Mean Serum Retinol Research Articles

Effectiveness of vitamin A supplementation among children under 5 years old in Kazakhstan

Micronutrient sufficiency leads to high rates of morbidity and mortality among children in Kazakhstan. Kazakhstan does not have a program for mandatory vitamin A supplementation of children under 5 years of age. Thus, the aim of this study was to assess the effectiveness of a pilot vitamin A supplementation program among children in Kazakhstan with the ultimate goal of informing future vitamin supplementation efforts. In Akmola and Kostanay regions of Kazakhstan, 529 children (aged 6-59 months) were randomly selected in each region through the local policlinics. In the first step of the study, mothers of the children were surveyed about the health status of their children using a standard data collection tool. Children were supplemented with Vitamin A using oral at a dose of 100,000 IU for children aged 6-11 months and 200,000 IU for children aged 12-59 months. Blood serum samples were collected for determining Vitamin A status. In the second step of the study, mothers were interviewed again about the health status of their children 6 months after the intervention and blood serum samples were collected to assess the efficacy of Vitamin A supplementation program. The number of self reported diarrhea cases and other intestinal infections significantly decreased after the vitamin A supplementation. The number of children with normal level of Vitamin A signficantly increased from before to after the intervention. Data from all participants (n = 529; pre VAS and 501 post VAS) showed that mean serum retinol levels increased significantly post VAS from 30.01 ±0.5 µg/dL to 61.06 ±1.2 µg/dL (p <0.001) Likewise, a significant change was observed in the cases of reported diarrhea between pre-test and post-test assessments (30 vs. 95; p <0.01). The health status of the examined children in the Akmola and Kostanay regions had significantly improved after the vitamin A supplementation and it points to the necessity of implementing Vitamin A supplementation program on the national level. This study has important policy implications for recommending the supplementation program on the national scale.

ASSOCIATION OF SERUM RETINOL CONCENTRATION WITH CARDIOVASCULAR DISEASES IN THE US NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY (NHANES) 2001-2006

Objective: The association between serum retinol concentration and cardiovascular disease is controversial. This study aimed to investigate the relationship between serum retinol concentration and cardiovascular diseases. Design and method: This cross-sectional study included 8240 non-pregnant participants aged over 20 in the National Health and Nutrition Examination Survey (NHANES) 2001-2006. Cardiovascular diseases were defined as a self-reported history of coronary heart diseases, heart attacks, angina pectoris, and stroke. Restricted cubic spline and logistic regression were employed to examine the association of serum retinol concentration with cardiovascular diseases with adjustments for potential confounders (i.e., demographics, socioeconomic status, body mass index, physical activity, alcohol, smoking, medical history, and use of vitamin A supplements). Results: 6.8% (95% CI, 6.0-7.6) of the participants had cardiovascular diseases. The mean (±standard error) serum retinol concentration was 2.06±0.13 μmol/L. Serum retinol concentration had a J-shaped relationship with cardiovascular diseases, with the lowest risk observed between 0.82 and 1.20 μmol/L. Stratified by gender, the serum retinol concentration with the lowest odds ratio was 0.99 μmol/L in men and 1.07 μmol/L in women. The lower and upper tail of serum retinol concentrations (< 0.82μmol/L or >1.20μmol/L) were associated with cardiovascular diseases [OR = 1.70, 95%CI (1.23-1.85), P<0.01] after adjusting for covariates. Conclusions: Serum retinol concentration has a J-shaped association with cardiovascular diseases. While serum retinol may be an independent predictor of cardiovascular diseases, further studies are needed to determine if this is a causal relationship.

A Study to Improve the Vitamin A and Iodine Status of Pregnant Women through a Multiple Micronutrient Fortified Salt.

