Which blood cutoff value should be used for vitamin A deficiency in children aged 3-10 years? A systematic review

Area of Science:

• Pediatric Nutrition
• Nutritional Deficiency
• Biochemistry

Background:

• Vitamin A deficiency is a global health concern, particularly in children.
• Established blood cutoff values for vitamin A deficiency are lacking for children aged 3-10 years.
• Accurate diagnostic criteria are essential for timely intervention and management.

Purpose of the Study:

• To identify reliable blood retinol concentrations for diagnosing severe vitamin A deficiency in children aged 3-10 years.
• To evaluate the diagnostic accuracy of existing blood retinol levels as indicators of vitamin A deficiency in this age group.

Main Methods:

• A systematic literature search was conducted across major databases (MEDLINE, Web of Science, Embase, Scopus).
• Two independent reviewers extracted data and assessed the quality of eligible articles.
• Hierarchical summary receiver operating characteristic models were used for diagnostic accuracy meta-analysis.

Main Results:

• Nine studies, totaling 15 articles, were included in the meta-analysis.
• The diagnostic accuracy for severe vitamin A deficiency showed low sensitivity (0.39) and moderate specificity (0.79).
• The area under the curve (AUC) for the overall analysis was 0.68, suggesting limited diagnostic performance.

Conclusions:

• Blood retinol concentrations demonstrate low diagnostic accuracy for identifying severe vitamin A deficiency in children aged 3-10 years.
• Current evidence is insufficient to establish a preferable cutoff point for this age group.
• Further research is needed to determine accurate biomarkers and diagnostic thresholds for vitamin A status in pediatric populations.