Nutritional assessment of serum and hepatic vitamin A levels in patients with cirrhosis

Andrzej Ukleja, James S. Scolapio, Joseph P. McConnell, James R. Spivey, Rolland C. Dickson, Justin H. Nguyen, Peter C. O’Brien

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Abstract

Background: Serum vitamin A (retinol) levels may not correlate with hepatic vitamin A stores in patients with cirrhosis; thus, supplementation of vitamin A based on serum levels may have a detrimental effect. Our aim was to determine whether serum levels correlate with hepatic stores in cirrhotic patients. Methods: A prospective study of patients with cirrhosis undergoing orthotopic liver transplantation was completed. Serum and hepatic levels of vitamin A were measured by high-performance liquid chromatography. Statistical analysis was performed using rank sum tests and Spearman rank correlation coefficients. Results: Fifty cirrhotic patients (33 men and 17 women, mean age 53 years) were compared with a control group (25 men and 25 women, mean age 47 years) of liver donors. Median serum levels of retinol were 259 μg/L in controls and 166 μg/L in cirrhotic patients (p < .001). Median hepatic levels of retinol were 25 μg/g in controls and 27.5 μg/g in cirrhotic patients (p not significant). Total hepatic vitamin A levels (retinol plus retinyl esters) were 471 μg/g in controls and 244 μg/g in cirrhotic patients (p = .028). Serum retinol did not correlate with total hepatic vitamin A stores in cirrhotic patients (rs = .10, p = .332). Conclusions: Serum retinol and total hepatic vitamin A stores are lower in cirrhotic patients than in controls. However, because levels of serum retinol do not correlate with hepatic vitamin A levels, the decision to prescribe vitamin A replacement for patients with cirrhosis should not be made solely on the basis of serum retinol levels.

Original languageEnglish (US)
Pages (from-to)184-188
Number of pages5
JournalJournal of Parenteral and Enteral Nutrition
Volume26
Issue number3
DOIs
StatePublished - Jan 1 2002

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ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

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