To study the efficacy of a multiple micronutrient fortified salt enriched with iron, iodine, vitamin A, vitamin B1, vitamin B2, vitamin B6, vitamin B12, niacin, and folic acid in improving serum retinol and iodine status of pregnant women. It was a randomized control trial in the antenatal clinic of a hospital. 151 women in the experimental group received a multiple micronutrient fortified salt to cook all their meals, and 150 women in the control group did not receive the fortified salt. Blood was collected in the three trimesters. Urine was collected in their first and third trimesters. Serum retinol, CRP (C-reactive protein), and AGP (Alpha glycoprotein) in blood were assessed, and iodine was assessed in urine. All the women were dewormed once. The inflammation adjusted mean serum retinol in three trimesters in the experimental group was 24.51, 27.29, and 25.68 µg/dL, and it was 28.97, 27.63, and 22.72 µg/dL in the control group. Over the study period of 6 months, the increase in serum retinol in the experimental group was 1.17 µg/dL whereas in the control group serum retinol decreased by 6.25 µg/dL. The experimental group increase in serum retinol is significantly more (p=0.0001) than the changes in retinol in the control group. The prevalence of serum retinol deficiency in the three trimesters was 39.1%,25.8%, and 37.7% in the experimental group and 14%, 22.7%, and 39.3% in the control group, and the change in the experimental group was significant (p=0.001) compared to the control group by binary logistic regression. Over the study period of 6 months there is a significant increase in urinary iodine concentration in the experimental group (p=0.030), showing absorption of iodine from the fortified salt whereas there is a significant decline in the iodine values in the control group (p=0.008). At the end of the study, the urinary iodine concentration of the experimental group was significantly more (p=0.0001) than that of the control group. The fortified salt was able to improve serum retinol levels and urinary iodine levels in pregnant women. Trial Registration. This trial was registered retrospectively on 19/02/2022 in the ISRCTN registry with trial ID ISRCTN17782574.

Retinol Depletion in COVID-19

Background and aimsCOVID-19 has been a devastating pandemic. There are indications that vitamin A is depleted during infections. Vitamin A is important in development and immune homeostasis. It has been used successfully in measles, RSV and AIDS infections. In this study, we aimed to measure the serum retinol levels in severe COVID-19 patients to assess the importance of vitamin A in the COVID-19 pathogenesis.MethodsThe serum retinol level was measured in two groups of patients: the COVID-19 group, which consisted of 27 severe COVID-19 patients hospitalized in the intensive care unit with respiratory failure, and the control group, which consisted of 23 patients without COVID-19 symptoms.ResultsThe mean serum retinol levels were 0.37 mg/L in the COVID-19 group and 0.52 mg/L in the control group. The difference between the serum retinol levels in the two groups was statistically significant. There was no significant difference in retinol levels between different ages and genders within the COVID-19 group. Comorbidity did not affect serum retinol levels.ConclusionThe serum retinol level was significantly lower in patients with severe COVID-19, and this difference was independent of age or underlying comorbidity. Our data show that retinol and retinoic acid signaling might be important in immunopathogenesis of COVID-19.

Association of Serum Retinol Concentrations With Metabolic Syndrome Components in Iranian Children and Adolescents: The CASPIAN-V Study.

BackgroundAs a fat-soluble vitamin, vitamin A plays a crucial role in adipogenesis, lipolysis, insulin resistance, and obesity. However, it is still unclear whether they are associated with cardiometabolic risk factors in children and adolescents. The current study aimed to determine the association between serum retinol concentration and the cluster of metabolic syndrome components among children and adolescents.MethodsThis nationwide cross-sectional study was performed on 2,518 students aged 7–18 years from the Childhood and Adolescence Surveillance and Prevention of Adult Non- communicable disease (CASPIAN-V) study. Students were selected via multistage cluster sampling method from 30 provinces of Iran in 2015. Multivariable logistic regression was used to assess the association of serum retinol concentration with metabolic syndrome (MetS) components.ResultsOverall, the mean (SD) age of study participants was 12.16 (3.04) years, and 44.9% (n = 1,166) of them were girls. The mean serum retinol concentration was 1.48 ± 1.55 μmol/L and vitamin A deficiency was observed among 19.7% (95% CI: 18.2–21.3) of study subjects. The results of the logistic regression analysis showed that increasing serum retinol concentrations were associated with an increased likelihood of developing obesity (OR: 1.12, 95% CI: 1.04, 1.20), abdominal obesity (OR: 1.07, 95% CI: 1.01, 1.14), low high-density lipoprotein cholesterol (HDL-C) (OR: 1.10, 95% CI: 1.04, 1.16) and high fasting blood glucose (FBG) (OR: 1.21, 95% CI: 1.10, 1.35), whereas it was associated with a decreased odds of developing high blood pressure (OR: 0.82, 95% CI: 0.73, 0.93). Nevertheless, there was no statistically significant association between metabolic syndrome itself and retinol concentration (OR: 1.02, 95% CI: 0.88, 1.18).ConclusionWe found that serum retinol concentration was positively associated with metabolic syndrome components such as obesity, low HDL-C, and high FBG, but not with metabolic syndrome itself.

