Retinol-binding protein in serum of xerophthalmic, malnourished children before and after treatment at a nutrition center

Abstract

Retinol-binding protein and prealbumin levels have been measured in the serum of children who are both malnourished and show clinical signs of xerophthalmia. The more severe the xerophthalmia the lower the concentration of retinol-binding protein and prealbumin in serum. When a dose of 100,000 IU of water-miscible retinol palmitate was injected, the retinol-binding protein did not reach a normal level within 24 hr as might have been expected if deficiency of vitamin A were the sole factor. A high protein diet containing β-carotene together with further vitamin A brought the retinol-binding protein and prealbumin levels to normal within about a week. Thirty-four children were admitted to the Nutrition Rehabilitation Centre; of these, nine (average age 3 years and 2 months) who stayed for a month or more, showed a median weight gain of 1.2 kg in the first month. But this rate of growth slowed down on return home. Of the children 12 with corneal xerophthalmia in one or both eyes were observed for a sufficient length of time for an assessment to be made of the effect of treatment on vision. None became blind but one had seriously impaired vision and one other lost one eye. The remaining children have normal vision or vision that although impaired will still enable them to lead an active life. We suggest that the children needed protein from which to synthesize retinol-binding protein before normal retinol transport could be re-established.