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Vitamin C Deficiency in a University Teaching Hospital

Lady Davis Institute for Medical Research, McGill University (R.G., L.J.H.)
Department of Diagnostic Medicine (S.E.), Jewish General Hospital, Montreal, CANADA

Address reprint requests to: Dr. L. John Hoffer, Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote-Ste.-Catherine Road, Montreal, Quebec, Canada H3T 1E2. E-mail: l.hoffer{at}mcgill.ca

Objectives: There is almost no information regarding the vitamin C status of patients treated in Canadian and American hospitals. We determined the prevalence and predictors of vitamin C deficiency in patients hospitalized on the acute-care wards of a Canadian teaching hospital, and tracked their plasma vitamin C concentrations while they were there.

Methods: This was a population-based cross-sectional and time course survey of 149 medical patients shortly after admission to a university teaching hospital. The procedure for sample handling, storage and analysis was validated by measuring the vitamin C concentrations of a reference sample of 141 presumably well nourished people and comparing the results with published norms.

Results: In keeping with published norms, 13% of people in the reference group had a subnormal vitamin C concentration (<28.4 µmol/L) and 3% were vitamin C deficient (<11.4 µmol/L). By contrast, 60% of hospitalized patients had a subnormal vitamin C concentration and 19% were deficient. A history of inadequate nutrition or failure to use a vitamin supplement prior to admission, low serum albumin, and male sex predicted plasma vitamin C deficiency, whereas use of a vitamin supplement prior to admission was associated with adequate vitamin C status in hospital. In a second measurement, obtained in 52 patients after an average of 17 days in hospital, vitamin C status had not improved.

Conclusions: Vitamin C deficiency is prevalent and sustained in patients in a Canadian teaching hospital. The abnormality can be prevented by providing a diet sufficient in vitamin C or by prescribing a multiple vitamin tablet.

Key words: ascorbic acid, vitamins, supplementation, scurvy