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Serum retinol concentrations in hospitalized severe protein-energy malnourished children
Maria de Fátima Costa Caminha1, Alcides da Silva Diniz, Ana Rodrigues Falbo
1Instituto Materno Infantil, Prof Fernando Figueira, Brasil. fatimacaminha@imip.org.br
Insights
Vitamin A deficiency (VAD) is common in hospitalized children with severe protein-energy malnutrition (PEM) and also affects healthy children. Interventions are crucial in areas with endemic diarrhea and poor socioeconomic conditions.
Area of Science:
- Nutritional Science
- Pediatric Health
- Public Health
Background:
- Vitamin A deficiency (VAD) is a significant public health issue in developing nations.
- Vitamin A status is often compromised in cases of protein-energy malnutrition (PEM).
Purpose of the Study:
- To evaluate and contrast serum retinol levels in hospitalized children suffering from severe PEM against those of healthy children.
- To investigate the correlation between serum retinol concentrations and various socio-demographic and clinical factors.
Main Methods:
- A prospective study involving 34 malnourished and 29 healthy children under 60 months old.
- Serum retinol levels were measured using high-performance liquid chromatography and adjusted for C-reactive protein levels.
- Comparisons were made based on nutritional status, gender, age, maternal education, family income, breastfeeding, residence, and morbidity.
Main Results:
- The prevalence of low serum retinol (<0.70 micromol/L) was 41.2% in severe PEM children and 24.1% in healthy children.
- Lower serum retinol was observed in children with less educated mothers and low family income, irrespective of nutritional status.
- Malnourished children with diarrhea exhibited significantly lower serum retinol levels compared to those without diarrhea.
Conclusions:
- Vitamin A deficiency is prevalent in both severely malnourished and healthy hospitalized children, though to a lesser extent in the latter.
- Recommended interventions for VAD prevention and control should target settings with endemic diarrhea and adverse socioeconomic conditions.
Background:
Vitamin A deficiency (VAD) is a major nutritional problem in many developing countries. Vitamin A status has been reported to be adversely affected in protein-energy malnutrition (PEM).
Objective:
To assess and compare serum retinol concentrations in hospitalized children with severe PEM and normal ones.
Methods:
A prospective series of 34 malnourished and 29 normal control children, <60 months old, hospitalized at IMIP, Recife-PE were recruited for the study between August 2004 and May 2005. Serum retinol level was assayed by high performance liquid chromatography and concentrations adjusted for presence of inflammation as evidenced by levels of C-reactive protein. Blood retinol level was compared according to nutritional status (severe PEM versus normal), gender, age, maternal schooling, family income, breastfeeding practice, residence and perceived morbidity.
Results:
The prevalence of low serum retinol (<0.70 micromol l(-1)) was 41.2% in children with severe PEM and 24.1% in normal children. Serum retinol concentrations were lower in children whose mothers had low schooling (p = 0.025) and families with low per capita income (p = 0.049), regardless of their nutritional status. Serum retinol concentrations had similar distribution between children with severe PEM and normal, when adjusted for gender (p > 0.05), age (p > 0.05), maternal schooling (p > 0.05), family income (p > 0.05), breastfeeding practice (p > 0.05) and residence (p > 0.05). However, malnourished children with diarrhoea showed lower serum retinol concentrations (p = 0.021) compared to those without diarrhoea.
Conclusion:
VAD was prevalent in hospitalized children with severe PEM and also among normal ones although in lesser magnitude. Intervention for prevention and control of deficiency of vitamin A are recommended in settings where diarrhea is endemic and there are unfavorable socio-economical conditions.
