Vitamin C, A, E, B2 and β-carotene status of patients with gastrointestinal diseases

Deficiency of vitamins is a risk factor for the development of various diseases of the gastrointestinal tract (GIT), and, on the contrary, diseases serve as the cause of the deficiency of these micronutrients. Data on the actual vitamin status of gastrointestinal patients are necessary to develop measures for its improvement.

Material and methods. The blood serum level of vitamins C, A, E, B₂ and β-carotene in 29 patients (10 men and 19 women) 22–80 years old with gastrointestinal diseases has been determined. The first group consisted of 14 patients with irritable bowel syndrome (IBS). The second group included patients with gastrointestinal diseases of various etiologies.

Results. There was no significant difference in vitamins C, A, E, B₂ and β-carotene sufficiency in patients with IBS and those with other gastrointestinal diseases. The characteristic features of the vitamin status of patients in both groups were the absence of individuals optimally provided with all vitamins, and a rather high frequency of occurrence (27.6%) of multiple deficiency of 3 vitamins and β-carotene. When the evaluation using 3 indicators at the same time (absolute concentration of vitamins C, E and their molar ratio) was carried out, only two patients in each group were optimally provided with vitamins C and E, and only three of them were optimally provided with β-carotene. Four patients in each group were adequately provided with all the vitamins studied. A combined deficiency of 3 micronutrients (any two vitamins and β-carotene) was found in two patients; combined deficiency of two vitamins or one vitamin and β-carotene was noted in 24.1% of the examined.

Conclusion. A purposeful development of vitamin complexes with effective doses for gastrointestinal patients is necessary.

1. Vilms E.A., Turchaninov D.V., Yunatskaya T.A., Sokhoshko I.A. Assessment of vitamin provision of the population of the large administrative and economic center of the Western Siberia. Hygiene and Sanitation (Gigiena i Sanitariya). 2017;96(3):277–80. (in Russian) https://doi.org/10.18821/0016-9900-2017-96-3-277-280

2. Kodentsova V.M., Beketova N.A., Nikitjuk D.B., Tutelyan V.A. Characteristics of vitamin provision in the adult population of the Russian Federation. The Russian Journal of Preventive Medicine. 2018;21(4):32–7. (in Russian)]. DOI: 10.17116/profmed201821432

3. Svetikova A.A., Kodentsova V.M., Vrzhesinskaya O.A., Pereverzeva O.G., Shahovskaya A.K., Kaganov B.S. Vitamin status and bone mineral density at patients with diseases of gastroenteric tract. Voprosy pitaniya (Problems of Nutrition). 2008;77(2):32–5. (in Russian)

4. Vrzhesinskaya O.A., Kodentsova V.M., Sokolnikov A.A., Svetikova A.A., Beketova N.A., Pereverzeva O.G. et al. Efficiency estimation of inclusion of specialized carbohydrate-protein product with vitamins and minerals in the diet of patients suffering from diseases of gastroenteric tract and osteopenia. Eksperimental’naya i klinicheskaya gastroenterologiya (Experimental & clinical gastroenterology). 2009;(6):104–9. (in Russian)

5. Iwakawa H., Fukui T., Fukuwatari T., Bamba S., Sasaki M., Tsujikawa T., Shibata K. Blood concentrations and renal clearance of watersoluble vitamins in outpatients with ulcerative colitis. Biomedical reports. 2019;10(3):202–10. DOI: 10.3892/br.2019.1191

6. Pan Y., Liu Y., Guo H., Jabir M.S., Liu X., Cui W., Li D. Associations between folate and vitamin B12 levels and inflammatory bowel disease: a meta-analysis. Nutrients. 2017;9(4):382. DOI: 10.3390/nu9040382

7. Barko P.C., Williams D.A. Serum concentrations of lipid‐soluble vitamins in dogs with exocrine pancreatic insufficiency treated with pancreatic enzymes. J. Vet. Intern. Med. 2018;32(5):1600– 8. DOI: 10.1111/jvim.15292

8. Torres M.J., Sabate J.M., Bouchoucha M., Buscail C., Hercberg S., Julia C. Food consumption and dietary intakes in 36,448 adults and their association with irritable bowel syndrome: NutrinetSante study. Therapeutic advances in gastroenterology. 2018;11:1756283X17746625. DOI: 10.1177/1756283X17746625

9. Taylor L., Almutairdi A., Shommu N., Fedorak R., Ghosh S., Reimer R.A. et al. Cross-Sectional Analysis of Overall Dietary Intake and Mediterranean Dietary Pattern in Patients with Crohn’s Disease. Nutrients. 2018;10(11):E1761. doi: 10.3390/nu10111761

10. Böhn L., Störsrud S., Simrén M. Nutrient intake in patients with irritable bowel syndrome compared with the general population. Neurogastroenterol. Motil. 2013;25(1):23–30. DOI: 10.1111/nmo.12001

11. Ligaarden S.C., Farup P.G. Low intake of vitamin B6 is associated with irritable bowel syndrome symptoms. Nutr. Res. 2011;31(5):356- 61. DOI: 10.1016/j.nutres.2011.04.001

12. Kagolanu D., Levine I., Katz S. The Role of Vitamin D in Elderly Inflammatory Bowel Disease Patients. Gastroenterology Hepatology. 2019;15(1):28–34.

