Approaches to Assess Vitamin A Status in Settings of Inflammation: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) Project
- PMID: 30115830
- PMCID: PMC6115742
- DOI: 10.3390/nu10081100
Approaches to Assess Vitamin A Status in Settings of Inflammation: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) Project
Abstract
The accurate estimation of vitamin A deficiency (VAD) is critical to informing programmatic and policy decisions that could have important public health implications. However, serum retinol and retinol binding protein (RBP) concentrations, two biomarkers often used to estimate VAD, are temporarily altered during the acute phase response, potentially overestimating the prevalence of VAD in populations with high levels of inflammation. In 22 nationally-representative surveys, we examined (1) the association between C-reactive protein (CRP) or α1-acid glycoprotein (AGP) and retinol or RBP, and (2) how different adjustment approaches for correcting for inflammation compare with one another. In preschool age children (PSC) and school age children (SAC), the association between inflammation and retinol and RBP was largely statistically significant; using the regression approach, adjustments for inflammation decreased the estimated prevalence of VAD compared to unadjusted VAD (range: -22.1 to -6.0 percentage points). In non-pregnant women of reproductive age (WRA), the association between inflammation and vitamin A biomarkers was inconsistent, precluding adjustments for inflammation. The burden of VAD can be overestimated if inflammation is not accounted for, and the regression approach provides a method for adjusting retinol and RBP for inflammation across the full range of concentrations in PSC and SAC.
Keywords: Vitamin A; infection; inflammation; retinol; retinol binding protein.
Conflict of interest statement
The authors declare no conflict of interest.
Figures


References
-
- Tanumihardjo S.A. Biomarkers of vitamin A status: What do they mean? Panama City, Panama, 15–17 September 2010. World Health Organization: Geneva, Switzerland. [(accessed on 15 May 2017)];2012 Available online: http://www.who.int/nutrition/publications/micronutrients/background_pape....
-
- WHO Indicators for assessing vitamin A deficiency and their application in monitoring and evaluation intervention programmes. [(accessed on 18 April 2015)]; Available online: http://www.who.int/nutrition/publications/micronutrients/vitamin_a_defic....
-
- WHO Serum retinol concentrations for determining the prevalence of vitamin A deficiency in populations. [(accessed on 16 January 2015)]; Available online: http://www.who.int/vmnis/indicators/retinol.pdf.
-
- Rosales F.J., Ritter S.J., Zolfaghari R., Smith J.E., Ross A.C. Effects of acute inflammation on plasma retinol, retinol-binding protein, and its mRNA in the liver and kidneys of vitamin A-sufficient rats. J. Lipid Res. 1996;37:962–971. - PubMed
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Research Materials
Miscellaneous