Effect of Fat-Soluble Vitamins A, D, E and K on Vitamin Status and Metabolic Profile in Patients with Fat Malabsorption with and without Urolithiasis

Abstract

Patients with intestinal fat malabsorption and urolithiasis are particularly at risk of acquiring fat-soluble vitamin deficiencies. The aim of the study was to evaluate the vitamin status and metabolic profile before and after the supplementation of fat-soluble vitamins A, D, E and K (ADEK) in 51 patients with fat malabsorption due to different intestinal diseases both with and without urolithiasis. Anthropometric, clinical, blood and 24-h urinary parameters and dietary intake were assessed at baseline and after ADEK supplementation for two weeks. At baseline, serum aspartate aminotransferase (AST) activity was higher in stone formers (SF; n = 10) than in non-stone formers (NSF; n = 41) but decreased significantly in SF patients after supplementation. Plasma vitamin D and E concentrations increased significantly and to a similar extent in both groups during intervention. While plasma vitamin D concentrations did not differ between the groups, vitamin E concentrations were significantly lower in the SF group than the NSF group before and after ADEK supplementation. Although vitamin D concentration increased significantly in both groups, urinary calcium excretion was not affected by ADEK supplementation. The decline in plasma AST activity in patients with urolithiasis might be attributed to the supplementation of ADEK. Patients with fat malabsorption may benefit from the supplementation of fat-soluble vitamins ADEK.

Vitamins as regulators of calcium-containing kidney stones — new perspectives on the role of the gut microbiome

“…In this study, the highest levels of vitamin E compared with other studies were reported in stone formers (16.4 mg/l) and the second highest in non-stone formers (12.0 mg/l) 51 . The detection method in this study 51 was similar to that used in other studies 233 , 234 ; thus, the reason why such relatively high values were reported is difficult to ascertain, and the existence of a population-based effect on blood levels of vitamin E might be hypothesized. Similar to what is observed in rats, human stone formers often have increased levels of markers of oxidative stress and a reduction in enzymes involved in oxidative protection 235 , 236 .…”

A 53-Year-Old Man Presenting with Pancreatic Exocrine Insufficiency 7 Years After Gastric Bypass Bariatric Surgery

“…A previous study showed fecal elastase levels are considerably low in the post-bariatric surgery population as compared to the general population [ 23 ]. Patients with malabsorption can develop serious nutritional deficiencies, especially in the fat-soluble vitamins A, D, E, and K [ 24 ].…”

Fat digestion and absorption: Normal physiology and pathophysiology of malabsorption, including diagnostic testing

“…46 Because of this malabsorption, patients are subsequently likely to acquire various nutrient deficiencies, including vitamin A, D, E, K, and B 12 , folate, iron, calcium, zinc, selenium, and magnesium. 50 Deficiencies in these vitamins and micronutrients may result in long-term health disorders, such as neurologic abnormalities, osteoporosis, sarcopenia, and immunodeficiency, and may lead to higher morbidity and disease severity. 50,51 Therefore, screening for these vitamin and mineral deficiencies at the time of diagnosis is recommended, as well as the appropriate supplementation of deficient vitamins and micronutrients.…”