Vitamin C in Home Parenteral Nutrition: A Need for Monitoring

Nutrients. 2020 Jun 3;12(6):1667. doi: 10.3390/nu12061667.

Abstract

To date, there are no recommendations about screening plasma vitamin C concentration and adjust its supplementation in patients on long-term home parenteral nutrition (HPN). The aim of this study was to evaluate vitamin C status and determine if a commercial multivitamin preparation (CMVP) containing 125 mg of vitamin C is sufficient in stable patients on HPN. All clinically stable patients receiving HPN or an intravenous fluid infusion at least two times per week for at least 6 months, hospitalized for nutritional assessment, were retrospectively included, for a total of 186 patients. We found that 29% of the patients had vitamin C insufficiency (i.e., <25 µmol/L). In univariate analysis, C-reactive protein (CRP) (p = 0.002) and intake of only 125 mg of vitamin C (p = 0.001) were negatively associated with vitamin C levels, and duration of follow-up in our referral center (p = 0.009) was positively associated with vitamin C levels. In multivariate analysis, only CRP (p = 0.001) and intake of 125 mg of vitamin C (p < 0.0001) were independently associated with low plasma vitamin C concentration. Patients receiving only CMVP with a low plasma vitamin C level significantly received personal compounded HPN (p = 0.008) and presented an inflammatory syndrome (p = 0.002). Vitamin C insufficiency is frequent in individuals undergoing home parenteral nutrition; therefore, there is a need to monitor plasma vitamin C levels, especially in patients on HPN with an inflammatory syndrome and only on CMVP.

Keywords: commercial multivitamin preparation; home parenteral nutrition; vitamin C.

MeSH terms

  • Adult
  • Aged
  • Ascorbic Acid / administration & dosage*
  • Ascorbic Acid / analysis
  • Ascorbic Acid / blood*
  • Ascorbic Acid Deficiency / blood
  • Ascorbic Acid Deficiency / diagnosis
  • Ascorbic Acid Deficiency / etiology*
  • Ascorbic Acid Deficiency / prevention & control*
  • Biomarkers / blood
  • Eating / physiology*
  • Female
  • Humans
  • Inflammation / etiology
  • Male
  • Middle Aged
  • Monitoring, Physiologic*
  • Nutrition Assessment*
  • Nutritional Physiological Phenomena / physiology*
  • Nutritional Status*
  • Parenteral Nutrition, Home Total* / adverse effects
  • Retrospective Studies

Substances

  • Biomarkers
  • Ascorbic Acid