (p < 0.01), in vitamin E-deficient vs. vitamin E-sufficient PBC patients (p < 0.05 to p < 0.01), and in PBC patients with serum vitamin E levels below 10 μg/ml vs. those with serum vitamin E levels above 10 μg/ml (p < 0.01). Vitamin E absorption was inversely related to stage of PBC, serum cholylglycine, total bilirubin, cholesterol, alkaline phosphatase, aspartate aminotransferase, and prothrombin time. Patients with serum vitamin E below 10 μg/ml, serum total bilirubin above 3 mg/dl, serum cholylglycine above 600 μg/dl, or serum alkaline phosphatase above 1000 IU/L had severe malabsorption of vitamin E and would be at high risk for the development of vitamin E deficiency. Therefore, vitamin E supplementation should be considered not only in patients in whom overt vitamin E deficiency is present, but also in PBC patients meeting these criteria.