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Assessing vitamin A status: past, present and future.

Sherry A Tanumihardjo1

  • 1Department of Nutritional Sciences, UW-Madison, Madison, WI 53706-1571, USA. sherry@nutrisci.wisc.edu

The Journal of Nutrition
|January 6, 2004
PubMed
Summary

Assessing vitamin A deficiency requires diverse methods, from traditional eye exams to advanced isotope dilution tests. The choice depends on laboratory resources and the need to accurately reflect liver vitamin A reserves.

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Area of Science:

  • Nutritional Biochemistry
  • Public Health
  • Ophthalmology

Background:

  • Traditional xerophthalmia classification is being supplemented by newer methods for vitamin A deficiency assessment.
  • Subclinical vitamin A deficiency is common, necessitating sensitive detection methods beyond overt eye signs.
  • Serum retinol levels can be misleading due to homeostatic control and infection-related fluctuations.

Purpose of the Study:

  • To review and compare various methods for assessing vitamin A status in populations.
  • To highlight the strengths and limitations of different diagnostic approaches for vitamin A deficiency.

Main Methods:

  • Review of established and emerging techniques for vitamin A assessment.
  • Discussion of functional tests (night blindness, dark adaptometry), biochemical markers (serum retinol, RBP), and dose-response tests.
  • Evaluation of isotope dilution techniques, including traditional and novel mass spectrometry-based assays.

Main Results:

  • Serum retinol and RBP levels are influenced by infection and homeostatic mechanisms, limiting their utility in reflecting true vitamin A stores.
  • Dose-response tests offer insights but do not quantify total body vitamin A reserves.
  • Isotope dilution tests, particularly newer mass spectrometry methods, provide more accurate assessments of liver vitamin A reserves.

Conclusions:

  • A range of vitamin A assessment methods exist, each with specific advantages and limitations.
  • The selection of an appropriate method is contingent upon the available laboratory infrastructure and the specific diagnostic goals.
  • Advanced techniques like isotope dilution assays are crucial for accurately determining vitamin A body stores.

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