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Original Research Communication |
1 From the US Department of Agriculture, Western Human Nutrition Research Center, Davis, CA, and the Nutrition Department, the University of California, Davis.
Background: Serum retinol decreases transiently during the acute phase response and can thus result in misclassification of vitamin A status.
Objective: Our objective was to determine the prevalence of acute phase response activation in a representative sample of the US population, identify the factors associated with this activation, and determine whether persons with an active acute phase response have lower serum retinol concentrations.
Design: Data from the third National Health and Nutrition Examination Survey (NHANES III) were analyzed. A serum C-reactive protein (CRP) concentration 
10 mg/L indicated an active acute phase response.
Results: Mean serum retinol was lowest in subjects aged <10 y and increased with age. Concentrations were higher in males than in females aged 20–59 y. The prevalence of a CRP concentration 10 mg/L was lowest in subjects aged <20 y (
4%) and increased with age to a maximum of nearly 15%. An elevated CRP concentration was 2.4-fold greater in females than in males aged 20–59 y. Serum retinol was lower in subjects with elevated CRP concentrations.
Conclusions: Serum retinol increases with age and males have higher mean values than do females aged 20–59 y. The prevalence of a CRP concentration 10 mg/L also increases with age, is 2-fold greater in females than in males aged 20–69 y, and is associated with common inflammatory conditions. Thus, inflammation appeared to contribute to the misclassification of vitamin A status in the NHANES III population, and serum CRP is useful in identifying subjects who may be misclassified.
Key Words: Retinol • vitamin A • acute phase response • C-reactive protein • CRP • third National Health and Nutrition Examination Survey • NHANES III • infection • inflammation
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