Vitamin A deficiency and inflammatory markers among preschool children in the Republic of the Marshall Islands

Nutrition Journal

Richard D Semba¹  Kennar Briand⁴  Michelle O Ricks¹  Neal A Palafox²  Mary V Gamble³  Barbara Dancheck¹  Maria Maqsood¹ 

[1] Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA;Department of Family Practice and Community Health, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA;Mailman School of Public Health, Columbia University, New York, New York, USA;Ministry of Health and Environment, Republic of the Marshall Islands

关键词: xerophthalmia;    vitamin A deficiency;    retinol;    inflammation;    acute phase response;   

Others  :  1151693
DOI  :  10.1186/1475-2891-3-21

 received in 2004-10-09, accepted in 2004-12-08,  发布年份 2004

【 摘 要 】

Background

The exclusion of individuals with elevated acute phase proteins has been advocated in order to improve prevalence estimates of vitamin A deficiency in surveys, but it is unclear whether this will lead to sampling bias. The purpose of the study was to determine whether the exclusion of individuals with elevated acute phase proteins is associated with sampling bias and to characterize inflammation in children with night blindness.

Methods

In a survey in the Republic of the Marshall Islands involving 281 children, aged 1–5 years, serum retinol, C-reactive protein (CRP), and α₁-acid glycoprotein (AGP) were measured.

Results

Of 281 children, 24 (8.5%) had night blindness and 165 (58.7%) had serum retinol <0.70 μmol/L. Of 248 children with AGP and CRP measurements, 123 (49.6%) had elevated acute phase proteins (CRP >5 mg/L and/or AGP >1000 mg/L). Among children with and without night blindness, the proportion with serum retinol <0.70 μmol/L was 79.2% and 56.8% (P = 0.03) and with anemia was 58.3% and 35.7% (P = 0.029), respectively. The proportion of children with serum retinol <0.70 μmol/L was 52.0% after excluding children with elevated acute phase proteins. Among children with and without elevated acute phase proteins, mean age was 2.8 vs 3.2 years (P = 0.016), the proportion of boys was 43.1% vs. 54.3% (P = 0.075), with no hospitalizations in the last year was 11.0% vs 23.6% (P = 0.024), and with anemia was 43.8% vs 31.7% (P = 0.05), respectively.

Conclusions

Exclusion of children with inflammation in this survey of vitamin A deficiency does not improve prevalence estimates for vitamin A deficiency and instead leads to sampling bias for variables such as age, gender, anemia, and hospitalization history.

【 授权许可】

   
2004 Maqsood et al; licensee BioMed Central Ltd.

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