Serum Retinol‐binding Protein and Vitamin a Levels in Malnourished Children

Abstract

Serum levels of vitamin A and retinol-binding protein (RBP) were measured in children with vitamin A deficiency, in children with protein-energy malnutrition (PEM) and in normal children, before and after administration of 100 000 IU of water-miscible vitamin A. Serum vitamin A and RBP levels were significantly low in children with vitamin A deficiency and in children with severe PEM, whereas the values in milder grades of PEM were similar to those of normal subjects. In severely malnourished children with corneal lesions, serum vitamin A concentration was reduced to a much greater extent than the level of serum RBP. Administration of vitamin A resulted in a significant increase in serum levels of both the components within 4 hours in all the 3 groups of children. The increase in RBP concentration observed in children with PEM was similar to that in vitamin A deficient children. These results indicate that in malnourished children, particularly in those who are at risk of developing keratomalacia, vitamin A is the main limiting factor. It is, therefore, recommended that children with PEM should be treated with vitamin A in addition to dietary protein and calories.

Albumin and Serum Vitamin A Status of Malnourished Children

“…The significantly lower levels of vitamin A, MUAC and albumin in the malnourished children may be due to low intake and malabsorption of vitamin A-rich foods, diminished bioavailability of provitamin A, exhaustion of hepatic stores of vitamin A, reduced hepatic albumin synthesis and reduced retinol binding protein required for vitamin A transport from the liver, increased demand for vitamin A and suppression of anabolic processes in order to compensate for increased energy requirement of the body in the malnourished, muscle wasting and depletion of proteins of the gut compartment resulting from imbalances between nutrient intakes and body requirement. The findings are similar to those reported in a number of studies [26,27,28,29], where significantly lower values of Vitamin A, MUAC or BMI in the malnourished compared with the well-fed cohort were demonstrated.…”

Predictors of serum retinol in children with shigellosis

“…In Peruvian children with diarrhea (1), serum retinol was independent of nutritional status (ie, weight-for-height or wasting). However, serum retinol was more depressed in Indian children with severe malnutrition than in those with either mild or inapparent malnutrition (31), in Nigerian children with corneal ulcer and measles (32), and in children of low socioeconomic status in northern Thailand (33). Most of our study children were severely malnourished as defined by anthropometric criteria and serum albumin.…”

Effect of intramuscular vitamin A injection on plasma levels of vitamin A and retinol-binding protein in malnourished children

“…However, there are situations in developing countries where the diets do not meet vitamin A requirements and, therefore, resort has been made to intermittent massive dose intervention (WHO, 1976;Reddy et al 1978). Malnourished children with corneal lesions are treated immediately on diagnosis with two or three massive doses of vitamin A (WHO, 1976;Reddy, 1978).…”

“…Hypervitaminosis A has been shown to be associated with increased concentration of total vitamin A in circulation, particularly retinyl ester which is not bound to the retinol-binding protein (RBP) (Mallia et al 1975;Smith & Goodman, 1976). Massive doses of vitamin A are now being increasingly used in developing countries for both treatment and prevention of xerophthalmia in children (WHO, 1976;Reddy, 1978). However, concern has been expressed over the safe use of such large doses of the vitamin, since the capacity of the liver to hold the absorbed retinol to the protein is limited in protein+nergy malnutrition (PEM).…”