ABSORPTION OF α-TOCOPHEROL AND TOCOPHERYL ESTERS BY PREMATURE AND FULL TERM INFANTS AND CHILDREN IN HEALTH AND DISEASE

Abstract

The ability of premature and full term infants in health and disease to absorb vitamin E (tocopherol) was determined using the technic of multiple withdrawals of small samples of capillary blood at three hour intervals following an oral dose of α-tocopherol or α-tocopheryl esters. Premature infants were found to absorb vitamin E as well as full term infants, when compared on the basis of the area under the curve for a 12 hour period following an oral dose of tocopherols at 20 mg./kg. body weight. This is in marked contrast to the diminished ability of the premature infant to utilize vitamin A and fats. In a series of 29 infants, those disease states diagnosed as fibrocystic disease of the pancreas, diarrhea and cirrhosis were characterized by a poor response to the test, i.e., the tolerance curve was low. Others, infants with a variety of disorders not associated with fat or fat-soluble vitamin intolerance, had characteristic absorption curves with a maximum nine hours after receiving oral tocopherol. In a series of 14 children and 1 adult, patients with sprue, celiac syndrome and lupus erythematosis were noted to absorb tocopherols poorly. Metabolic disorders with associated hypercholesterolemia were observed to give abnormally high values for the area under the curve. A comparison of vitamin A absorption with vitamin E or tocopherol absorption in a series of 10 observations indicated that patients responding poorly to one test did poorly in both. No difference in response was noted when various esterified forms of tocopherol were administered in place of α-tocopherol. This is contrary to the reported increase in biologic potency (rat assay) of the esterified forms of tocopherol. An index calculated from the fasting and nine hour levels of serum tocopherol which corrected for the tocopherol equivalents supplied by the ester forms compared favorably with the area measurements and failed to demonstrate any difference in absorption of the free versus ester tocopherol.