Low Serum Levels Of Vitamin Research Articles

Investigation of Serum Vitamin A Levels of Children who had a History of Recurrent Diarrhoea and Acute Respiratory Infections in Ankara

Vitamin A deficiency is considered a widespread public health problem among preschool children in the developing countries. A limited number of studies reveal an association between xerophthalmia and significant systemic diseases including protein-energy malnutrition, diarrhoea, and acute respiratory infections. The present study was carried out to assess the vitamin A status of preschool children who have a history of recurrent acute respiratory infections and diarrhoea. We have already shown that serum vitamin A levels of all the study groups were lower than the control group (P less than 0.001) and the detailed statistical analyses made clear that malnutrition is the major contributing factor (P less than 0.001) although infections also have a negative effect on serum vitamin A levels (P less than 0.01). We have also shown that subclinical vitamin A deficiency is a problem of public health importance in this region, since about 64 per cent of the children examined were found to have low levels of serum vitamin A (less than 20 micrograms/dl).

Vitamin E intake and risk of cataracts in humans.

Experimental evidence suggests that oxidative stress due to the accumulation of free radicals plays a role in the pathogenesis of cataracts and that the process can be prevented or ameliorated by antioxidants. In addition, a recent study found that cataract patients tended to have lower serum levels of vitamins C, E, or carotenoids than did control subjects. This investigation, which compared the self-reported consumption of supplementary vitamins by 175 cataract patients with that of 175 individually matched, cataract-free subjects, revealed that the latter group used significantly more supplementary vitamins C and E (p = 0.01 and 0.004, respectively). Inasmuch as the observed reduction in risk of cataracts was at least 50%, a randomized, controlled trial of vitamin supplementation in cataract prevention seems justified.

Serologic precursors of cancer: serum micronutrients and the subsequent risk of pancreatic cancer

In a nested case-control study the stored, frozen sera from 22 cases of cancer of the pancreas and 44 matched control subjects were assayed for retinol, retinol-binding protein, total carotenoids, beta-carotene, lycopene, vitamin E (alpha-tocopherol), and selenium. Prediagnostic serum levels of lycopene and Se were lower among cases than among matched control subjects. These differences remained after adjustment was made for possible confounding by smoking, educational level, and the other measured serum levels. Low levels of serum vitamin E appeared to have a protective effect but a chance association between vitamin E and cancer of the pancreas could not reasonably be excluded. The association between cancer of the pancreas and serum Se was significant when the data were analyzed as a whole but its effect was seen principally in men.

Vitamin A levels of blood in collared peccaries ( Tayassu tajacu) from South Texas

1. 1. Serum vitamin A concentrations were determined for 24 adult female collared peccaries from 1 captive and 2 wild populations during the period 30 January–15 March, 1983. 2. 2. Normal serum vitamin A concentrations of well-fed captive peccaries ( X = 39.0 μg/dl) were slightly higher than the reported range of values for domestic swine. 3. 3. Mean vitamin A concentrations of blood serum did not differ among the captive and 2 wild populations. However, a few individuals from the wild populations had low serum levels of vitamin A which suggested a possible vitamin A deficiency for these females.

Serum beta-carotene, vitamins A and E, selenium, and the risk of lung cancer.

We studied the relation of serum vitamin A (retinol), beta-carotene, vitamin E, and selenium to the risk of lung cancer, using serum that had been collected during a large blood-collection study performed in Washington County, Maryland, in 1974. Levels of the nutrients in serum samples from 99 persons who were subsequently found to have lung cancer (in 1975 to 1983) were compared with levels in 196 controls who were matched for age, sex, race, month of blood donation, and smoking history. A strong inverse association between serum beta-carotene and the risk of squamous-cell carcinoma of the lung was observed (relative odds, 4.30; 95 percent confidence limits, 1.38 and 13.41). Mean (+/- SD) levels of vitamin E were lower among the cases than the controls (10.5 +/- 3.2 vs. 11.9 +/- 4.90 mg per liter), when all histologic types of cancer were considered together. In addition, a linear trend in risk was found (P = 0.04), so that persons with serum levels of vitamin E in the lowest quintile had a 2.5 times higher risk of lung cancer than persons with levels in the highest quintile. These data support an association between low levels of serum vitamin E and the risk of any type of lung cancer and between low levels of serum beta-carotene and the risk of squamous-cell carcinoma of the lung.