Baseline Levels of Retinol-Binding Protein 4 and Vitamin A in Healthy Subjects, Stargardt Disease, and Geographic Atrophy Patients

Introduction: The accumulation of lipofuscin is a hallmark in the pathogenesis of Stargardt disease type 1 (STGD1) and geographic atrophy (GA) secondary to age-related macular degeneration. Limiting lipofuscin accumulation by inhibiting the retinol-binding protein 4 (RBP4) is being explored as a potential treatment target for those diseases. In this study, we aimed to establish the concentration of RBP4 in the systemic circulation in different age cohorts of healthy individuals and to check if patients with STGD1 or GA may show abnormal RBP4 levels. Methods: Forty healthy subjects of various age-groups, 15 Stargardt patients, and 15 GA patients were included in the study. We measured RBP4 levels, serum retinol (SR) levels, complete blood count, and blood chemistry including liver function tests. Results: Mean RBP4 for all cohorts was 26,911.40 ± 6,198.61 ng/mL, and mean SR 1.75 ± 0.36 µmol/L. Age was not found to significantly impact levels neither of RBP4 and SR nor of the RBP4-to-SR ratio. Also, the 2 patient groups showed similar blood levels to their age-matched controls. Conclusion: Serum RBP4 and SR do not appear to be affected by age in healthy individuals and remain within normal limits in both STGD1 and GA.

The impact of seasonal variation on anemia and nutritional status with associated factors in 6–12 years Ghanaian school age children in peri-urban communities

Malnutrition remains a public health issue among children in resource poor countries where seasonality affects food availability, food consumption, and nutritional status of a population. The aim of this study was to determine prevalence of anemia, low vitamin A and associated factors in school-age children in dry and wet season in a peri-urban setting. This was a six months observational study where data and samples were collected from school age children 6–12 years in mid-March (dry season) and mid-August (rainy season) 2020. Data and biological samples collected, were analyzed to determine prevalence of adequate dietary intakes, anemia, low vitamin A, and under-nutrition among participants. The study participants had 40.9% and 32.3% prevalence of anemia, 30.1% and 19.4% prevalence of low vitamin A, 12.9% and 10.8% level of wasting, and 63.4% and 94.6% level of adequate iron intake in the dry and wet seasons respectively. The cohort of anemic participants had mean hemoglobin concentrations as 10.6(1.7)ug/dl and 11.4(91.1)ug/dl in the dry and wet seasons respectively and significantly different at p = 0.001. The prevalence of anemia among them declined from 100.0% in the dry season to 79.0% in the wet season. They had mean serum retinol concentration as 22.4(6.4)ug/dl and 25.0(8.9)ug/dl, (significantly different at p = 0.014), prevalence of low vitamin A at 36.8% and 31.6%, prevalence of wasting as 23.7% and 18.4%, and prevalence of thinness as 10.2% and 7.9% in the dry and wet seasons respectively. Anemia associated significantly with parental monthly income of 1000–1500 cedis (180–269 USD), (OR:046, p = 0.039), and low vitamin A level (<20 μg/dl), (OR: 0.319, p = 0.049) in the dry season. Anemia associated significantly with low serum retinol (<20 μg/dl) (OR:0.070, p = 0.003) and dry season’s low hemoglobin (<11.5 g/dl) (OR:0.302, p = 0.034) among the participants. Seasonal variation from the dry to wet season have consequential effect on anemia, and nutritional status with associated factors among the study participants. Anemia associated significantly with parental monthly income in the dry season and with low serum retinol and dry season’s low hemoglobin in the wet season. Nutrition interventions will be more beneficial to the study participants during the dry season.

Bioavailability Studies of Vitamin A and E in Indigenous Vegetables and their Potential Use in the Management of HIV and AIDS

Levels of vitamins in selected indigenous vegetables in Butula, western Kenya were determined and foods containing high levels of vitamin A and E were used to make food formulation. The bioavailability of these vitamins in food formulation was estimated using algorithm procedure.&#x0D; Determination of β-carotene and α-tocopherol content was done using HPLC procedure. Fresh blanched vegetables contained high levels of β-carotene; 4000 − 9700 µg/100g and α-tocopherol levels; 3000 − 7350 µg/100g. Solar dried vegetables contained β-carotene levels ranging from 572 − 854 µg/g and α-tocopherol levels ranging from 281 to 673 µg/g dry weights. Solar dried vegetables contained significantly lower (P&lt;0.05) amounts of β-carotene and α-tocopherol as compared with fresh vegetables. The mean serum retinol α-tocopherol and β-carotene levels were 0.937, 0.144 and 17.787µmol/l respectively. Bioavailability estimated using algorithm indicated a +2.17 change in serum β-carotene and +7.776 changes in serum α-tocopherol, a positive indication that consumption of indigenous vegetables can meet the recommended dietary allowances of vitamins A (750 µg retinol equivalent/day) and E (8 mg/day). The bioavailable vitamins are capable of boosting the immune system and therefore delay early use of ARV’S.

