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Urinary excretion of retinol in children with acute diarrhea
J O Alvarez1, E Salazar-Lindo, J Kohatsu
1Department of International Health, University of Alabama at Birmingham 35294-0008, USA.
Insights
Children hospitalized with acute diarrhea excrete significant amounts of retinol in their urine, contributing to vitamin A depletion. This urinary retinol loss is linked to rotavirus infection and fever.
Area of Science:
- Pediatrics
- Nutritional Science
- Infectious Diseases
Background:
- Acute childhood infections are linked to xerophthalmia (vitamin A deficiency).
- Severe infections in adults cause increased urinary retinol excretion.
- The mechanism of vitamin A depletion during childhood infections is unclear.
Purpose of the Study:
- To investigate urinary retinol excretion in children hospitalized with acute diarrhea.
- To determine the relationship between urinary retinol loss and vitamin A status in pediatric patients.
Main Methods:
- Measured 24-hour urinary retinol excretion in 44 hospitalized children with acute diarrhea.
- Compared urinary retinol levels with healthy, age-matched control subjects.
- Assessed associations between retinol excretion, rotavirus infection, fever, and serum retinol concentrations.
Main Results:
- Children with acute diarrhea excreted significant amounts of retinol (mean 1.44 µmol/24h on day 1).
- Urinary retinol excretion decreased over hospitalization (0.62 µmol/24h on day 2, 0.23 µmol/24h on day 3).
- Healthy controls showed no measurable urinary retinol excretion; excretion was linked to rotavirus and fever.
Conclusions:
- Urinary retinol excretion is a significant finding in children with acute diarrhea.
- This loss may contribute to the vitamin A depletion observed in childhood infections.
- Further research is needed to confirm the role of urinary retinol loss in xerophthalmia.
Abstract:
Acute infections of childhood are associated with an increased of xerophthalmia, apparently due to depletion of vitamin A stores. The mechanism responsible for this is not known. Recently, it has been reported that severe infections in adult patients (ie, sepsis and pneumonia) result in excretion of large quantities of retinol in the urine. In 44 children hospitalized for treatment of acute diarrhea we found mean urinary excretions of 1.44 mumol retinol/24 h on day 1 of hospitalization, 0.62 mumol retinol/24 h on day 2, and 0.23 mumol/24 h on day 3. Healthy control subjects matched for age did not excrete measurable amounts of retinol in the urine. Retinol excretion was associated strongly with rotavirus diarrhea and presence of fever. Furthermore, serum retinol concentration was negatively associated with duration of diarrhea before hospitalization, suggesting that urinary excretion of retinol may be an important contributor to vitamin A depletion.