Proxy Markers of Serum Retinol Concentration, Used Alone and in Combination, to Assess Population Vitamin A Status in Kenyan Children.
Loading...
Date
2015
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Objectives: To assess the diagnostic performance of serum concentrations of retinol-binding protein (RBP), transthyretin, retinol concentration measured by fluorometry and RBP:transthyretin molar ratio, either alone or in combination, to estimate the prevalence of vitamin A deficiency (serum retinol concentration <0.70 μmol/L measured by high-performance liquid chromatography(HPLC)).
Methods: A cross-sectional study was conducted in 15 primary schools in Kibwezi and Makindu districts in Eastern province, Kenya in June 2010 with 375 schoolchildren (6-12 years), 25 randomly selected from each school by lot quality assurance sampling.
Results: Complete data were collected for 372 children. Mean serum concentration of retinol (HPLC), RBP and transthyretin were 0.87 (SD 0.19) µmol/L, 0.67 (SD 0.17) µmol/L and 3.0 (SD 0.62) µmol/L. The mean RBP: Transthyretin molar ratio was 0.23. The prevalence of vitamin A deficiency measured with HPLC was 18%. Transthyretin and RBP showed the largest area under the curve (AUCs 0.96 and 0.93, respectively). Logistic regression resulted in a model predicting vitamin A deficiency based on RBP, transthyretin and C-reactive protein (AUC: 0.98) and prevalence depending cutpoints for the linear predictor were calculated.
Conclusions: Combination of transthyretin, RBP and C-reactive protein in a linear predictor showed excellent diagnostic performance in assessing vitamin A status, and has great potential to eventually replace serum retinol concentration measured by HPLC as the preferred method to assess the population burden of vitamin A deficiency. Further research is needed to confirm whether this linear predictor yields similar results in different populations and laboratories. Our methodology can be widely applied for other diagnostic aims.
Description
Keywords
Citation
Talsma Elise F, Verhoef Hans, Brouwer Inge D, Mburu-deWagt Anne, Hulshof Paul J M, Melse-Boonstra Alida. Proxy Markers of Serum Retinol Concentration, Used Alone and in Combination, to Assess Population Vitamin A Status in Kenyan Children. European Journal of Nutrition & Food Safety. 2015 Special issue; 5(5): 615-616.