A Comparison of Vitamin A Status Among Elderly Chinese Population Between 2002 and 2012: A Cross-Sectional Analysis of the China National Nutrition and Health Survey

Abstract Objectives Vitamin A deficiency is recognized as a major public health nutrition issue in developing countries including China. It is one of the most common micronutrient deficiencies, yet vitamin A status of the elderly in China paucity of data since 2002. We sought to evaluate Chinese elderly aged 60 years and above in vitamin A status, and to compare vitamin A insufficiency between year 2002 and 2012. Methods We compared serum retinol concentrations from the China National Nutrition and Health Survey 2002 (CNNHS 2002), with CNNHS data collected during 2010 through 2012 (CNNHS 2010–2012). Complete data were available for 4933 elderly participants in CNNHS 2002 and 5613 elderly participants in CNNHS 2010–2012. Results The mean serum retinol concentration was 1.69 (95% confidence interval (CI): 1.68–1.71) μmol/L during CNNHS 2002 and increase to 1.98 (1.96–2.00) μmol/L during CNNHS 2010–2012. Compared with 2002, the vitamin A levels in the elderly across all region, gender and age groups showed an upward trend, with the difference being statistically significant (all P &amp;lt; 0.05). In 2012, the incidence of VAD in the elderly participants was higher than in 2002 (3.39vs1.46) (P &amp;lt; 0.001). However, the incidence of marginal VAD was lower than in 2002 (7.38vs8.62) (P = 0.019). VAD in those being large cities, small and medium-sized cities, rural area, male and female, aged 60–69 or 70–79 were higher than in 2002 (all P &amp;lt; 0.05), poor rural areas was significantly lower than in 2002 (P &amp;lt; 0.001). The prevalence of marginal VAD among the urban elderly in 2012 was higher than in 2002 (P &amp;lt; 0.05), whereas the prevalence was lower than that in 2002 among the rural elderly (P &amp;lt; 0.001). The prevalence of marginal VAD in the male elderly (P &amp;lt; 0.001) and in the 60–69 age group (P = 0.014) were lower than in 2002. Conclusions Our findings showed that vitamin A status among elderly was greatly improved by 10 years, but VAD remains a public health problem in the Chinese elderly population. Therefore, reducing the incidence of VAD is crucial to the health of the elderly in China. In particular, attention needs to be paid to the nutrition and health status of urban and ≥80 year elderly. Funding Sources This research was supported by the Special Fund for Health-scientific Research in the Public Interest (No. 20,120,212) from the National Health and Family Planning Commission of the People's Republic of China.

Association of Serum Alpha-Tocopherol and Retinol with the Extent of Coronary Lesions in Coronary Artery Disease.

Background and aims: Fat-soluble vitamins play an important role in the pathogenesis of cardiovascular disease and progression of atherosclerosis. This study aimed at investigating the relationship of the serum levels of alpha-tocopherol and retinol with the extent of coronary lesions in patients with coronary artery disease. Methods. Patients with coronary artery disease (n=177) aged 30–74 years, who underwent their first coronary angiography, were enrolled. The extent of coronary lesions was assessed using the Friesinger index (FI). Accordingly, patients were grouped as follows: FI = 0–4 (n=90), FI = 5–9 (n=50), and FI = 10–15 (n=37). Serum levels of vitamins were ‬determined via high-performance liquid chromatography and serum biochemical analysis. Results. Assessment of FI-based groups revealed that 50.8% patients had a coronary artery lesion to a low extent (FI 0–4). Individuals in this group were younger and had lower glucose and serum alpha-tocopherol levels than the other groups (p < 0.05). Low levels of alpha-tocopherol were more frequent in the FI 0–4 group than that in the other groups (p=0.03). No difference was observed between the mean serum retinol levels among the FI-based groups (n=0.492), and the low frequency of retinol was consistent among the FI groups (n=0.348). Conclusions. The low level of alpha-tocopherol together with the presence of dyslipidemia is probably associated with the initial events in atherosclerosis. Increased alpha-tocopherol levels in patients with more extensive coronary artery lesions may have resulted from altered vitamin E metabolism with increased oxidative stress.

