Association between the intake of vitamins and trace elements from supplements and C-reactive protein: results of the MONICA/KORA Augsburg study

OBJECTIVE: To examine the association between plasma concentrations of C-reactive protein (CRP) and the intake of vitamins and trace elements from supplements possibly related to inflammation such as vitamin C, vitamin E, carotenoids, selenium and zinc. DESIGN: Cross-sectional study using data from the Monitoring of Trends and Determinants in Cardiovascular Disease/Cooperative Health Research in the Region of Augsburg (MONICA/KORA) Survey 1994/95. SETTING: Region of Augsburg, Southern Germany. SUBJECTS: Population-based sample of 2045 women and 2172 men, aged 25-74 years. RESULTS: Intake of dietary supplements containing vitamins and trace elements was associated with lower CRP levels in women. Especially vitamin E in combination with other vitamins like vitamin C, vitamin B(1), B(2), B(6), B(12), niacin, folic acid, pantothenic acid and selenium, was significantly associated with lower CRP levels. Odds ratios for elevated CRP levels (>3.0 mg/l) after multivariable adjustment were 0.57 (95% confidence interval (CI): 0.37, 0.89) for the intake of vitamin E and 0.57 (95% CI: 0.35, 0.91) for the intake of multivitamins, defined as taking three or more different vitamins. These associations were not seen in men. Intake of vitamin C, carotenoids or zinc was not significantly associated with levels of CRP in both men and women. CONCLUSIONS: Our data indicate that the intake of certain vitamins and trace elements from supplements is associated with lower CRP concentrations in women. Thus, intake of these micronutrients could influence the inflammatory process underlying the pathogenesis of atherosclerosis. Specific dose response relationships and the best combinations of vitamins and trace elements have to be determined in further studies.     

赖氨葡锌颗粒对反复呼吸道感染儿童血清微量元素锌含量的影响

目的观察赖氨葡锌颗粒对反复呼吸道感染儿童血清微量元素锌含量的影响,探讨儿童反复呼吸道感染与血清微量元素锌的关系。方法将58例反复呼吸道感染患儿纳入观察组,取56例同年龄段的健康儿童作为健康对照组,取静脉血测定微量元素锌含量;对患儿组进行口服赖氨葡锌冲剂治疗6个月后再进行血微量元素锌测定,观察治疗前后血微量元素锌的变化。结果患儿组血锌为(43.62±3.22)μmol/L,而对照组血锌为(77.78±6.56)μmol/L,患儿组血锌明显低于对照组,差异具有显著性意义(P<0.01);患儿组经口服赖氨葡锌颗粒治疗6个月后血锌上升到(72.30±6.08)μmol/L,比治疗前明显升高,治疗后前后比较,差异有显著性意义(P<0.01)。结论赖氨葡锌颗粒可明显升高反复呼吸道感染儿童血清微量元素锌的含量,说明微量元素锌与儿童反复呼吸道感染有关。     

Effect of Antioxidants and B-Group Vitamins on Risk of Infections in Patients with Type 2 Diabetes Mellitus

Previous studies have revealed that diabetic patients have a decline in immunity and an increased risk of infections, and this may be associated with poor micronutrient status. The aim of this study was to measure the effect of dietary supplements on risk of infection in patients with type 2 diabetes mellitus. One hundred patients with type 2 diabetes mellitus were randomly assigned to receive an oral dose of daily B-group vitamins and antioxidant vitamins (n = 50) or an identical placebo (n = 50) daily for 90 days. Patients had baseline, three and 12 month assessment for nutritional status, fruits and vegetables intake, physical activity and self-reported infections. Supplementation with antioxidants and B-group vitamins significantly increased the plasma concentration of vitamin E and folate and reduced homocysteine in the intervention group (p-values were 0.006, 0.001 and 0.657, respectively). The number of infections reported by the treatment group after three months of supplements was less than that reported by the placebo group, 9 (27%) vs. 15 (36%) (p = 0.623). Corresponding numbers of infections at 12 months were 25 (67.5%) and 27 (56.3%), respectively (p = 0.488). Up to 90% of the diabetic patients were either overweight or obese with a sedentary life style, and their body weight increased further during three months of follow up. The study showed that multivitamin supplements improved vitamin blood concentrations; however, this did not reduce the number of infections in diabetic patients.     

