Department of Medical Oncology, University Medical Center Groningen, University of Groningen, The Netherlands.
Aliment Pharmacol Ther. 2010 Dec;32(11-12):1398-404. doi: 10.1111/j.1365-2036.2010.04479.x. Epub 2010 Oct 7.
Somatostatin analogues are administered to control hormone hypersecretion in acromegaly and carcinoid patients. Somatostatin analogues can increase fat in the stools, which can lead to loss of fat-soluble vitamins. The effect of long-term somatostatin analogue use on vitamin levels remains unknown.
To investigate the prevalence of fat-soluble vitamin deficiencies in long-term somatostatin analogue users.
All acromegaly and carcinoid patients using somatostatin analogues for ≥ 18 months visiting the University Medical Center Groningen between December 2008 and April 2009 were eligible. Vitamin levels of fat-soluble vitamins in blood, clinical and vitamin-dependent laboratory parameters were collected.
In all, 19 acromegaly and 35 carcinoid patients were included. Twelve patients experienced steatorrhoea; two carcinoid patients experienced night blindness. Forty-two (78%) were deficient for one or more vitamins, and 32% (n = 17) had multiple deficiencies. Deficiencies for vitamin A, D, E, K1 and E in erythrocytes occurred in 6%, 28%, 15%, 63% and 58% of the patients. Prevalence of vitamin D, E and K1 deficiencies was similar in both patient groups. Treatment duration did not influence vitamin levels. The length of intestinal resection and age correlated negatively with vitamin A levels.
Fat-soluble vitamin deficiencies are frequent during long-term somatostatin analogue treatment. Therefore, fat-soluble vitamins should be monitored in these patients.
生长抑素类似物被用于控制肢端肥大症和类癌患者的激素过度分泌。生长抑素类似物会增加粪便中的脂肪含量，从而导致脂溶性维生素流失。长期使用生长抑素类似物对维生素水平的影响尚不清楚。
调查长期使用生长抑素类似物的患者脂溶性维生素缺乏的发生率。
所有在 2008 年 12 月至 2009 年 4 月期间在格罗宁根大学医学中心使用生长抑素类似物≥18 个月的肢端肥大症和类癌患者均符合入选标准。收集血液中脂溶性维生素的维生素水平、临床和维生素依赖的实验室参数。
共纳入 19 例肢端肥大症患者和 35 例类癌患者。12 例患者出现脂肪泻；2 例类癌患者出现夜盲症。42 例（78%）存在 1 种或多种维生素缺乏，32%（n=17）存在多种维生素缺乏。6%的患者红细胞中维生素 A、D、E、K1 和 E 缺乏，28%、15%、15%、63%和 58%的患者缺乏。两组患者维生素 D、E 和 K1 的缺乏率相似。治疗时间的长短并未影响维生素水平。肠切除的长度和年龄与维生素 A 水平呈负相关。
长期使用生长抑素类似物治疗会导致脂溶性维生素缺乏，因此应监测这些患者的脂溶性维生素水平。