Effect of Moringa Leaves Powder Consumption on Young Children Nutritional and Serum Retinol Status in Burkina Faso Rural Area

The promotion of the consumption of indigenous plant species with high nutritional value is an important nutrition intervention in Africa rural areas. The current student was a randomized control trial of two groups (ᶲG₥ and ᶲGm) with a baseline and an endline evaluation after 12 weeks. A total of 119 pre-school children received Moringa leaf powder and changes in vitamin A and anthropometric indicators of children were assessed against changes for control group children. After 12 weeks, the mean WHZ reflecting acute malnutrition declined in both groups. The mean WHZ decreased from -2.31 z-score to -1.86 z-score in group 1 (ᶲG₥) and -2.20 z-score to -1.88 z-score in group 2 (ᶲGm) receiving Moringa as a dietary supplement with a statistically significant decrease in groups (p <0.001). The mean serum retinol concentration in children was below the cut-off defining VA deficiency (<0.7 μmol.L-1). The baseline prevalence of VA deficiency was 56.8% in group 1 and 53.8% in group 2. Mean retinol concentrations increased significantly from 0.64 μmol.L-1 to 0.73 μmol.L-1 (p <0.001) in Group 1 (ᶲG₥ (Control) and from 0.64 μmol.L-1 to 0.74 ± 0.05 μmol.L-1 (p <0.001) in group 2 (ᶲGm). Significant increase was observed regardless of gender in both groups. The change between groups was not statistically significant (p=0.838). Our findings showed that the intervention was not effective enough in the change in serum retinol status in children (p = 0.379). The change in serum retinol was significantly influenced by serum retinol concentration at baseline. Therefore, the promotion of Moringa leaf consumption should be complemented by additional approaches to increase VA intake, as well as through public health measures such as deworming programs, to enhance its effectiveness in the fight against VA deficiencies and many other micronutrients.

The role of serum retinol in nonalcoholic fatty liver disease

Background Retinol has been involved in the regulation of lipid metabolism and hepatic steatosis. Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) have emerged as the most common chronic liver diseases. A minority of affected patients develop subsequently hepatic fibrosis, whereas most of them exhibit simple steatosis. Indeed, the relation between retinol and NAFLD and NASH is still incomplete and unknown. Objective This study aimed to identify the clinical relevance of retinol in patients with NAFLD and NASH. Patients and methods This study enrolled 90 individuals who were selected from the outpatient clinic of Al Zahraa University Hospital, Egypt, which comprised 30 patients with NAFLD, 30 with NASH and 30 healthy persons as a control group. Serum glucose, lipid profiles, markers of liver damage, serum retinol, and abdominal ultrasound were studied. Results Serum retinol concentrations were significantly lower in NAFLD and NASH than in control, where the mean serum retinol concentration in patients with NAFLD was 23.02±2.9 and NASH was 11.7±2.3, and it was significantly lower than those in controls, with 36.1±2.7 (P&lt;0.01). Conclusion Circulating retinol concentrations were lower in patients with NAFLD and were associated with hepatic lipid metabolism and insulin resistance.

Vitamin A Status in the Mother-Child Couple at the University Teaching Hospital of Angondje in Gabon

Introduction: Vitamin A deficiency is responsible for severe disorders, and sometimes irreversible consequences in children. We aimed to evaluate the Vitamin A status of newborns in Gabon. Method: prospective study from August to December 2017 at the maternity of the University Teaching Hospital of Angondje (Gabon). We included at random mother-child pairs. A nutritional inquiry on Vitamin A was ran in the selected parturient. We performed the measurement of serum retinol booth in mother and child according to standardized and strict criteria, in Gabon and in France. World Health Organization defines Vitamin A deficiency by serum retinol .7 μmol/L. Results: We included 75 mother-child couples. The mean age of the mothers was 25.7 ± 7 years, 89.3% of neonates were an age gestational ≥ 36 weeks, and 10.7% were premature. Mango was the most commonly used source of Vitamin A and 27% of women consumed more than 3 times a week. The mean serum retinol of the mothers was 0.87 μmol/L ± 0.35 extremes [0.22 μmol/L - 1.79 μmol/L], the mean serum retinol of the newborns was 0.92 μmol/L ± 0.30 extremes [0.24 μmol/l - 1.84 μmol/L].Vitamin A deficiency was observed in 23.3% (n = 25; CI 95% [22.1% - 25.8%]) of mothers and 20% (n = 15; CI 95% [18.2% - 22%]) newborns. There was a weak correlation between the serum retinol of mothers and serum retinol of newborns (r = 0, 17). Conclusion: The prevalence of Vitamin A deficiency is quite important in neonates of our investigation, and justifies a systematic supplementation.

