UKINETS2018 Poster Presentations (1) (28 abstracts)
Assessment of fat-soluble vitamins and trace elements in neuroendocrine tumour (NET) patients on somatostatin analogues
Mfon Ewang-Emukowhate 1, , Tara Whyand 1 , Yasmin Chotai De Lima 1 , Christos Toumpanakis 1 , Dalvinder Mandair 1 , Aimee Hayes 1 , Ashley Grossman 1 , Devaki Nair 2 & Martyn Caplin 1
1Neuroendocrine Tumour Unit, Royal Free Hospital, London, UK; 2Clinical Biochemistry, Royal Free Hospital, London, UK.
Introduction: NETs are a diverse group of neoplasms that originate from cells of the diffuse endocrine system. Often somatostatin analogues (SSA) are used as a first line treatment. Loose stools and steatorrhea are common adverse effects of SSA. This can affect the absorption of fat soluble vitamins and trace elements (TE). In this study we assess the prevalence of these deficiencies.
Methods: A prospective study of 66 patients on SSA. Vitamins A,D,E,K and the trace elements; copper, zinc and selenium were analysed. Duration of SSA use, stool type, treatment with creon and vitamin supplements were also recorded.
Results: Mean age was 64+/− 10 years. 97% (64) of primary tumour were small intestinal NET, 1.5% (1) pancreatic NET and 1.5% (1) hindgut NET. 47% of patients were deficient in at least one vitamin and 55% in at least one TE. 8.6%, 19%, 5% and 47% deficiencies were seen for vitamins A,D,E and K. It was 4.7%, 51.6%, and 16% for copper, zinc and selenium. Two patients had deficiencies in all fat soluble vitamins and TE. 53% (35) of patients reported taking multivitamins, vitamin D or a combination of both. They continued at the same dose during follow up. 20 patients (31%) recorded loose stools, of these, 70% were on creon pancreatic enzyme therapy. 42% (28) of patients were on Octreotide; 24 (86%) were on Octreotide LAR 30 mg, 1 (3.5%) on 40 mg and 1 (3.5%) on 50 mg, 2 (7%) were on SC Octreotide >600 mcg daily. 58% (38) of patients were on Lanreotide autogel; 95% (36) were on 120 mg and 5% (2) on 90 mg. Mean duration of SSA use was 6.3+/− 4.1 years. 94% of patients have been on SSA for over a year.
Conclusions: Deficiencies in fat soluble vitamins and TE is not uncommon in NET patients on SSA. Creon use, prescribed for NET patients with diarrhoea and steatorrhoea was more frequent in patients on SSA for more than a year. Supplementation of fat soluble vitamins and TE should be considered.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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