13. Cho Y., Lee Y., Choi Y., Jeong S. Association of the Vitamin D Level and Quality of School Life in Adolescents with Irritable Bowel Syndrome. J. Clin. Med. 2018;7(12):E500. DOI: 10.3390/jcm7120500

14. Mohn E., Kern H., Saltzman E., Mitmesser S., McKay D. Evidence of drug–nutrient interactions with chronic use of commonly prescribed medications: an update. Pharmaceutics. 2018;10(1):E36. DOI: 10.3390/pharmaceutics10010036

15. Werlang M.E., Palmer W.C., Lacy B.E. Irritable Bowel Syndrome and Dietary Interventions. Gastroenterology Hepatology (NY). 2019;15(1):16–26.

16. Iakushina L.M., Beketova N.A., Bender E.D., Kharitonchik L.A. Methods of high-performance liquid chromatography for determining vitamin levels in biologic fluids and food products. Vopr. pitaniya (Probl Nutrition) 1993;(1):43–8. (in Russian)]

17. Kodentsova V., Vrzhesinskaya O., Spirichev V. Fluorometric riboflavin titration in plasma by riboflavinbinding apoprotein as a method for vitamin B2 status assessment. Ann. Nutr. Metab. 1995;39:355–60. doi 10.1159/000177885

18. Kodentsova V.M., Kharitonchik L.A., Vrzhesinskaia O.A., Pereverzeva O.G., Blazheevich N.V., Spirichev V.B. Refining criteria for supplying the body with vitamin C. Voprosy medicinskoj himii (Problems of Medical Chemistry). 1995;41(1):53– 57. (in Russian)

19. Kodentsova V.M., Vrzhesinskaya O.A., Spirichev V.B. The alteration of vitamin status of adult population of the Russian Federation in 1987–2009 (To the 40th anniversary of the Laboratory of vitamins and minerals of Institute of Nutrition at Russian Academy of Medical Sciences). Voprosy pitaniya (Problems of Nutrition). 2010;79(3):68–72. (in Russian)

20. Gey K.F. Vitamins E plus C and interacting conutrients required for optimal health. Biofactors. 1998;7(1–2):143–174. DOI: 10.1002/biof.5520070115

21. Mazzawi T., Hausken T., Gundersen D., El-Salhy M. Effects of dietary guidance on the symptoms, quality of life and habitual dietary intake of patients with irritable bowel syndrome. Mol. Med. Rep. 2013;8(3):845–52. DOI: 10.3892/mmr.2013.1565.

22. Williams C.E., Williams E.A., Corfe B.M. Vitamin D status in irritable bowel syndrome and the impact of supplementation on symptoms: what do we know and what do we need to know? European J. Clin. Nutr. 2018;72(10):1358–1363. DOI: 10.1038/s41430-017-0064-z

23. Li J., Chen N., Wang D., Zhang J., Gong X. Efficacy of vitamin D in treatment of inflammatory bowel disease: A meta-analysis. Medicine. 2018;97(46):e12662. DOI: 10.1097/MD.0000000000012662

24. Jalili M., Vahedi H., Poustchi H., Hekmatdoost A. Effects of Vitamin D Supplementation in Patients with Irritable Bowel Syn drome: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial. Int. J. Prev. Med. 2019;10:16. DOI: 10.4103/ijpvm.IJPVM_512_1734.

25. Kodentsova V.M., Vrzhesinskaya O.A. Multivitamin-mineral complexes «dosa–effect» correlation. Voprosy pitaniia (Problems of Nutrition). 2006;75(1):30–39. (in Russian)

26. Simek R.Z., Prince J., Syed S., Sauer C.G., Martineau B., Hofmekler T., et al. A pilot study evaluating efficacy of two dosing regimens for repletion of hypovitaminosis D in pediatric inflammatory bowel disease. Journal of pediatric gastroenterology and nutrition. 2016;62(2):252–8. DOI: 10.1097/MPG.0000000000000915

27. Karimi S., Tabataba-vakili S., Yari Z., Alborzi F., Hedayati M., Ebrahimi-Daryani N., Hekmatdoost A. The effects of two vitamin D regimens on ulcerative colitis activity index, quality of life and oxidant/anti-oxidant status. Nutrition Journal. 2019;18(1):16. DOI: 10.1186/s12937-019-0441-7

28. Kodentsova V.M., Kharitonchik L.A., Vrzhesinskaia O.A., Abdulkerimova Kh.Z. Substantiation of the need of fortification with vitamins of the diet of children with gastrointestinal diseases. Voprosy pitaniya (Problems of Nutrition). 2001;70(3):15–9. (in Russian)