Thiamine, riboflavin, pyridoxine, and vitamin C status in premature infants receiving parenteral and enteral nutrition

Background: There is a paucity of data about water soluble vitamin status i n low birthweight infants. Therefore, the authors' objective was to assess current feeding protocols. Methods: The authors measured serum concentrations for riboflavin, pyridoxi ne, and vitamin C and functional assays for thiamine and riboflavin longitu dinally in 16 premature infants (birthweight, 1,336 +/- 351 g; gestational age, 30 +/- 2.5 weeks) before receiving nutrition (time 1, 2 +/- I days), d uring supplemental or parenteral nutrition (time 2, 16 +/- 10 days) and whi le receiving full oral feedings (time 3, 32 +/- 15 days). In plasma, vitami n C was measured colorimetrically, and riboflavin and pyridoxine were measu red using high-performance liquid chromatography. The erythrocyte transketo lase test as a functional evaluation of thiamine and the erythrocyte glutat hione reductase test for riboflavin were measured colorimetrically. Results: At time 1, nutrient intake of vitamins were negligible because inf ants were receiving intravenous glucose and electrolytes only. Intakes diff ered between time 2 and time 3 for thiamine (510 +/- 280 and 254 +/- 115 mu g . kg(-1) . d(-1), respectively), riboflavin (624 +/- 305 and 371 +/- 193 mug . kg(-1) . d(-1), respectively), and pyridoxine (394 +/- 243 and 173 +/ - 85 mug/100 kcal, respectively), but not for vitamin C (32 +/- 17 and 28 /- 12 mg . kg(-1) . d(-1), respectively). Blood levels at times 1, 2, and 3 were for thiamine (4.9 +/- 2.7%. 3.3 +/- 6.6%, and 4.1 +/- 9% erythrocyte transketolase test, respectively), riboflavin (0.91 +/- 0.31, 0.7 +/- 0.3, 0.91 +/- 0.18 erythrocyte glutathione reductase test, respectively), ribofl avin (19.5 +/- 17, 23.3 +/- 8.6, 17.6 +/- 10 ng/mL, respectively), pyridoxi ne (32 +/- 25, 40 +/- 16, 37 +/- 26 ng/mL, respectively), and vitamin C (5. 2 +/- 3, 5 +/- 2.2, 10 +/- 5 mug/mL, respectively) and did not differ at th ose times. Conclusions: Current intakes of these vitamins, except for possibly vitamin C, during parenteral and enteral nutrition seem to result in adequate plas ma concentrations and normal functional indices.