Use of serum retinol-binding protein for prediction of vitamin A deficiency: effects of HIV-1 infection, protein malnutrition, and the acute phase response

被引:0
|
作者
Baeten, JM
Richardson, BA
Bankson, DD
Wener, MH
Kreiss, JK
Lavreys, L
Mandaliya, K
Bwayo, JJ
McClelland, RS
机构
[1] Univ Washington, Dept Epidemiol, Seattle, WA 98104 USA
[2] Univ Washington, Dept Biostat, Seattle, WA 98104 USA
[3] Univ Washington, Dept Lab Med, Seattle, WA 98104 USA
[4] Univ Washington, Dept Med, Seattle, WA 98104 USA
[5] Coast Prov Gen Hosp, Mombasa, Kenya
[6] Univ Nairobi, Dept Med Microbiol, Nairobi, Kenya
来源
AMERICAN JOURNAL OF CLINICAL NUTRITION | 2004年 / 79卷 / 02期
关键词
Vitamin A; retinol; micronutrient deficiency; retinol-binding protein; nutritional assessment; nutritional status;
D O I
暂无
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Background: Serum retinol is the most commonly used indicator of vitamin A status. Retinol is transported in a 1-to-1 complex with retinol-binding protein (RBP). RBP is easy and inexpensive to measure, and studies have shown a high correlation between concentrations of RBP and concentrations of retinol. The performance of RBP in the context of infection or protein malnutrition, however, has not been evaluated. Objective: Our aim was to determine whether RBP is a good surrogate measure for retinol in the context of HIV-1 infection, protein malnutrition, and the acute phase response. Design: The relation between RBP and retinol was examined in a cross-sectional study of 600 Kenyan women. Results: There was a high correlation between concentrations of RBP and those of retinol (r = 0.88). When equimolar cutoffs were used, RBP predicted marginal vitamin A status (retinol < 1.05 mumol/L) with 93% sensitivity and 75% specificity and vitamin A deficiency (retinol < 0.70 mumol/L) with 91% sensitivity and 94% specificity. Similarly high sensitivities and specificities were found among subgroups with HIV-1 infection, a positive acute phase response, and protein malnutrition. Protein malnutrition and a positive acute phase response were common, especially among HIV-1-infected women, and were independently and synergistically associated with lower RBP concentrations. Conclusions: Equimolar RBP cutoffs predict vitamin A deficiency with high sensitivity and specificity, even in the context of infection and protein malnutrition. Like retinol, RBP may not accurately identify true vitamin A status under all conditions, because the acute phase response and protein malnutrition depress RBP concentrations. However, RBP may be a simple, inexpensive tool for assessment of vitamin A deficiency in population studies.
引用
收藏
页码:218 / 225
页数:8
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