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American Journal of Clinical Nutrition, Vol. 72, No. 1, 146-153, July 2000
© 2000 American Society for Clinical Nutrition

Original Research Communications

Hyporetinolemia and acute phase proteins in children with and without xerophthalmia1,2,3

Richard D Semba, Muhilal, Keith P West, Jr, Gantira Natadisastra, Ward Eisinger, Yin Lan and Alfred Sommer

1 From the Department of Ophthalmology, School of Medicine, and the Department of International Health, Johns Hopkins University, Baltimore; the Nutrition Research and Development Centre, Ministry of Health, Bogor, Indonesia; and the Cicendo Eye Hospital, Bandung, Indonesia.

Background: The relations among hyporetinolemia, acute phase proteins, and vitamin A status in children are unclear.

Objective: The objective was to examine the relations between acute phase proteins and plasma retinol concentrations in children with and without clinical vitamin A deficiency (Bitot spots and night blindness).

Design: The study was a nonconcurrent analysis of acute phase protein concentrations and other data from a previous clinical trial. Preschool children, 3–6 y of age, with (n = 118) and without (n = 118) xerophthalmia were assigned to receive oral vitamin A (60 mg retinol equivalent) or placebo and were seen at 5 wk. All children received oral vitamin A (60 mg retinol equivalent) at 5 wk.

Results: At baseline, {alpha}1-acid glycoprotein (AGP) was elevated in 42.9% and 23.5% (P < 0.003) and C-reactive protein (CRP) was elevated in 17.7% and 13.7% (NS) of children with and without xerophthalmia, respectively. Hyporetinolemia (retinol < 0.7 µmol/L) occurred in 61.0% and 47.4% (P < 0.04) of children with and without xerophthalmia, respectively. A history of fever, a history of cough, and nasal discharge noted on examination were each associated with elevated acute phase proteins. Vitamin A supplementation increased plasma retinol at 5 wk but had no significant effect on concentrations of acute phase proteins.

Conclusions: Elevated acute phase protein concentrations and infectious disease morbidity are closely associated during vitamin A deficiency.

Key Words: Vitamin A • acute phase proteins • retinol • xerophthalmia • {alpha}1-acid glycoprotein • C-reactive protein • morbidity • infection • preschool children • Indonesia




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