Saliva for Assessing Vitamin A Status in Extremely Preterm Infants: A Diagnostic Study
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Published on: December 27, 2024
Abhijeet A Rakshasbhuvankar1,2,3, Michael W Clarke4,5, Karen Simmer6,7
1Neonatal Clinical Care Unit, King Edward Memorial and Perth Children's Hospitals, Perth, Washington, Australia, abhijeet.rakshasbhuvankar@health.wa.gov.au.
Insights
Saliva analysis is not reliable for determining vitamin A status in extremely preterm infants. Current methods and collection materials do not provide accurate individual vitamin A measurements from saliva in this vulnerable population.
Area of Science:
- Neonatal Medicine
- Nutritional Science
- Biochemistry
Background:
- Salivary analysis offers a minimally invasive method for monitoring hormones and vitamins.
- Assessing vitamin A status in extremely preterm infants is crucial for their development.
- Previous research highlights the potential of saliva as a diagnostic fluid.
Purpose of the Study:
- To evaluate the effectiveness of salivary measurements for assessing vitamin A status in extremely preterm infants.
- To compare salivary retinol levels with plasma retinol levels in this population.
- To determine if saliva can be a reliable biomarker for vitamin A in neonates.
Main Methods:
- Paired saliva and blood samples were collected from infants born before 28 weeks gestation.
- Plasma retinol was quantified using high-performance liquid chromatography.
- Salivary retinol was measured via enzyme-linked immunosorbent assay.
Main Results:
- Adequate saliva volume was obtained from 68% of the 30 infants studied.
- No significant correlation was found between plasma and salivary retinol levels (Spearman's rho = 0.16, p = 0.3).
- Bland-Altman analysis revealed wide limits of agreement for retinol measurements between saliva and plasma.
Conclusions:
- Current salivary collection materials and analytical techniques are insufficient for reliable vitamin A status assessment in extremely preterm infants.
- Individual vitamin A status determination from saliva is not feasible in this neonatal group.
- Further research is needed to develop accurate salivary biomarkers for neonatal nutrition.
Background:
Salivary measurement of hormones and vitamins is gaining prominence as a minimally invasive procedure with the negligible potential for harm. We aimed to assess the utility of saliva for assessing vitamin A status in extremely preterm infants.
Methods:
Paired saliva and blood samples were collected at 4 weeks of age from infants born <28 weeks of gestation using a proprietary polymer swab. Plasma retinol was measured using high-performance liquid chromatography, and salivary retinol was measured using enzyme-linked immunosorbent assay.
Results:
Thirty infants were recruited with a median (IQR) gestation and birth weight of 26.2 weeks (24.8-27.2) and 865 g (718-1,002), respectively. An adequate volume of saliva (>50 µL) was obtained in 68%. There was no significant correlation (Spearman's correlation coefficient = 0.16, p = 0.3) between individual plasma and salivary retinol levels. Bland-Altman analysis showed wide limits of agreement (-113 to +119%) between individual plasma and salivary retinol levels.
Conclusion:
Individual vitamin A status cannot be determined reliably from saliva in extremely preterm infants using current collection materials and analysis techniques.
