Tocopherol Isomers in Intravenous Lipid Emulsions and Resultant Plasma Concentrations

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Abstract
Conflicting reports exist regarding the relative tocopherol isomer content of Intralipid ranging from 99% as α‐tocopherol to as much as 90% as γ‐tocopherol. Our direct assay of Intralipid as well as plasma levels measured in premature infants receiving Intralipid confirm the existence of a low α, high γ‐tocopherol content and imply the need for α‐tocopherol supplementation in patients receiving Intralipid, particularly the relatively tocopherol‐deficient premature infant. Furthermore, the observation of abnormal erythrocyte hemolysis test values despite “normal” total tocopherol plasma concentrations may be explained by high plasma levels of non‐α, biologically less active isomers. The quantitation of tocopherol isomers helps explain this discrepancy and suggests the need for future studies of vitamin E status to employ measurements of tocopherol isomers in reporting results. (Journal of Parenteral and Enteral Nutrition 8:269–273, 1984)

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