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Tytuł pozycji:

Vitamin E supplementation in people with cystic fibrosis.

Tytuł:
Vitamin E supplementation in people with cystic fibrosis.
Autorzy:
Okebukola PO; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Kansra S; Department of Paediatric Respiratory Medicine, Sheffield Children's Hospital NHS Trust, Sheffield, UK.
Barrett J; West Midlands Adult Cystic Fibrosis Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Źródło:
The Cochrane database of systematic reviews [Cochrane Database Syst Rev] 2020 Sep 06; Vol. 9. Cochrane AN: CD009422. Date of Electronic Publication: 2020 Sep 06.
Typ publikacji:
Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Systematic Review
Język:
English
Imprint Name(s):
Publication: 2004- : Chichester, West Sussex, England : Wiley
Original Publication: Oxford, U.K. ; Vista, CA : Update Software,
MeSH Terms:
Dietary Supplements*
Cystic Fibrosis/*blood
Vitamin E/*administration & dosage
Vitamins/*administration & dosage
Adolescent ; Adult ; Bias ; Child ; Child, Preschool ; Exocrine Pancreatic Insufficiency/complications ; Female ; Humans ; Infant ; Male ; Placebos/administration & dosage ; Randomized Controlled Trials as Topic ; Vitamin E/blood ; Vitamin E/chemistry ; Vitamin E Deficiency/prevention & control ; Vitamins/chemistry ; alpha-Tocopherol/administration & dosage
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Substance Nomenclature:
0 (Placebos)
0 (Vitamins)
1406-18-4 (Vitamin E)
H4N855PNZ1 (alpha-Tocopherol)
Entry Date(s):
Date Created: 20200906 Date Completed: 20201019 Latest Revision: 20220919
Update Code:
20240104
PubMed Central ID:
PMC8406985
DOI:
10.1002/14651858.CD009422.pub4
PMID:
32892350
Czasopismo naukowe
Background: People with cystic fibrosis are at an increased risk of fat-soluble vitamin deficiency, including vitamin E. Vitamin E deficiency can cause a host of conditions such as haemolytic anaemia, cerebellar ataxia and cognitive difficulties. Vitamin E supplementation is widely recommended for people with cystic fibrosis and aims to ameliorate this deficiency. This is an updated version of the review.
Objectives: To determine the effects of any level of vitamin E supplementation on the frequency of vitamin E deficiency disorders in people with cystic fibrosis.
Search Methods: We searched the Cochrane Group's Cystic Fibrosis Trials Register and also searched international online trial registries for any ongoing clinical trials that were not identified during our register search. Date of last search of the Register: 11 August 2020. Date of last search of international online trial registries: 20 July 2020.
Selection Criteria: Randomised controlled trials and quasi-randomised controlled trials comparing any preparation of vitamin E supplementation to placebo or no supplement, regardless of dosage or duration.
Data Collection and Analysis: Two authors extracted outcome data from each study (published information) and assessed the risk of bias of each included study. They assessed the quality of the evidence using GRADE.
Main Results: Four studies with a total of 141 participants were included in the review, two of these were in children (aged six months to 14.5 years), and two did not specify participants' age. All studies used different formulations and doses of vitamin E for various durations of treatment (10 days to six months). Two studies compared the supplementation of fat-soluble as well as water-soluble formulations to no supplementation in different arms of the same study. A third study compared a water-soluble formulation to a placebo; and in the fourth study a fat-soluble formulation of vitamin E was assessed against placebo. There was limited detail about randomisation and blinding in the included studies which compromises the quality of the evidence base for the review. The heterogeneous mix of the formulations with differing biovailabilities among these studies also limits the generalisability of the data to the wider cystic fibrosis population. None of the studies in either comparison report the review's primary outcomes of vitamin E total lipid ratio or the incidence of vitamin E-specific deficiency disorders, or the secondary outcomes lung function or quality of life. Water-soluble vitamin E Water-soluble vitamin E may improve serum vitamin E levels compared with control at six months, one study (45 participants), mean difference (MD) 19.74 umol/L (95% confidence interval (CI) 13.48 to 26.00) (low-quality evidence). Similar results were also seen at one month, two studies (32 participants), MD 17.66 umol/L (95% CI 10.59 to 24.74) and at three months, one study (45 participants), MD 11.61 umol/L (95% CI 4.77 to 18.45). Only one study (45 participants) reported weight (secondary outcome of growth and nutritional status) at one and six months, but showed no difference between treatment and control at either time point. Fat-soluble vitamin E Two studies (36 participants) reported higher levels of serum vitamin E at one month with fat-soluble vitamin E compared with control, MD 13.59 umol/L (95% CI 9.52 to 17.66); however, at three months one study (36 participants) showed no difference between treatment and control. No studies in this comparison reported on growth or nutritional status.
Authors' Conclusions: Vitamin E supplementation may lead to an improvement in vitamin E levels in people with cystic fibrosis, although evidence we assessed was low quality. No data on other outcomes of interest were available to allow conclusions about any other benefits of this therapy. In future, larger studies are needed, especially in people already being treated with enteric-coated pancreatic enzymes and supplemented with vitamin E, to look at more specific outcome measures such as vitamin E status, lung function and nutritional status. Future studies could also look at the optimal dose of vitamin E required to achieve maximal clinical effectiveness.
(Copyright © 2020 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.)
Update of: Cochrane Database Syst Rev. 2017 Mar 06;3:CD009422. (PMID: 28262916)

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