Red palm oil bean-stew improved serum vitamin A and haemoglobin concentrations and anthropometric indicators of school children with low vitamin A concentrations in a malaria-endemic setting

Vitamin A deficiency (VAD), anaemia, and parasitic infections are among the major nutritional and health problems confronting Ghanaian school children. This study assessed the impact of red palm oil bean-stew consumption on serum retinol and haemoglobin concentrations of Ghanaian school children in a malaria-endemic setting. The design was a pre-post nutrition intervention study. It involved 142 6-12 year-old children. Participants were selected by simple random sampling. After baseline sample and data collection, the participants consumed red palm oil bean-stew with gari (made from fermented, grated cassava flour), three times a week for a period of six months. Final biological samples and data were collected as at baseline. Dietary data were collected using Food Frequency Questionnaires and the 24-hour recall procedure. Serum retinol was measured with High Performance Liquid Chromatography and haemoglobin by Haemocue Haemoglobinometer. Malaria parasitaemia and hookworms were examined by microscopy from blood films and stool samples using the Giemsastaining and Kato-Katz techniques, respectively. Data were analysed with Statistical Package for Social Sciences version-23. Mean values for outcome variables were compared between baseline and final using paired t-tests. Results indicated that majority of the participants (82.4%) consumed cereals. Many of them also (98.6%) never consumed dairy or dairy products. Mean serum retinol concentration was 12.1 ± 6.6μg/dl during baseline and 16.2 ± 6.4μg/dl at final, the difference significant at p<0.05. The mean haemoglobin concentration at baseline was 119.4 ± 10.6 g/l and 126.0 ± 9.34g/l at final, with a significant difference at p<0.05. The prevalence of VAD defined as serum retinol concentration <20μg/dl was 76.2% at the end of the study being significantly different from that at baseline (93.6%), p<0.05. Prevalence of anaemia was 30.3% and 11.3% at baseline and final, respectively with a significant difference at p<0.05. Malaria parasitaemia was prevalent: 67.6 % at baseline and 62.7% at the end of the study. Only one participant (0.01%) was found with hookworm infestation. For participants with VAD, 48.3% and 36.2% improved to moderate and normal vitamin A status, respectively at the end of the study. The prevalence of anaemia among VAD participants was 36.2 % at baseline and 12.1 % at final. In conclusion, red palm oil beanstew consumption increased the haemoglobin concentration and minimized prevalence of anaemia among the study participants. It also increased serum retinol concentrations and minimized the prevalence of vitamin A deficiency (especially severe vitamin A deficiency) among the study participants. Keywords: Red palm oil, Vitamin A, Haemoglobin, School children, Malaria, Parasitaemia

Study on vitamin A nutritional status of 6- to 17-year-old urban children and adolescents between 2010 and 2012 in China

Objective: To investigate the vitamin A nutritional status of 6- to 17-year-old urban children and adolescents by analyzing serum retinol level, between 2010 and 2012 in China. Methods: Data were obtained from the China Nutrition and Health Survey in 2010-2012. Using multi-stage stratified sampling and the population proportional stratified random sampling method, 6 617 children aged 6-17 years from 32 metropolis and 41 middle-sized and small cities of China were selected. The questionnaire survey was used to collect demographic information. Blood samples were analyzed using high-performance liquid chromatography to determine serum retinol concentration, and the World Health Organization guidelines were used to evaluate the nutritional status of vitamin A. Vitamin A levels, vitamin A deficiency, and marginal vitamin A deficiency in children with different characteristics were compared. Results: A total of 3 785 cases with valid samples were obtained. The overall mean serum retinol concentration level was (1.49±0.71) μmol/L; the mean serum retinol concentration was (1.55±0.69) μmol/L for metropolis and (1.49±0.75) μmol/L for middle-sized and small cities (P>0.05). The mean serum retinol concentration was (1.52±0.78) μmol/L for boys and (1.47±0.68) μmol/L for girls (P>0.05). The mean serum retinol concentration level was (1.46±0.70) μmol/L for 6- to 11-year-old children and (1.54±0.65) μmol/L for 12- to 17-year-old children (P<0.05). The total vitamin A deficiency rate and marginal vitamin A deficiency rate was 7.69% (291/3 785) and 18.57% (703/3 785), respectively. The vitamin A deficiency rate was 8.00% (36/450) for metropolis and 7.64% (65/3 335) for middle-sized and small cities; 8.12% (155/1 908) for boys and 7.25% (136/1 877) for girls; and 8.04% (171/2 115) for 6- to 11-year-old children and 7.18% (120/1 670) for 12- to 17-year-old children. No significant differences were observed for region, sex, or age (P>0.05). The marginal vitamin A deficiency rate was 19.11% (86/450) for metropolis and 18.50% (617/3 335) for middle-sized and small cities; 18.19% (347/1 908) for boys and 18.97% (356/1 877) for girls, with no significant differences observed (P>0.05). The marginal vitamin A deficiency rate was 16.54% (350/2 115) for 6- to 11-year-old children and 21.13% (353/1 670) for 12- to 17-year-old children (P<0.05). Conclusion: The vitamin A nutritional status of 6- to 17-year-old Chinese urban children and adolescents between 2010 and 2012 has improved, and the gap between cities is narrowing. However, vitamin A deficiency overall remains high, especially in younger children, and requires specific attention.