Neurologic syndrome associated with low levels of vitamin E in primary biliary cirrhosis

A 41-yr-old woman with primary biliary cirrhosis developed weakness and wasting in proximal muscles, areflexia, and decreased proprioceptive and vibratory sensation. Investigations revealed low serum levels of vitamin E and electromyographic and muscle biopsy changes consistent with a neuropathy. Sural nerve histology demonstrated axonal dystrophy with patchy demyelination. These features closely resemble a neurologic syndrome associated with chronic cholestatic liver disease and vitamin E deficiency in children. Adults with chronic cholestasis may also be susceptible to neurologic damage from prolonged malabsorption of vitamin E.

741 VITAMIN E LEVELS IN SMALL FOR GESTATIONAL AGE NEWBORNS

Small for gestational age (SGA) newborns are frequently denied adequate nutrition during intrauterine development. The fat stores of a full term, SGA newborn are less than that of a preterm newborn of the same weight. This may result in deficiencies of essential nutrients, especially of fat soluble, lipid stored vitamins. We measured serial serum Vitamin E levels in 29 SGA and AGA neonates (G.A. 30-41 wk) in the first week of life, using Hashim's spectrophotometric micro-method. The results are tabulated below. Statistical analysis using the chi square test revealed no significant differences in the Vitam E levels in SGA newborns as compared to the control group. The data of this small sample suggest a trend of lower serum levels of Vitamin E in full term, SGA versus full term AGA babies, although no similar trend was observed in the preterm infants.

Vitamin A status of the newborn in relation to gestational age, body weight, and maternal nutritional status

Studies were made of the vitamin A status of newborn as judged by cord serum vitamin A in relation to gestational age, birth weight, and maternal vitamin A status in 130 + 79 mother-infant pairs belonging to low and high income groups in urban Baroda. The mean values for maternal serum vitamin A (εg/dl, mean ± SE) in the two groups were 21.8 ± 0.59 (n = 130) and 29.3 ± 0.80 (n = 79), respectively. The corresponding values for cord serum vitamin A were 13.8 ± 0.40 and 19.6 ± 0.64 for full-term infants and 7.5 ± 0.44 and 12.9 ± 0.80 for premature infants. Even for comparable levels of maternal serum vitamin A, differences were found between income groups regarding birth weight and cord serum vitamin A. Mothers of premature infants had lower levels of serum vitamin A than those of full-term infants suggesting maternal vitamin A status to be one of the correlates of prematurity. Significant correlations were found between cord serum vitamin A, maternal serum vitamin A, gestational age, and growth status. These studies suggest that a poor vitamin A status is one of the features associated with a higher prevalence of prematurity and intrauterine growth retardation found in poorly nourished populations. These findings stress the importance of satisfactory vitamin A supplies to pregnant and nursing mothers to prevent vitamin A deficiency and growth retardation in the progeny.

Vitamin D metabolism and anticonvulsant therapy: effect of sunshine on incidence of osteomalacia.

To study the association between anticonvulsant therapy and osteomalacia or rickets, we evaluated 450 epileptic patients receiving anticonvulsants and residing in an institution for the mentally retarded in Florida. Fifty-five of them with increased mean serum alkaline phosphatase and mildly depressed mean serum calcium levels were identified as being at risk for having osteomalacia. None of them, however, had low serum levels of vitamin D (25[OH]D) or radiologic evidence of osteomalacia or rickets. In contrast to reports from northern climates, we found minimal evidence of anticonvulsant-induced bone disease. The study suggests that exposure to sunshine in our patients probably prevented the development of anticonvulsant-induced osteomalacia or rickets.

Vitamin E deficiency with normal serum vitamin E concentrations in children with chronic cholestasis.

We studied serum vitamin E levels and the ratio of serum vitamin E to serum lipid levels in 11 children with chronic cholestasis complicated by vitamin E deficiency, as defined by characteristic neurologic signs or sural-nerve histopathology in addition to impaired intestinal absorption of vitamin E. Eight of the children had low levels of serum vitamin E, as well as low ratios of serum vitamin E to total lipids and to cholesterol. However, three patients had normal serum vitamin E levels but low ratios of serum vitamin E to total lipids (two of the three had normal ratios of vitamin E to cholesterol). In four patients who were not vitamin E-deficient, all three values were normal. We conclude that vitamin E deficiency may exist in a child with a normal serum vitamin E concentration and that the ratio of serum vitamin E to total serum lipids is the most reliable biochemical index of vitamin E status during chronic childhood cholestasis.

