Advertisement

Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Plasma vitamin E levels and vitamin E/β-lipoprotein relationships in small preterm infants during the early anemia of prematurity

Abstract

The vitamin E status of AGA preterm infants (birth weights≦1500 g) was studied during the first 10 weeks of life. The total polyunsaturated fatty acid content of the diet was 12%, and medicinal iron was given from 4 weeks of age. Plasma vitamin E concentrations correlated significantly with β-lipoprotein levels in the infants not supplemented with tocopherol. The low plasma vitamin E levels observed in these infants thus reflect the low transport capacity of the plasma, and do not necessarily signify vitamin E deficiency. Erythrocytes from the preterm infants showed increased hemolysis in the hydrogen peroxide hemolysis test, also when the plasma tocopherol levels were above 11.6 μmol/l; and for the same level of tocopherol, the degree of hemolysis varied considerably. This indicates that factors other than the tocopherol concentrations influence this test. When glucose was added to the cells during the test the hemolysis decreased. A group of infants supplemented with 7.5 IU water-soluble tocopherol/day showed satisfactory median levels of the vitamin, both when assessed as plasma vitamin E concentrations and as vitamin E/β-lipoprotein ratios. However, some infants had low plasma concentrations and ratios, particularly at 4 weeks of age. This indicates that this supplementary dose is insufficient when a water-soluble preparation is used. A very wide range of plasma vitamin E concentrations was observed in the supplemented infants. A word of caution against too vigorous supplementation in small preterm infants is therefore warranted.

This is a preview of subscription content, log in to check access.

References

  1. 1.

    Bieri JG (1975) Vitamin E. Nutr Rev 33:161–167

  2. 2.

    Dallmann PR (1974) Iron, vitamin E, and folate in the preterm infant. J Pediatr 85:742–752

  3. 3.

    Ehrenkranz RA, Bonta BW, Ablow RC, Warshaw JB (1978) Amelioration of bronchopulmonary dysplasia after vitamin E administration. N Engl J Med 299:564–569

  4. 4.

    Farrell PM, Bieri JG (1975) Megavitamin E supplementation in man. Am J Clin Nutr 28:1381–1386

  5. 5.

    Farrell PM, Bieri JG, Fratantoni JF, Wood RE, di Sant'Agnese PA (1977) The occurence and effects of human vitamin E deficiency. J Clin Invest 60:233–241

  6. 6.

    Farrell PM, Levine SL, Murphy D, Adams AJ (1978) Plasma tocopherol levels and tocopherol-lipid relationships in a normal population of children as compared to healthy adults. Am J Clin Nutr 31:1720–1726

  7. 7.

    Gairdner D, Marks J, Roscoe JD (1955) Blood formation in infancy. Part IV. The early anaemia of prematurity. Arch Dis Child 30:203–211

  8. 8.

    Gairdner D, Pearson J (1971) A growth chart for premature and other infants. Arch Dis Child 46:783–787

  9. 9.

    Gordon HH, Nitowski HM, Cornblath M (1955) Studies of tocopherol deficiency in infants and children. I. Hemolysis of erythrocytes in hydrogen peroxide. Am J Dis Child 90:669–681

  10. 10.

    Gross S, Melhorn DK (1974) Vitamin E-dependent anemia in the premature infants. III. Comparative hemoglobin, vitamin E, and erythrocyte phospholipid responses following absorption of either water-soluble or fat-soluble d-alpha tocopheryl. J Pediatr 85:753–759

  11. 11.

    Hågå P, Lunde G (1978) Selenium and vitamin E in cord blood from preterm and fullterm infants. Acta Paediatr Scand 67:735–739

  12. 12.

    Johnson L, Schaffer D, Boggs TR Jr (1974) The premature infant, vitamin E deficiency and retrolental fibroplasia. Am J Clin Nutr 27:1158–1173

  13. 13.

    Melhorn DK, Gross S (1971) Vitamin E-dependent anemia in the premature infant. I. Effects of large doses of medicinal iron. J Pediatr 79:569–580

  14. 14.

    Oski FA (1980), Vitamin E—a radical defense. N Engl J Med 303:454–455

  15. 15.

    Oski FA, Barness LA (1967) Vitamin E deficiency: A previously unrecognized cause of hemolytic anemia in the premature infant. J Pediatr 70:211–220

  16. 16.

    Phelps DL (1979) Vitamin E: Where do we stand? Pediatrics 63:933–935

  17. 17.

    Ritchie JH, Fish MB, McMasters V, Grossman M (1968) Edema and hemolytic anemia in premature infants. A vitamin E deficiency syndrome. N Engl J Med 279:1185–1190

  18. 18.

    Williams ML, Shott RJ, O'Neal PL, Oski FA (1975) Role of dietary iron and fat on vitamin E deficiency anemia of infancy. N Engl J Med 292:887–890

Download references

Author information

Correspondence to Per Hågå.

Additional information

with the technical assistance of Sissel Kran

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Hågå, P. Plasma vitamin E levels and vitamin E/β-lipoprotein relationships in small preterm infants during the early anemia of prematurity. Eur J Pediatr 136, 143–147 (1981). https://doi.org/10.1007/BF00441916

Download citation

Key words

  • Infant, premature
  • Vitamin E
  • Lipoproteins, LDL