Selected vitamins and trace elements support immune function by strengthening epithelial barriers and cellular and humoral immune responses

Adequate intakes of micronutrients are required for the immune system to function efficiently. Micronutrient deficiency suppresses immunity by affecting innate, T cell mediated and adaptive antibody responses, leading to dysregulation of the balanced host response. This situation increases susceptibility to infections, with increased morbidity and mortality. In turn, infections aggravate micronutrient deficiencies by reducing nutrient intake, increasing losses, and interfering with utilization by altering metabolic pathways. Insufficient intake of micronutrients occurs in people with eating disorders, in smokers (active and passive), in individuals with chronic alcohol abuse, in certain diseases, during pregnancy and lactation, and in the elderly. This paper summarises the roles of selected vitamins and trace elements in immune function. Micronutrients contribute to the body's natural defences on three levels by supporting physical barriers (skin/mucosa), cellular immunity and antibody production. Vitamins A, C, E and the trace element zinc assist in enhancing the skin barrier function. The vitamins A, B6, B12, C, D, E and folic acid and the trace elements iron, zinc, copper and selenium work in synergy to support the protective activities of the immune cells. Finally, all these micronutrients, with the exception of vitamin C and iron, are essential for antibody production. Overall, inadequate intake and status of these vitamins and trace elements may lead to suppressed immunity, which predisposes to infections and aggravates malnutrition. Therefore, supplementation with these selected micronutrients can support the body's natural defence system by enhancing all three levels of immunity.     

Effect of a blueberry nutritional supplement on macronutrients,food group intake,and plasma vitamin E and vitamin C in US athletes

Antioxidants from a blueberry beverage may impact plasma vitamins. We examined vitamins/food selection in 12 college athletes during 30 days compared with placebo. Blood was collected before and after exercise at the beginning of the study (day 1) and then after a 30-day period of taking a daily supplemental beverage (day 30). The six trials involved blood that was drawn pre-beverage ingestion/pre-exercise (trials 1 and 4), post-beverage ingestion/pre-exercise (trials 2 and 5), and post-beverage ingestion/1 h post-exercise (trials 3 and 6), on day 1 (trials 1, 2, and 3) and day 30 (trials 4, 5, and 6). Analysis of variance revealed non-significant differences for macronutrient or γ-tocopherol and vitamin C intakes by food frequency questionnaire or plasma vitamins by liquid chromatography. There was a trend (P=0.083) in the group×time interaction for α-tocopherol intake by repeated-measures analysis of variance. Blueberry α-tocopherol (23.91±9.31 mg) was significantly (P<0.05) higher than placebo α-tocopherol intake (7.59±0.95 mg) on day 1, but not on day 30 (blueberry, α-tocopherol=9.04±2.35 mg, placebo, α-tocopherol=11.46±3.65 mg) by pairwise comparisons. Blueberry supplementation did not affect plasma vitamin concentrations or γ-tocopherol and vitamin C intakes, and may reduce α-tocopherol intake in those starting with a higher α-tocopherol intake, yet not altering athletes' eating habits.     

Multi-Level Immune Support by Vitamins C and D during the SARS-CoV-2 Pandemic

Vitamins C and D have well-known immune supportive roles, with deficiencies in both vitamins predisposing to increased risk and severity of respiratory infections. Numerous studies have indicated that administration of these vitamins, particularly to people who are deficient, can decrease the risk and severity of respiratory infections. This has stimulated an interest in the potential efficacy of these vitamins in people with novel coronavirus (SARS-CoV-2) infection and its more severe disease (COVID-19). In this overview, we highlight the current research evidence around the multiple levels of immune support provided by vitamins C and D in the context of general respiratory infections and with a focus on the current SARS-CoV-2 pandemic. These include: prevention of infection; attenuating infection symptoms and severity; adjunctive therapy for severe disease; attenuating ongoing sequelae (long COVID); and immunisation support. Although some of these topics have not yet been investigated in great depth concerning SARS-CoV-2 and COVID-19, extensive research into the role of these vitamins in general respiratory infections has highlighted directions for future research in the current pandemic.     

