Vitamin deficits in severe alcoholic fatty liver of man calculated from multiple reference units

Liver tissue levels of thiamine, pantothenate, biotin, vitamin B₁₂, total folates, nicotinate, and vitamin B₆ were determined in biopsy and autopsy specimens from 69 patients with normal liver and 44 patients with severe fatty liver. These results define normal liver tissue B-complex vitamin levels in man and demonstrate a significant reduction of all the vitamins when the liver is severely infiltrated with fat. When vitamin levels in liver were related to dry weight, total fats, total nitrogen, and DNA-phosphorus as reference bases, vitamin titers in order of decreasing magnitude in normal livers were nicotinate, pantothenate, B₆, thiamine, N⁵-methyltetrahydrofolates, other tetrahydrofolates, B₁₂, and biotin. In the severe fatty liver pantothenate was higher than nicotinate and other tetrahydrofolates were higher than N⁵-methyltetrahydrofolates. Biotin was markedly decreased in the severe fatty liver when dry weight, total fat, total nitrogen, and DNA-phosphorus were each used as reference base; however, the thiamine and N⁵-methyltetrahydrofolate pattern varied if dry weight alone was used as reference base. Total liver fat compared favorably with total nitrogen and DNA-phosphorus as a reference base. It showed close agreement with, on one hand, tissue vitamin decreases and on the other hand, with histologically demonstrable fat.