Serum and hepatic vitamin E assessment in cirrhotics before transplantation

Background: Hepatic vitamin E may have a protective effect against hepatocyte injury; therefore, vitamin E replacement or supplementation may be beneficial in patients with cirrhosis. However, serum vitamin E may not correlate with hepatic vitamin E stores, making decisions regarding treatment difficult based on serum levels alone. The specific aims of this study were to determine hepatic concentrations of vitamin E and to determine whether serum levels of vitamin E correlate with hepatic vitamin E stores in cirrhotics. Methods: A prospective study of cirrhotics undergoing orthotopic liver transplantation (OLT) was completed. Serum and hepatic levels of vitamin E were measured by high-performance liquid chromatography. Statistical analysis was performed using rank sum tests and Spearman's rank correlation coefficient. Results: Fifty cirrhotics (33 males, 17 females; mean age of 53 years) were studied. The control group (25 males, 25 females; mean age of 47 years) consisted of the liver donors. The median serum levels of vitamin E in controls and cirrhotics were 5.95 and 7.8 mg/L, respectively (p =.009). The median hepatic levels (0.10 mg/g) in the control and cirrhotic groups were similar (p =.037). There was a significant correlation between serum and hepatic vitamin E levels in cirrhotics (R = 0.335; p =.017). Conclusions: A positive correlation exists between serum and hepatic concentrations of vitamin E in cirrhotics, therefore making serum vitamin E levels a useful reference for treatment using exogenous vitamin E.