Vitamin and mineral status in patients with hyperphenylalaninemia

Autors de IIS La Fe

• Jaime Dalmau Serra

  Autor

• Isidro Vitoria Miñana

  Autor

Autors aliens a IIS La Fe

• Crujeiras V
• Aldamiz-Echevarria L
• Andrade F
• Roca I
• Leis R
• Fernandez-Marmiesse A
• Couce ML

Grups d'Investigació

• Nutrición y Metabolopatías

  Investigador Principal

  Patricia Correcher Medina

Abstract

Natural sources of protein and some vitamins and minerals are limited in phenylketonuria (PKU) treated patients, who should receive optimal supplementation although this is not yet fully established. We conducted a cross-sectional observational multicenter study including 156 patients with hyperphenylalaninemia. Patients were stratified by age, phenotype, disease detection and type of treatment. Annual median blood phenylalanine (Phe) levels, Phe tolerance, anthropometric measurements, and biochemical parameters (total protein, prealbumin, electrolytes, selenium, zinc, B-12, folic acid, ferritin, 25-OH vitamin D) were collected in all patients. 81.4% of patients had biochemical markers out of recommended range but no clinical symptoms. Total protein, calcium, phosphorus, B-12, ferritin, and zinc levels were normal in most patients. Prealbumin was reduced in 34.6% of patients (74% with PKU phenotype and 94% below 18 years old), showing almost all (96.3%) an adequate adherence to diet. Selenium was diminished in 25% of patients (95% with PKU phenotype) and also 25-OHD in 14%. Surprisingly, folic acid levels were increased in 39% of patients, 66% with classic PKU. Phosphorus and 1352 levels were found diminished in patients with low adherence to diet. Patients under BH4 therapy only showed significant lower levels of B-12. This study shows a high percentage of prealbumin and selenium deficiencies as well as an increased level of folic acid in PKU treated patients, which should lead us to assess an adjustment for standards supplements formulated milks. (C) 2015 Elsevier Inc. All rights reserved.

Keywords

• Folic acid; Nutrition; Phenylketonuria; Selenium; Tetrahydrobiopterin