Maintenance of vitamin and trace element status in intravenous nutrition using a complete nutritive mixture

Complete nutritive mixtures (CNM) of all intravenous nutrients including fat emulsions are being used increasingly because of their convenience. However, this may lead to chemical interactions and reduce the amount of active vitamins and trace elements made available to the patient. We have studied the effects on micronutrient status of provision of all nutrients in one 3-liter bag (CNM: amino acids, dextrose, Intralipid 20%, a nine-element trace metal mixture, and complete fat- and water-soluble vitamin mixtures) in 10 postoperative surgical patients [median intravenous nutrition (IVN) 14.5 days, range 7-38]. A similar group received the fat emulsion plus water- and fat-soluble vitamins as a separate infusion (SI) from a 3-liter bag (median IVN 14.0 days, range 8-28). Serum and urine magnesium, zinc, copper, manganese, chromium, and selenium, serum vitamins A, E, C, folate, and B12, RBC B1, B2 B6, and folate and leukocyte vitamin C were measured at weekly intervals. All patients in both groups maintained or improved their status for all the micronutrients analyzed. No significant differences between the CNM and SI groups were found in blood concentrations of any of the elements or vitamins. Only for urine copper did the CNM lead to increased excretion (1.51 +/- 0.59 mumol/24 hr; copper input 20 mumol/day), compared to SI (1.00 +/- 0.70 mumol/day, p less than 0.001 Mann-Whitney test) suggesting possible interaction. It is concluded that micronutrient status was maintained during short-term IVN with the CNM and that it did not lead to a significantly greater loss of vitamins or essential trace elements than the SI system.     

Daily Intake of Milk Enriched with n-3 Fatty Acids,Oleic Acid,and Calcium Improves Metabolic and Bone Biomarkers in Postmenopausal Women

Objective: Nutritional strategies can be effective for the prevention of menopause-related diseases, such as osteoporosis and cardiovascular disease. Our aim was to evaluate the effects of a dairy product enriched in polyunsaturated fatty acids, calcium, oleic acid, and vitamins on cardiovascular markers and bone metabolism in postmenopausal women with moderate cardiovascular risk.

Methods: One hundred seventeen healthy postmenopausal women (aged 45 ± 7.7 years) were allocated to 2 groups: the intervention group (IG; n = 63), who consumed 0.5 L/day of a low-lactose skimmed milk enriched with 40 mg/100 mL of eicosapentaenoic acid (EPA) + docosahexaenoic acid (DHA), 0.54 g/100 mL oleic acid, and vitamins, and the control group (CG; n = 54), who consumed 0.5 L/day of semiskimmed milk 0.5 L/day enriched with vitamins A and D.

Results: After 12 months, in the IG there was an improvement in lipid profile: a ?5.78% decrease in total cholesterol (p = 0.010), ?9.79% (p = 0.004) in low-density lipoprotein (LDL) cholesterol, ?9.56% (p < 0.001) in total cholesterol (TC)/high-density lipoprotein (HDL) ratio, and ?3.38% in LDL/HDL ratio (p < 0.001). No changes were observed in the CG. In the IG we observed a decrease of ?28.20% in high-sensitivity C-reactive protein (hs-CRP; p = 0.012). There was no effect on bone turnover markers or serum osteoprotegerin (OPG) in either of the study groups. In the IG, receptor activator of nuclear factor κB ligand (RANKL) was reduced ?17.64% (p = 0.003), with no effect in the CG.

Conclusion: In postmenopausal women with moderate cardiovascular risk, dietary supplementation with a dairy drink enriched with fatty acids (EPA+DHA), oleic acid, minerals, and vitamins induces a positive effect on cardiovascular risk and parameters of bone metabolism. Its regular consumption may be a useful nutritional support for postmenopausal women.     

