http://www.ajcn.org/cgi/content/abstract/76/6/1351
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American Journal of Clinical Nutrition, Vol. 76, No. 6,
1351-1357, December 2002
© 2002 American Society for
Clinical Nutrition
Original Research Communication |
1 From the Department of Epidemiology and International Health, School of Public Health, University of Alabama at Birmingham (CBS and JOA); the Departments of Pediatrics (LMF and HH), Mathematics (MC), Physiologic Sciences (AC), and Pathology (RHG), Universidad Peruana Cayetano Heredia, Lima, Peru; the Department of International Health, School of Public Health, Johns Hopkins University, Baltimore (RHG); and AB PRISMA, Lima, Peru (RHG).
Background: The relative-dose-response (RDR) test is used to identify subjects with marginal liver vitamin A stores, but its use has not been evaluated during episodes of infection.
Objective: The objective was to assess, with the RDR test, the vitamin A status of children recovering from pneumonia.
Design: As part of a double-blind, placebo-controlled clinical trial of high-dose vitamin A supplements among children hospitalized with pneumonia in Lima, Peru, we examined the association of treatment group, nutritional status, severity of disease, and induction of the acute phase response [on the basis of serum C-reactive protein (CRP)] on serum retinol and the RDR test.
Results: Serum retinol was low at admission and increased
significantly in both the vitamin A and placebo groups during
recovery. Serum CRP had a significant, inverse association with
retinol at both admission and discharge. Serum retinol and CRP
concentrations never differed significantly between the treatment
groups. Among subjects with CRP
10 mg/L, 21% in the vitamin A group and
20% in the placebo groups (P = 0.83) had a positive RDR test
result. Among subjects with CRP <10 mg/L, 56% in the placebo group
but only 6% in the vitamin A group had positive RDR test results
(P = 0.002).
Conclusion: The RDR test was useful in assessing the vitamin A status of children recovering from pneumonia when CRP concentrations were <10 mg/L but not when CRP concentrations were higher.
Key Words: Vitamin A • retinol • acute phase response • pneumonia • C-reactive protein • CRP • relative-dose-response test • RDR test • children • Peru
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Copyright © 2002 by The American Society for Clinical Nutrition, Inc.
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