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Acute-phase protein levels, diarrhoea, Trichuris trichiura and maternal education are predictors of serum retinol: a cross-sectional study of children in a Dhaka slum, Bangladesh

Published online by Cambridge University Press:  08 March 2007

Katja Kongsbak ,
Mohammed A. Wahed ,
Henrik Friis  and
Shakuntala H. Thilsted
Katja Kongsbak*
Affiliation:
Department of Human Nutrition, The Royal Veterinary and Agricultural University, Rolighedsvej 30, 1958 Frederiksberg C, Denmark
Mohammed A. Wahed
Affiliation:
International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B): Centre for Health and Population Research, GPO Box 128, Mohakhali, Dhaka 1000, Bangladesh
Henrik Friis
Affiliation:
Department of Epidemiology, Institute of Public Health, University of Copenhagen, Øster Farimagsgade 5B, PO Box 2099, 1014 Copenhagen K, Denmark
Shakuntala H. Thilsted
Affiliation:
Department of Human Nutrition, The Royal Veterinary and Agricultural University, Rolighedsvej 30, 1958 Frederiksberg C, Denmark
*
*Corresponding author: Ms Katja Kongsbak, fax +45 35 28 24 83, email katjakongsbak@yahoo.dk, kak@kvl.dk
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Abstract

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The objectives of the present study were to identify predictors of serum retinol concentration as well as to assess the prevalence of low serum retinol concentration, in both the whole population after correcting for the effect of serum C-reactive protein (CRP) (using multiple categories), and the healthy subgroup. A cross-sectional study of 579 apparently healthy children, aged 3–7 years from a Dhaka slum, Bangladesh, was conducted. The effects of age, gender, serum CRP and α1-antichymotrypsin, reported morbidity (during the previous 2 weeks), Ascaris lumbricoides and Trichuris trichiura infections, parental education, wasting, stunting and underweight on serum retinol were estimated using multiple linear regression. The mean serum retinol concentration was 0·84 (sd 0·27) μmol/l. Elevated serum CRP levels, reported diarrhoea, reported nasal discharge and T. trichiura infection were negative predictors of serum retinol, whereas maternal education was a positive predictor. Compared with a serum CRP level of <1 mg/l, CRP levels of 2 to <5, 5 to <10 and ≥10 mg/l were associated with 0·12, 0·16 and 0·32 μmol/l lower serum retinol, respectively. The prevalence of low serum retinol (<0·70 μmol/l) fell from 31·2 % to 15·6 % in the whole population, after correcting for the effect of CRP, and was 20·1 % in the healthy subgroup (CRP <2 mg/l). The prevalence of low serum retinol was high but overestimated due to the effect of CRP. Interventions are needed to address low serum retinol in Bangladesh. Controlling diarrhoea, nasal discharge and T. trichiura infection and improving maternal education may be important interventions. The use of multiple categories of acute-phase proteins and cut-off values that indicate elevated levels need further research.

Keywords

Vitamin A deficiencySerum retinolAcute-phase proteinsChildren
Type
Research Article
Information
British Journal of Nutrition , Volume 96 , Issue 4 , October 2006 , pp. 725 - 734
Copyright
Copyright © The Nutrition Society 2006

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