Influence of vitamins, trace elements, and iron on lipid peroxidation reactions in all-in-one admixtures for neonatal parenteral nutrition

Background: The purpose of this study was to evaluate the effect of vitamins, trace elements, or iron on lipid peroxidation in all‐in‐one parenteral nutrition (PN) admixtures for preterm neonates. Methods: Malondialdehyde (MDA) concentrations were analyzed over a 24‐hour period (H1‐H24) in lipid‐containing PN solutions that have a composition identical to that used in the routine clinical care of preterm infants. Six different solutions were prepared and evaluated when exposed to ambient light and light‐protected conditions as follows: control (without vitamins [Vit], trace elements [TE], or iron [Fe] [Vit?TE?Fe?]), solution 1 (Vit+TE+Fe?), solution 2 (Vit+TE?Fe?), solution 3 (Vit?TE+Fe?), solution 4 (Vit?TE?Fe+), and solution 5 (Vit+TE+Fe+). Results: MDA concentrations in PN solutions were significantly higher at H24 than at H0 when they contained multivitamins (P < .001), trace elements (P = .002), or iron saccharate (P = .018). MDA concentration was particularly high when all 3 micronutrients were present (P < .001) or when the solutions were exposed to ambient light. In solutions containing iron, MDA concentrations were elevated at H0, and levels did not change whether protected from (P < .001) or exposed to (P < .001) from light. Conclusions: The addition of vitamins and trace elements to PN solutions induces a significant increase in peroxidation products, which are lowered when admixtures are protected from light. Iron should not be included in these solutions, even if solutions are light‐protected. By following these conditions it is possible to use all‐in‐one admixtures in the nutrition management of preterm infants.     

Maternal Diet,Infection, and Risk of Cord Blood Inflammation in the Bangladesh Projahnmo Pregnancy Cohort

Inflammation may adversely affect early human brain development. We aimed to assess the role of maternal nutrition and infections on cord blood inflammation. In a pregnancy cohort in Sylhet, Bangladesh, we enrolled 251 consecutive pregnancies resulting in a term livebirth from July 2016–March 2017. Stillbirths, preterm births, and cases of neonatal encephalopathy were excluded. We prospectively collected data on maternal diet (food frequency questionnaire) and morbidity, and analyzed umbilical cord blood for interleukin (IL)-1α, IL-1β, IL-6, IL-8 and C-reactive protein. We determined associations between nutrition and infection exposures and cord cytokine elevation (≥75% vs. <75%) using logistic regression, adjusting for confounders. One-third of mothers were underweight (BMI < 18.5 kg/m²) at enrollment. Antenatal and intrapartum infections were observed among 4.8% and 15.9% of the sample, respectively. Low pregnancy intakes of B vitamins (B1, B2, B3, B6, B9 (folate)), fat-soluble vitamins (D, E), iron, zinc, and linoleic acid (lowest vs. middle tertile) were associated with higher risk of inflammation, particularly IL-8. There was a non-significant trend of increased risk of IL-8 and IL-6 elevation with history of ante-and intrapartum infections, respectively. In Bangladesh, improving micronutrient intake and preventing pregnancy infections are targets to reduce fetal systemic inflammation and associated adverse neurodevelopmental outcomes.     

The Adjuvant Nutritional Intervention in Cancer (ANICA) Trial

Adjuvant Nutritional Intervention in Cancer (ANICA) was a clinical study carried out in Denmark in the 1990s with 32 typical patients with breast cancer, aged 32–81 yr and classified high risk because of tumor spread to the lymph nodes. The patients received standard therapy for their breast cancer, but got from the start additionally an adjuvant therapy in form of a cocktail consisting of vitamin C (2,850 mg/day), vitamin E (2,500 IU/day), beta-carotene (32.5 IU/day), selenium (Se; 387 micrograms/day), various other vitamins and essential trace elements, essential fatty acids (1.2 g gamma-linolenic acid/day and 3.5 g omega-3 PUFAs/day), and coenzyme Q₁₀ (CoQ₁₀, 90 mg/day). The protocol was later changed, with reduction of the Se intake and more coenzyme Q₁₀ than when the study was started. The average survival of high-risk breast patients in the study was 50% after 5 yr, whereas for low-risk breast cancer patients (without metastases in the axilla when treatment was started), the average survival was 90% after ten years. The main investigator died, and the final report from the ANICA study was therefore never written. However, the published preliminary results from the trial were very promising; it seems, therefore, important to follow-up this study.     

