Excessive faecal losses of vitamin A (retinol) in cystic fibrosis

Abstract

Vitamin A (retinol) deficiency is a recognised complication of cystic fibrosis and is presumed to be a consequence of an impairment in the digestion and absorption of dietary fats. The dietary intake of fat and retinol was assessed from a seven day weighed food intake in 11 subjects with cystic fibrosis and 12 matched controls. Faecal excretion of retinol and fat were measured from three day stool collections. There was little difference between the two groups in the intake of fat or retinol equivalents. When studied the subjects with cystic fibrosis were clinically stable and the apparent absorption of fat was not significantly different to that in the controls. There was a significant increase in the faecal losses of retinol in cystic fibrosis, which was unrelated to the degree of fat in the stool. In cystic fibrosis the median retinol recovered in the stool was 40% of the intake, compared with 1.8% in the controls. It is concluded that there is a specific defect in the handling of retinol by the gastrointestinal tract in cystic fibrosis, which may be unrelated to the digestion and absorption of dietary fat.