Related Experiment Videos
Plasma ferritin concentration in relation to vitamin A and E status of children with severe oedematous malnutrition
D A Adelekan1, D I Thurnham, O O Adeodu
1Department of Paediatrics and Child Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
Insights
Children with severe malnutrition have higher ferritin levels and lower vitamin A and E status. Despite low plasma tocopherol, the tocopherol:cholesterol ratio suggests adequate vitamin E in malnourished children.
Area of Science:
- Nutritional Biochemistry
- Pediatric Nutrition
- Micronutrient Metabolism
Background:
- Severe malnutrition in children is associated with various micronutrient deficiencies.
- Plasma ferritin levels can be elevated in inflammatory conditions, potentially confounding micronutrient status assessment.
- Understanding vitamin A and E status is crucial for managing severe malnutrition.
Purpose of the Study:
- To investigate the association between plasma ferritin concentration and vitamin A and E status in children with severe oedematous malnutrition.
- To compare micronutrient status between malnourished children and healthy controls.
Main Methods:
- Study included 17 children (15-72 months) with severe oedematous malnutrition and 10 age-matched healthy controls.
- Plasma concentrations of ferritin, beta-carotene, alpha-tocopherol, and retinol were measured.
- Vitamin E status was assessed using plasma alpha-tocopherol and tocopherol:cholesterol ratio.
- Vitamin A status was assessed using plasma retinol concentrations.
Main Results:
- Malnourished children had significantly higher plasma ferritin concentrations compared to controls.
- Patients exhibited significantly lower plasma beta-carotene, alpha-tocopherol, and retinol levels.
- 88% of malnourished children had plasma alpha-tocopherol below the deficiency threshold, yet the tocopherol:cholesterol ratio indicated adequate vitamin E status.
- 70.5% had marginal vitamin A status, and 3 had vitamin A deficiency.
- Anaemia was prevalent in malnourished children.
- No significant correlation was found between elevated ferritin and plasma vitamin A or E concentrations.
Conclusions:
- Severe malnutrition is linked to elevated plasma ferritin and impaired vitamin A and E status.
- The tocopherol:cholesterol ratio may be a more reliable indicator of vitamin E status in malnourished children than absolute plasma tocopherol levels.
- Micronutrient supplementation, particularly for vitamin A, should be considered in managing severe malnutrition.
Abstract:
The association between plasma ferritin concentration and vitamin A and E status was studied in 17 children aged 15-72 months with severe oedematous malnutrition. The controls were 10 children of similar age who were apparently well and with no obvious signs of clinical malnutrition. Plasma ferritin concentration in the patients was significantly higher than that in the control children. Conversely, the plasma concentrations of beta-carotene, alpha-tocopherol and retinol in patients were significantly lower than those in plasma of control children. The median (interquartile range) plasma alpha-tocopherol concentration of patients, 6.03 (5.29-9.50) mumol/l, is below the threshold of vitamin E deficiency (11.6 mumol/l). Fifteen of 17 (88%) malnourished patients were found to have plasma tocopherol concentrations below the normal threshold. However, all the patients had a tocopherol: cholesterol ratio greater than 2.22, indicating adequate vitamin E status for the level of cholesterol present in plasma. Twelve of 17 patients (70.5%) had plasma retinol concentration less than 0.70 mumol/l, indicative of marginal vitamin A status, while 3 patients had plasma retinol concentrations less than 0.35 mumol/l, indicating vitamin A deficiency. The median (interquartile range) plasma retinol concentration of patients, 0.51 (0.41-0.93) mumol/l, is significantly less than that of control children, 0.96 (0.74-1.09) mumol/l; p less than 0.01 Mann Whitney U test. Furthermore, anaemia (Hb less than 110 g/l) was widespread in the patients. The results also indicate no significant correlation between elevated ferritin concentration and the concentrations of beta-carotene, retinol and alpha-tocopherol in the patients' plasma.(ABSTRACT TRUNCATED AT 250 WORDS)