Use of vitamins,trace elements,or herbal products does not differ between cancer patients and population in general

Objective: To examine how widely cancer patients use vitamins, trace elements, and herbal products. Methods: The Health and Social Support Study (HeSSup) population consisted of a stratified random sample drawn from the Finnish Population Register in four age groups: 20–24, 30–34, 40–44, and 50–54 years. The survey was carried out by postal questionnaire during 1998, with a response rate of 40.0%. Altogether, 19 626 individuals returned the follow-up questionnaire during 2003, a response rate of 75.8%. The sample comprised 167 individuals diagnosed with malignant cancer from 1998 to 2002 according to the Finnish Cancer Registry. Respondents in 2003 were asked about their use of vitamins, trace elements, or herbal products during the last year. Four randomly selected age- and sex-matched controls for comparison were selected for every cancer patient. Results: One in three among both cancer patients and controls had not used vitamins, trace elements, or herbal products at all. In this respect, there were no statistically significant differences between cancer patients and their respective controls.

Conclusion: If the use of these products is useless, cancer patients act as reasonable as the population in general. If their use is generally recommended for supplementary therapy, cancer patients do not follow recommendations.     

Serum vitamins in adult patients with short bowel syndrome receiving intermittent parenteral nutrition

Background: Short bowel syndrome (SBS) occurs after massive intestinal resection, and parenteral nutrition (PN) therapy may be necessary even after a period of adaptation. The purpose of this study was to determine the vitamin status in adults with SBS receiving intermittent PN. Methods: The study was conducted on hospitalized adults with SBS who were receiving intermittent PN therapy (n = 8). Nine healthy volunteers, paired by age and sex, served as controls. Food ingestion, anthropometry, plasma folic acid, and vitamins B₁₂, C, A, D, E, and K were evaluated. Results: The levels of vitamins A, D, and B₁₂ in both groups were similar. SBS patients presented higher values of folic acid (21.3 ± 4.4 vs 14.4 ± 5.2, P = .01) and lower values of vitamin C (0.9 ± 0.4 vs 1.2 ± 0.3 mg/dL, P = .03), α‐tocopherol (16.3 ± 3.4 vs 24.1 ± 2.7 µmol/L, P < .001), and phylloquinone (0.6 ± 0.2 vs 1.0 ± 0.5 nmol/L, P < .03). Eight‐seven percent of patients had vitamin D deficiency, and all patients presented with serum vitamin E levels below reference values. Conclusions: Despite all efforts to offer all the nutrients mentioned above, SBS patients had lower serum levels of vitamins C, E, and K, similar to those observed in patients on home PN. These findings suggest that the administered vitamins were not sufficient for the intermittent PN scheme and that individual adjustments are needed depending on the patient's vitamin status.     

