Plasma ferritin concentration in relation to vitamin A and E status of children with severe oedematous malnutrition

Abstract

The association between plasma ferritin concentration and vitamin A and E status was studied in 17 children aged 15-72 months with severe oedematous malnutrition. The controls were 10 children of similar age who were apparently well and with no obvious signs of clinical malnutrition. Plasma ferritin concentration in the patients was significantly higher than that in the control children. Conversely, the plasma concentrations of beta-carotene, alpha-tocopherol and retinol in patients were significantly lower than those in plasma of control children. The median (interquartile range) plasma alpha-tocopherol concentration of patients, 6.03 (5.29-9.50) mumol/l, is below the threshold of vitamin E deficiency (11.6 mumol/l). Fifteen of 17 (88%) malnourished patients were found to have plasma tocopherol concentrations below the normal threshold. However, all the patients had a tocopherol: cholesterol ratio greater than 2.22, indicating adequate vitamin E status for the level of cholesterol present in plasma. Twelve of 17 patients (70.5%) had plasma retinol concentration less than 0.70 mumol/l, indicative of marginal vitamin A status, while 3 patients had plasma retinol concentrations less than 0.35 mumol/l, indicating vitamin A deficiency. The median (interquartile range) plasma retinol concentration of patients, 0.51 (0.41-0.93) mumol/l, is significantly less than that of control children, 0.96 (0.74-1.09) mumol/l; p less than 0.01 Mann Whitney U test. Furthermore, anaemia (Hb less than 110 g/l) was widespread in the patients. The results also indicate no significant correlation between elevated ferritin concentration and the concentrations of beta-carotene, retinol and alpha-tocopherol in the patients' plasma.(ABSTRACT TRUNCATED AT 250 WORDS)

Antioxidant status in children with protein-energy malnutrition (PEM) living in Cairo, Egypt

“…According to our study, the children with either KWO or MAR are associated with subnormal plasma concentrations of vitamin A and RBP. These results are in agreement with others (Sandstead et al, 1965;Adelekan et al, 1991;Bluhm et al, 1993;Hussain et al, 1996;Goetgthebur et al, 1996). In fact, 12% of KWO and 26% of marasmic children in our study population had a serum retinol concentration less than 0.35 umolaL, the values considered to re¯ect depletion of liver stores .…”

“…These vitamins included vitamins A, C and E. The plasma concentrations of these vitamins were all markedly depressed in the presence of KWO and MAR. The existence of biochemical evidence of antioxidant vitamins have also been reported by others (Laditan & Ette;1982, Adelekan et al, 1991Becker et al, 1994).…”

Vitamin E status in protein energy malnutrition

“…Plasma cholesterol levels are known to fall in infections as a result of an increased permeability of the vasculature (17) which is a part of acute phase response. Adelekan et al (11) further observed that tocopherol/cholesterol ratios were not significantly different in the malnourished and the control children (indicating adequate vitamin E for the level of cholesterol present in plasma) and concluded that low circulating vitamin E levels in malnourished children were the consequence of infections rather than of malnutrition per se.…”

“…Majority of the PEM (84 per cent) cases had serum vitamin E concentration below the normal threshold (500 pg/dl). Adelekan et al (11) reported that 88 per cent of the malnourished children have plasma tocopherol concentrations below the normal threshold. However.…”

“…Thumham et al (10) have studied vitamin E, total lipids as well as individual lipids concentrations and suggested that tocopherol/cholesterol ratio has greatest sensitivity of those ratios based on total or individual lipids. Though plasma ~z-tocopherol concentration has been shown to be reduced in children with severe oedematous malnutdtion, tocopherol/cholesterol ratio remains unaltered (11). The present study was therefore planned to assess vitamin E status of children with PEM.…”