The relationship of dietary and serum vitamin A to the occurrence of cervical intraepithelial neoplasia in sexually active women

Sexually active women with colposcopically directed, biopsy-proved cervical intraepithelial neoplasia were matched with normal control subjects with regard to age, race, and socioeconomic status, in order to determine if dietary and serum vitamin A (retinol) levels can be considered one of the contributing risk factors for the development of this disease process. An evaluation of women in the group with cervical intraepithelial neoplasia statistically showed lower levels of serum vitamin A (p = 0.1), although, dietary profiles of both groups did not yield a statistically significant difference (p = 0.7). These results suggest that low serum levels of vitamin A may be associated with the development of cervical intraepithelial neoplasia.

Nervous and ocular disorders in children with cholestasis and vitamin A and E deficiencies.

Thirteen children, aged 10 months to 20 years, presenting with chronic cholestasis from the first month of life and with low serum levels of vitamins A and/or E, have been investigated for neurological and ophthalmological symptoms. Clinical findings consisted of 4 types: peripheral neuropathy; cerebellar dysfunction; abnormalities of eye movement, and retinal degenerative changes. The results of electrophysiological and morphological studies of muscle and nerves were consistent with neurono-axonal degeneration. Electrical abnormalities of the retina, especially a decrease of the b wave of electroretinogram, appear to be the first sign of the syndrome, allowing early detection. Evidence for vitamin deficiency (E or E+A) suggests substitutive parenteral treatment in such patients.

Nutritional assessment of senior rural Utahns by biochemical and physical measurements

Biochemical composition of blood and urine was used to evaluate the nutritional status of 187 ambulatory, older residents of five rural Utah communities. Measurements were also taken of height, weight, and blood pressure. The sample included 58 men and 129 women, with a mean age of 69 years. No deficiencies were observed for hemoglobin, hematocrit, and serum iron levels, although approximately 15% of the men had low levels for the first two indices. Serum mineral status for zinc, copper, sodium, potassium, magnesium, and calcium was adequate for most of the participants. Of the women 40% and of the men 21% had low serum total protein levels. No low serum levels of vitamin A and carotene were observed. Urinary excretion of riboflavin and thiamine was high for approximately 90% of the participants. Of the women 46% and of the men 37% had serum cholesterol values above 249 mg/100 ml of serum. One half of the women and 30% of the men were determined to be obese. Approximately one-fourth of both sexes had systolic pressures above 160 mm Hg.

Hypovitaminosis A in the Americas

Technical Group on Hypovitaminosis A in the Americas Hypovitaminosis A attracted attention as a public health problem in Latin America and the Caribbean area at the first and second Pan American Health Organization Technical Advisory Committee Meetings on Nutrition, 1962 and 1968, and as a result of the worldwide survey of xerophthalmia sponsored by the World Health Organization in 1962. Results of many nutrition surveys show that a low dietary intake of vitamin A is widespread in sectors of the population in many parts of this hemisphere. Clinical and biochemical studies also indicate that hypovitaminosis A exists in certain portions of the population. Partial and total blindness resulting from severe vitamin A deficiency, in association with protein-calorie malnutrition, has been reported often in relation to high case-fatality rates. It may be concluded that hypovitaminosis A represents a public health problem in this hemisphere. It was considered important that the Pan American Health Organization provide some guidelines to the control and prevention of this condition and a technical group was convened for this purpose in 1968. The following definition was proposed for hypovitaminosis A, as it may be applied to human populations in the context of public health practice: The presence of depleted tissues stores and low serum levels of vitamin A which may result from a prolonged deficient dietary intake and lead to serious clinical lesions of the eye. Criteria for diagnosis should include clinical, biochemical, and dietary measurements. Any one indication by itself is not sufficient proof of vitamin A deficiency, but should arouse suspicion. Many factors, nutritional, physiological, and pathological, can influence vitamin A status and must be taken into account. From available data, it was evident that xerophthalmia is generally found in those parts of the Caribbean and Central and South American areas where living standards for the majority of people are low. The preschool children, or more specifically those from 6 months to 4 years of age, represent the most vulnerable group in the socially deprived sectors and are also the most difficult to reach and protect. The biochemical data from ICNND surveys in Latin America and the West Indies showed that from 5 to 45% of the overall population surveyed had serum vitamin A levels under 20 εg/100 ml. Vulnerable groups including children and pregnant women had even higher proportions of low or deficient values. Using the standards of the FAO/WHO expert committee, the intake was also deficient for a large majority, judging from the vitamin A content of the diets. Based on the available information, the committee made specific recommendations for the treatment and prevention of vitamin A deficiency and defined areas in which PAHO should encourage research.