妊娠期补充微量元素及维生素对妊娠高血压疾病的预防作用

目的探讨孕妇妊娠期补充微量元素(铁和锌)及维生素(叶酸和维生素D)对妊娠高血压疾病的预防作用。方法以2014年1月到2016年3月期间在海南省三亚市妇幼保健医院妇产科就诊经医学检查确认怀孕的768例育龄期女性为研究对象,随机平均分为A、B、C三组,其中A组补充适量的维生素(包括叶酸和维生素D)和微量元素(包括铁和锌);B组补充适量铁和锌两种微量元素,而不补充维生素;C组既不补充维生素也不补充微量元素。考察在经过补充微量元素和维生素后,三组血中铁、锌含量,叶酸及维生素含量,24小时动态血压指标和妊娠高血压发病率上的差异。结果 A、B组血液中的铁、锌含量较C组有明显提高;通过口服补充维生素,A组血液中的叶酸和维生素D含量较B、C两组有明显提高。经24小时动态血压检测比较发现,A、B、C三组在收缩压和舒张压存在显著差异,三组在妊娠高血压总发病率、1级高血压发病率和2级高血压发病率比较上也存在显著差异,C组B组A组,差异均有统计学意义。结论孕妇妊娠期补充微量元素(铁和锌)和维生素(叶酸和维生素D)相比不补充的孕妇,妊娠高血压综合征的发生率明显下降,妊娠期补充微量元素(铁和锌)和维生素(叶酸和维生素D)对预防妊娠高血压疾病具有一定的作用。     

L-Ascorbic Acid and α-Tocopherol Reduces Hepatotoxicity Associated with Arsenic Trioxide Chemotherapy by Modulating Nrf2 and Bcl2 Transcription Factors in Chang liver Cells

Arsenic trioxide (As₂O₃) is a promising new regimen for the treatment of acute promyelocytic leukemia (APL). The induction of oxidative stress mediated by reactive oxygen species (ROS) and excessive intracellular calcium influx are the main reasons behind As₂O₃ toxicity. Since liver is the major organ for xenobiotic metabolism, it is always under stress. Antioxidant vitamins such as L-Ascorbic acid (L-AA) and α-Tocopherol (α-TOC) have been proposed to have beneficial effects against a variety of pathological conditions and are known by their free radical scavenging properties. The present study evaluates the curative efficacy of L-AA and α-TOC against As₂O₃ toxicity using immortalized human Chang liver cells. Our results suggest that L-AA (100 µM) and α-TOC (50 µM) recovered As₂O₃ (10 µM) cytotoxicity. Furthermore, As₂O₃ treatment showed an increase in lipid peroxidation and depletion in antioxidant status, mitochondrial trans membrane potential and values of total antioxidant capacity. Cotreatment of antioxidant vitamins with As₂O₃ resulted in a significant reversal of oxidative stress markers. Our findings substantiate the effect of antioxidant vitamins in protecting the hepatocytes from oxidative stress which may be attributed through Nrf2 (Nuclear factor erythroid 2-related factor 2) mediated upregulation of Bcl2 (B-cell lymphoma 2) expression.     

Effect of vitamin and trace-element supplementation on cognitive function in elderly subjects

OBJECTIVE: To determine whether supplementation with vitamins and trace elements in modest amounts influences cognitive function in apparently healthy, elderly subjects. METHODS: The study was designed as a randomized, double-blind, placebo-controlled trial. Ninety-six, apparently healthy, independent men and women older than 65 y of age were recruited and randomized to receive a supplement of trace elements and vitamins or a placebo daily for 12 mo. Blood-nutrient levels were estimated at baseline and at the end of the study. The major outcome measure assessed was cognitive function consisting of immediate and long-term memory, abstract thinking, problem-solving ability, and attention. RESULTS: Eighty-six subjects completed the 1-y trial. The supplemented group showed a significant improvement in all cognitive tests (P < 0.001 to 0.05) except long-term memory recall (P > 0.1). Those whose blood-nutrient levels were below the reference standard showed lower responses on cognitive tests. There was no significant correlation between individual nutrient levels and performance on various cognitive function tests. CONCLUSIONS: Cognitive functions improved after oral supplementation with modest amounts of vitamins and trace elements. This has considerable clinical and public health significance. We recommend that such a supplement be provided to all elderly subjects because it should significantly improve cognition and thus quality of life and the ability to perform activities of daily living. Such a nutritional approach may delay the onset of Alzheimer's disease.     

