Deficiencies in fat-soluble vitamins in long-term somatostatin analogue users

Helle-Brit Fiebrich (1, 2) , Gerrit van den Berg (3) , Ido P Kema (4) , Thera P Links (3) , Jan H Kleibeuker (5) , Andre van Beek (3) , Annemiek Me Walenkamp (1) , Wim J Sluiter (3) , Elisabeth Ge de Vries (6)

1 Dept Medical Oncology
2 University Groningen
3 Endocrinology
4 Laboratory Medicine
5 Gastroenterology
6 Dept Medical Oncology

Background Somatostatin analogues are administered to control hormone hypersecretion in acromegaly and carcinoid patients. Somatostatin analogues can increase fat in the stools, which can lead to loss of fat-soluble vitamins. The effect of long-term somatostatin analogue use on vitamin levels is unknown. Aim To investigate the prevalence of fat-soluble vitamin deficiencies in long-term somatostatin analogue users. Methods All acromegaly and carcinoid patients using somatostatin analogues for ≥ 18 months visiting the UMCG, between December 2008 and April 2009 were eligible. Vitamin levels of fat-soluble vitamins in blood, clinical and vitamin-dependent laboratory parameters were collected. Results 19 acromegaly and 35 carcinoid patients were included. Twelve patients experienced steatorrhoea, two carcinoid patients experienced night blindness. Forty-two (78%) were deficient for ≥ one vitamins, 32% (n=17) for multiple. Deficiencies for vitamin A, D, E, K1 and E in erythrocytes occurred in 6%, 28%, 15%, 63% and 58% of the patients. Prevalence of vitamin D, E and K1 deficiencies were similar in both patients groups. Treatment duration did not influence vitamin levels. Length of intestinal resection and age correlated negatively with vitamin A levels. Conclusions Fat-soluble vitamins deficiencies are frequent during long-term somatostatin analogue treatment. Therefore, fat-soluble vitamins should be monitored. (NTR trialcode 1730)

Mots clés: Medicine

Helle-Brit Fiebrich, Gerrit van den Berg, Ido P Kema, Thera P Links, Jan H Kleibeuker, et al.. Deficiencies in fat-soluble vitamins in long-term somatostatin analogue users. Alimentary Pharmacology and Therapeutics, 2010, 32 (11-12), pp.1398. ⟨10.1111/j.1365-2036.2010.04479.x⟩. ⟨hal-00583894⟩