Estado nutricional de micronutrientes de crianças segundo características pessoais e das creches

Resumo Objetivou-se verificar as diferenças no estado nutricional de micronutrientes de crianças segundo as características pessoais e das creches, além de testar o comportamento dessas diferenças de acordo com o crescimento linear. Estudo transversal com 271 crianças assistidas em creches. As concentrações médias (± EP) de hemoglobina, de zinco no soro e de retinol no soro foram de 11,79 g/dL (± 1,08), 81,58 µg/dL (± 16,56) e 1,68 μmol/L (± 0,45), respectivamente, valores inferiores nas crianças de 9-24 meses e naquelas que estudavam em salas de área inadequadas. Crianças com eosinofilia e em regime parcial apresentaram concentrações médias de hemoglobina e de zinco estatisticamente inferiores. O poliparasitismo esteve associado a baixas concentrações de hemoglobina e de retinol. De acordo com o crescimento linear, crianças com condições específicas (meninas, mais de 24 meses de idade, de zona urbana, não poliparasitadas) tiveram concentrações de zinco inferiores, quando diagnosticadas com déficit de estatura, em relação às eutróficas. Conclui-se que as crianças estudadas apresentaram diferenças no estado nutricional de micronutrientes influenciadas por processos parasitários e por problemas estruturais das creches. Além disso, estabeleceram diferenças relacionadas ao crescimento linear da criança.

Provitamin A–biofortified maize increases serum β-carotene, but not retinol, in marginally nourished children: a cluster-randomized trial in rural Zambia

Background: Vitamin A deficiency remains a nutritional concern in sub-Saharan Africa. Conventionally bred maize hybrids with high provitamin A carotenoid concentrations may have the potential to improve vitamin A status in maize-consuming populations.Objective: We evaluated the efficacy of regular provitamin A carotenoid–biofortified “orange” maizemeal (∼15 μg β-carotene/g) consumption in improving vitamin A status and reducing vitamin A deficiency in children.Design: This was a cluster-randomized controlled trial in the rural farming district of Mkushi, Zambia. All 4- to 8-y-old children in an ∼400-km2 area were identified and grouped by proximity into clusters of ∼15–25 children. We randomly assigned clusters to 1) orange maizemeal (n = 25), 2) white maizemeal (n = 25), or 3) a parallel, nonintervention group (n = 14). Children in intervention clusters (n = 1024) received 200 g maizemeal for 6 d/wk over 6 mo; the maizemeal was prepared according to standardized recipes and served in cluster-level kitchens. Staff recorded attendance and leftovers. We collected venous blood before and after the intervention to measure serum retinol, β-carotene, C-reactive protein, and α1-acid glycoprotein.Results: Intervention groups were comparable at baseline, and vitamin A status was better than anticipated (12.1% deficient on the basis of serum retinol <0.7 μmol/L). Although attendance at meals did not differ (85%), median daily maize intake was higher in white (154 g/d) than in orange (142 g/d) maizemeal clusters. At follow-up, mean serum β-carotene was 0.14 μmol/L (95% CI: 0.09, 0.20 μmol/L) higher in orange maizemeal clusters (P < 0.001), but mean serum retinol (1.00 ± 0.33 μmol/L overall) and deficiency prevalence (17.1% overall) did not differ between arms.Conclusion: In this marginally nourished population, regular biofortified maizemeal consumption increased serum β-carotene concentrations but did not improve serum retinol. This trial was registered at clinicaltrials.gov as NCT01695148.

Prevalence and influence factors of vitamin A deficiency of Chinese pregnant women.