Texte long argumentaire – CHAMP 7 – Nutrition parentérale en réanimation. Recommandations formalisées d’experts. Nutrition artificielle en réanimation SFAR-SRLF-SFNEP

Parenteral nutrition (PN) is a nutritional support technique consisting in the intravenous infusion of macronutrients (glucose, aminoacids and triglycerides), micronutrients (vitamins and trace elements), water and electrolytes. In the intensive care, PN is indicated in case of failure, insufficient or contra-indicated enteral nutrition. This paper has allowed the elaboration, according to the GRADE method, of the field 7 recommendations “Parenteral nutrition in the intensive care unit” of the French Societies SFAR-SRLF-SFNEP guidelines “Nutrition support in the intensive care unit”: 7.1 Ready-to-use tricompatimental bags rather than separated solutions have to be used (strong agreement); 7.2 It is requested to supplement the patient with vitamins and trace elements together with the administration of parenteral nutrition (strong agreement); 7.3 Lipid intake must be no more than 1.5 g/kg/day (strong agreement); 7.4 Parenteral nutrition must be administered continuously with an electric nutrition output-controlled pump, and cyclic administration must be avoided (strong agreement); 7.5 A central venous catheter must be used if the osmolarity of solutions exceed 850 mosm/l) (strong agreement); 7.6 Parenteral nutrition should be delivered through a dedicated route of the central venous catheter (weak agreement); 7.7 A metabolic complication or an excessive intake of nutrients should be looked after in case of blood analyses abnormalities (transaminases, bilirubin, gamma GT, alkaline phosphatases, ionogram, phosphates, glycemia, triglyceridemia) (strong agreement).     

Water-Soluble Vitamins and Trace Elements Losses during On-Line Hemodiafiltration

Maintenance hemodialysis induces water-soluble vitamins and trace elements losses, which is why recommendations regarding potential supplementation were provided, but mainly based on conventional hemodialysis. This study′s aim was to measure the water–soluble vitamins and trace element losses during one on-line post-dilution hemodiafiltration (HDF) session. Thirty-nine patients under maintenance HDF were enrolled. We used the Theraflux^® sampler (Theradial Corp., Orvault, France) to analyze the full session dialysate mass transfer. Blood and dialysate samples were collected before and after one HDF session to measure B1, B2, B6, B9, B12, C vitamins, zinc, and selenium concentrations. Values significantly decreased for B1 (20.2%), B2 (13%), B6 (25.4%), B9 (32.6%), C (66.6%) and selenium (6.7%). No significant differences were found for vitamin B12 and zinc. The dialysate losses per session were 1.12 ± 0.88 mg for vitamin B1, 0.28 ± 0.30 mg for B2, 0.33 ± 0.09 mg for B6, 0.3 ± 0.18 mg for B9, 147.5 ± 145.50 mg for C and 25.75 ± 6.91 mg for zinc. Vitamin B12 and selenium were under detection values. In conclusion, during a standard 4hr-HDF session, we found important losses for vitamin B1, B6, B9, C and zinc, suggesting the need for regular monitoring of plasma levels and systematic supplementation of these compounds.     

Vitamin supplementation reduces the level of homocysteine in the urine of autistic children

Significant differences in homocysteine levels in the urine of autistic children are observed. We hypothesized that vitamin supplementation might reduce the level of urinary homocysteine. To rationalize such a hypothesis, analyses were performed using the gas chromatography/mass spectrometry method. The homocysteine level in the urine of autistic children was measured twice: (1) before vitamin supplementation (group C, 30 autistic children) and (2) after supplementation, with either folic acid and vitamins B₆ and B₁₂ (group A1, 24 autistic children) or vitamins B₆ and B₁₂ alone (group A2, 6 autistic children). The homocysteine level in the urine of autistic children before vitamin supplementation was 2.41 ± 1.10 mmol/mol creatinine (mean ± SD difference). After treatment, the homocysteine level was reduced to 1.13 ± 0.44 and 1.33 ± 0.39 mmol/mol creatinine for A1 and A2 groups, respectively. The intake of vitamins B₆ and B₁₂, together with folic acid, was found to be more effective in lowering the levels of urinary homocysteine than the intake of vitamins B₆ and B₁₂ alone. Our findings may lead to the recommendation of including vitamins B₆ and B₁₂ together with folic acid supplementation in the diets of children with autism.