Abstract
Background
To determine the prevalence of ascorbic acid deficiency in the surgical population,
whether the body mass index (BMI) has an effect on ascorbic acid concentrations; and
whether an association exists between ascorbic acid deficiency and adverse surgical
outcomes.
Methods
Preoperative plasma ascorbic acid concentrations were prospectively assessed in 20–60-year-old
patients undergoing elective abdominal surgery. Ascorbic acid deficiency was defined
as any concentration ≤0.3 mg/dL and depletion as any concentration >0.3–0.59 mg/dL.
Results
Of the 266 patients evaluated, 167 had a BMI ≥35 kg/m2. A greater BMI was associated with lower mean ascorbic acid concentrations (P = .021). Of the 266 patients, 96 (36%) had abnormally low ascorbic acid concentrations,
with 57 (21%) depleted and 39 (15%) deficient. The factors associated with decreased
mean ascorbic acid concentrations included younger age (P = .004) and limited vegetable and fruit intake (P = .026). Ascorbic acid supplementation was associated with lower depletion and deficiency
rates (P = .001).
Conclusion
Ascorbic acid depletion and deficiency occur within the surgical population. The contributing
factors included younger age, limited intake of fruits and vegetables, lack of vitamin
supplementation, and greater BMI. Low concentrations of ascorbic acid did not affect
the surgical outcome.
Keywords
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References
- Criteria and recommendations for vitamin C intake.JAMA. 1999; 281: 1415-1423
- Vitamin C function and status in chronic disease.Nutr Clin Care. 2002; 15: 66-74
- Subclinical scurvy—hypovitaminosis C.Geriatrics. 1972; 27: 130-131
- Scurvy.J Am Acad Dermatol. 1994; 30: 881-883
- Hemorrhage associated with vitamin C deficiency in surgical patients.Surgery. 2002; 131: 408-412
- Evidence for a recommended dietary allowance for vitamin C from pharmacokinetics: a comment and analysis.Proc Natl Acad Sci. 1996; 93: 14344-14348
- Water-soluble vitamin absorption in intestine.Annu Rev Physiol. 1980; 42: 157-171
- Vitamin C.in: Shils M.E. Olson J.A. Shike M. Ross A.C. Modern nutrition in health and disease. 9th ed. Lippincott Williams & Wilkins, Baltimore1999: 467-483
- Ascorbic acid—scurvy.Prog Food Nutr Sci. 1975; 1: 493-506
- Bachelor scurvy.Int J Dermatol. 1982; 21: 209
- The influence of smoking on vitamin C status in adults.Am J Public Health. 1989; 79: 158-162
- Ascorbic acid requirements for smokers: analysis of a population survey.Am J Clin Nutr. 1991; 53: 1466-1470
- Ascorbic acid depletion in patients undergoing chronic hemodialysis.Am J Clin Nutr. 1970; 23: 1339-1346
- Serum beta-carotene and vitamin C as biomarkers of vegetable and fruit intakes in a community-based sample of French adults.Am J Clin Nutr. 1997; 65: 1796-1802
- Serum concentrations of beta-carotene, vitamins C and E, zinc and selenium are influenced by sex, age, diet, smoking status, alcohol consumption and corpulence in a general French adult population.Eur J Clin Nutr. 2005; 59: 1181-1190
- Serum homocysteine, B12 and folic acid concentration in Thai overweight and obese subjects.Int J Vitam Nutr Res. 2003; 73: 8-14
- Associations between body mass index and the prevalence of low micronutrient levels among US adults.MedGenMed. 2006; 8: 59
- Platelet function in scurvy and experimental human vitamin C deficiency.Thromb Res. 1981; 24: 85-93
- Ascorbic acid and blood vessels: the formation and maintenance of connective tissue and blood vessels within polyvinyl sponge implants in ascorbic acid supplemented and ascorbic acid depleted guinea pigs.Arch Pathol. 1961; 72: 535-545
- Obesity: preventing and managing the global epidemic.Report of a WHO consultation. 1997; (Geneva, Switzerland. June 3–5)
- Nutrition in adverse environments, 1.Hum Nutr Appl Nutr. 1982; 36: 35-45
- Experimental scurvy in man.Am J Clin Nutr. 1969; 22: 535-548
- Vitamin C deficiency and depletion in the United States: the Third National Health and Nutrition Examination Survey, 1988 to 1994.Am J Public Health. 2004; 94: 870-875
- Vitamin C status of an outpatient population.J Am Coll Nutr. 1998; 17: 366-370
- Vitamin C.in: Dietary reference intakes for vitamin c, vitamin e, selenium, and carotenoids. National Academy Press, Washington, DC2000: 95-185
- Vitamin C status of a campus population: college students get a C minus.J Am Coll Health. 1998; 46: 209-213
- Plasma ascorbic acid concentrations and fat distribution in 19,068 British men and women in the European Prospective Investigation into Cancer and Nutrition Norfolk Cohort Study.Am J Clin Nutr. 2005; 82: 1203-1209
- Obesity and systemic oxidative stress: clinical correlates of oxidative stress in the Framingham Study.Arterioscler Thromb Vasc Biol. 2003; 23: 434-439
- Scurvy and the gastrointestinal tract.Gastrointest Endosc. 1997; 45: 195-196
- Ascorbic acid economy in surgical patients.Ann NY Acad Sci. 1961; 92: 246-267
- Recurrent hemoperitoneum reversed by ascorbic acid.JAMA. 1977; 237: 1358-1359
- The bioavailability to humans of ascorbic acid from oranges, orange juice and cooked broccoli is similar to that of synthetic ascorbic acid.J Nutr. 1993; 123: 1054-1061
Article info
Publication history
Published online: July 10, 2008
Accepted:
June 26,
2008
Received in revised form:
June 24,
2008
Received:
April 11,
2008
Footnotes
This study was supported by the Gundersen Lutheran Medical Foundation.
Identification
Copyright
© 2009 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