BackgroundVitamin A plays an important role in the periods of rapid cellular growth and differentiation, especially during pregnancy, which is supplied by the mother to the fetus. The aim of this study is to assess the prevalence and potential influence factors of prenatal VAD of Chinese pregnant women.MethodsChina National Nutrition and Health Survey 2010–2013(CHNNS2010–2013) is a nationally representative cross-sectional study. It involved the random selection of 150 districts (urban) or counties (rural). Each site randomly selected 30 pregnant women. Because volume of blood and incomplete data was taken into consideration,the final sample was formed by 1209 participants. Serum retinol concentrations were measured by high performance liquid chromatography. Characteristics of the pregnant women were collected by a questionnaire. Comparing retinol level across categories of independent variables was tested by the Mann-Whitney U test. Logistic and linear regression analyses were used to identify influence factors of Chinese pregnant women.ResultsThe mean serum retinol level of the pregnant women was 1.63 μmol/L (95 % CI 1.60–1.67) and 64[5.3 % (95 % CI 4.03–6.56)] had VAD. The odds of VAD were significantly higher among the pregnant women in the poor rural areas and without college or university education and low- income. Pregnant women in the second and third trimester had 2.40 (95 % CI 1.05–5.46) and 2.82 (95 % CI 1.34–5.93) times increased odds of VAD compared with those in the first trimester respectively. Pregnant women of drinker had 3.10(1.65–5.81) times increased odds of VAD compared with those no drinker. Pregnant smokers had 5.68 (95 % CI 2.23–14.49) times higher odds of VAD compared with pregnant with non-smoker without passive smoking.ConclusionsVAD is of mild public-health issue in Chinese pregnant women. Such as : in the poor rural areas and without received college or university education and low- income and advanced gestational age and unhealthy lifestyles of pregnant women such as smoking and drinking. These were pertinent influence factors of VAD.

Serum retinol in post-partum mothers and newborns from an impoverished South African community where liver is frequently eaten and vitamin A deficiency is absent.

Serum retinol was assessed in mothers and newborns from an impoverished South African community where liver is frequently eaten and vitamin A deficiency known to be absent. Paired cord and maternal blood (n = 201) were collected after delivery and analysed for serum retinol and C-reactive protein (CRP). Liver intake during pregnancy and intention to breastfeed were also assessed. Mean serum retinol was 1.03 µmol/L ± 0.40 in mothers and 0.73 ± 0.24 µmol/L in newborns, with 21.4% and 49.3% having serum retinol <0.70 µmol/L (<20 µg/dL), respectively. Raised CRP was found in 59.9% of mothers, with a significant negative correlation between serum retinol and CRP (r = -0.273; p < 0.0001). Liver was eaten by 87.6% of mothers, and 99% indicated their intention to breastfeed. Despite consumption of liver, serum retinol was low in both the mother and the newborn. The conventional cut-off for serum retinol, i.e. <0.70 µmol/L may therefore not apply for the mother and newborn in the period immediately after delivery. Serum retinol may be influenced by factors other than vitamin A status, e.g. the haemodilution of pregnancy, as well as the acute phase response induced by the birth process, as suggested by raised CRP in 60% of mothers. In the newborns, the low serum retinol is likely to increase rapidly, as liver is frequently eaten by mothers and practically all of them intended to breastfeed. Our results confirm the need for better indicators of vitamin A status or alternative cut-off values during this period.

Alcohol Drinking Obliterates the Inverse Association Between Serum Retinol and Risk of Head and Neck Cancer.

This analysis evaluated the association between serum retinol levels and risk of head and neck cancer (HNC) and whether the association is modulated by the use of alcohol, betel quid, or cigarette. In addition, we also examined the association between HNC risk and 2 single nucleotide polymorphisms, TTR rs1667255 and RBP4 rs10882272, that have been associated with serum retinol levels. Unconditional logistic regression was performed to evaluate the association between serum retinol levels and HNC risk among 160 HNC cases and 198 controls. The associations between TTR rs1667255 and RBP4 rs10882272 and serum retinol levels or HNC risk were evaluated by linear regression and unconditional logistic regression, respectively, for 418 HNC cases and 497 controls. The results showed that HNC cases had a lower mean serum retinol level compared with controls (845.3 μg/L vs 914.8 μg/L, P = 0.03). An inverse association between serum retinol levels and HNC risk occurred among never/occasional alcohol drinkers but not among regular drinkers. TTR rs1667255 was associated with serum retinol levels; however, neither TTR rs1667255 nor RBP4 rs10882272 was associated with HNC risk. In summary, this study showed an inverse association between serum retinol levels and HNC risk, specifically among never/occasional alcohol drinkers. More studies are needed to establish the underlying biologic mechanisms for the inverse association between serum retinol levels and HNC risk and the modulation of this relationship by alcohol drinking.