Vitamin C in Home Parenteral Nutrition: A Need for Monitoring

J. Grillot (1) , S. Ait , C. Bergoin (2) , T. Couronne , Eric Blond (1) , C. Peraldi , D. Barnoud (3) , C. Chambrier (4) , M. Lauverjat

1 CarMeN - Cardiovasculaire, métabolisme, diabétologie et nutrition
2 Service d'Hépatologie et de Gastroentérologie [Lyon]
3 Hôpital Edouard Herriot [CHU - HCL]
4 HCL - Hospices Civils de Lyon, Departement de Neurologie

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., \textless25 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 \textless 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.

Mots clés: vitamin C; Baxter; B Braun; Coloplast; Fresenius Kabi; Nutricia; Nestlé Clinical Nutrition; Shire. C.C. received lecture fees from Aguettant; commercial multivitamin preparation; Elivie; Janssen-Cilag; Mayoly Spindler; and MSD. T.C. none. E.B. none. C.P. received; LVL Medical and Nutricia.; fees from Nestlé Health Science France and Shire. C.B. received lecture fess from; and Nestlé Health Science France. S.A. received lecture; home parenteral nutrition; lecture fees from Takeda and Geistlich Pharma. D.B. received lecture fees from; Shire; Zealand. M.L. received lecture fees from Shire; Theradial; Takeda; Abbvie; Linde Homecare France; Experf Rhone Alpes

Domaines: Sciences du Vivant [q-bio]

J. Grillot, S. Ait, C. Bergoin, T. Couronne, Eric Blond, et al.. Vitamin C in Home Parenteral Nutrition: A Need for Monitoring. Nutrients, 2020, 12 (6), ⟨10.3390/nu12061667⟩. ⟨hal-02902508⟩