Absorption of Vitamin A by Infants Receiving Fat-Free or Fat-Containing Dried Skim Milk Formulas

P ROTEIN-CALORIE MALNUTRITION is a major factor in the high morbidity and mortality of children in the underdeveloped areas of Brazil. A deficiency of vitamin A frequently is associated with protein-calorie deficiency in many areas of the world, including Northeast Brazil (1). A recent Brazil-United States nutrition survey of Northeast Brazil found that a large proportion of the population had low serum levels of vitamin A and low intakes of the vitamin in the usual diet (2). The association of protein-calorie and vitamin A deficiencies has been confirmed in many 1 From the Instituto de Medecina Infantil de

Role of vitamin E in iron deficiency anemia.

The investigations were made to clarify the role of vitamin E in iron defici-ency anemia and the following results were obtained:1. Seventy-eight cases with ircn deficiency anemia showed lower level of serum vitamin E (0.88±0.16mg per 100ml) than 100 healthy adults (1.25±0.12mg per 100ml).2. In those cases who showed excellent recovery from anemia following iron therapy, significant increase of serum vitamin E level was observed, and in the relapsing cases the serum vitamin E level was depressed again in the relapsed stage. The cases with insufficient recovery from anemia following iron therapy were found to have lesser increase of serum vitamin E.3. Combination therapy with iron and vitamin E was proved to decrease the incidence of relapse in iron deficiency anemia and to bring better prognosis in iron deficiency anemia with insufficient recovery following iron therapy alone. Namely, relapse occurred in 26.6% of patients treated with combination therapy in comparison with relapse 53.3% of patients treated with iron therapy alone. In fifty percent of the cases with insufficient recovery from anemia, further in-crease of hemoglobin level was observed following comb nation therapy.Role of vitamin E in clarifyinn the pathophysiology and treatment of iron deficiency anemia was discussed.A part of this paper was presented at the International Society of Hematology XIIth Congress, New York, September, 1968.

INFERTILITY IN MALE PATIENTS WITH CYSTIC FIBROSIS

Repeated semen analyses done on eight mature male patients with cystic fibrosis have consistently shown azoospermic semen of low volume, low or normal viscosity, increased turbidity, yielding a positive color reaction for fructose. All patients are well developed, well nourished and of normal weight and height although seven of the eight have pancreatic insufficiency. The external genitalia and prostate glands of all patients have been judged normal by a urologist. The eight patients have had minimal respiratory symptoms and mild pulmonary disease. All are either finishing college or, having finished, are employed full time. Histologic examination of testicular tissue obtained at biopsy from one subject and at autopsy from nine additional cases showed active spermatogenesis though 50 percent of the spermatozoa had malformed heads. A possible genetic abnormality was suggested by the presence of many binucleate spermatocytes, spermatocytes containing cytoplasmic inclusions resembling polar bodies and many sticky and incomplete meiosis. Other factors which may be responsible for or contribute to infertility in the male with cystic fibrosis are the low serum levels of vitamins A and E or some interference with the normal transport of the sperm.

Impairment of Intestinal Absorption of Vitamin A Palmitate in Severe Protein Malnutrition (Kwashiorkor)

The effect of an oral dose of 75,000 μg of vitamin A as palmitate on vitamin A serum levels has been tested in children suffering from kwashiorkor. It was found that on admission, this amount of the vitamin ester had no detectable effect on serum levels. After dietary treatment based exclusively on therapeutic amounts of acidified half skimmed milk, the test dose resulted in very marked serum vitamin A increases as early as the fifth day, and in some patients even by the third day of treatment. In another group of children an unsupervised ad libitumdiet failed to produce this change in three to five days. The possible relation of these observations to histopathologic and biochemical alterations in the pancreas, liver and intestine is discussed. It is suggested that the low levels of serum vitamin A found in kwashiorkor may be a consequence of a generalized failure to absorb fat-soluble factors.