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Association of diarrhea and low serum retinol in Peruvian children
E Salazar-Lindo1, M Salazar, J O Alvarez
1Department of Pediatrics, Universidad Peruana, Cayetano Heredia.
Insights
Acute diarrhea in children significantly lowers serum retinol levels, indicating a potential depletion of vitamin A. This study highlights the critical link between diarrheal illness and vitamin A status in pediatric populations.
Area of Science:
- Nutritional Science
- Pediatric Health
- Clinical Research
Background:
- Vitamin A is essential for immune function and overall child health.
- Diarrheal diseases are a major cause of childhood morbidity and mortality globally.
- Previous research suggests infections can impact micronutrient status.
Purpose of the Study:
- To investigate the association between acute diarrhea and vitamin A status in children.
- To quantify the effect of diarrhea on serum retinol concentrations.
- To control for potential confounding factors like age, sex, and malnutrition.
Main Methods:
- A case-control study involving 137 children in Lima, Peru.
- Serum retinol levels measured spectrophotometrically in children with diarrhea (n=72) and healthy controls (n=65).
- Statistical analysis using multivariate models to adjust for confounding variables.
Main Results:
- Children with acute diarrhea had significantly lower serum retinol levels (0.51 +/- 0.48 mumol/L) compared to controls (1.00 +/- 0.32 mumol/L).
- Diarrhea was independently associated with reduced retinol concentration, even after adjusting for age, sex, and acute malnutrition.
- The multivariate estimate confirmed a substantial negative impact of diarrhea on serum retinol.
Conclusions:
- Acute diarrhea is strongly linked to lower circulating retinol concentrations in children.
- Diarrheal episodes may contribute to vitamin A depletion, potentially impairing immune defenses.
- Findings underscore the importance of monitoring vitamin A status in children experiencing diarrhea.
Abstract:
To examine the relationship between acute diarrhea and vitamin A status, a study was conducted in 137 children (72 with diarrhea and 65 illness-free control subjects) in the city of Lima, Peru. Serum retinol was measured spectrophotometrically in samples collected in 1987 and kept frozen until they were analyzed simultaneously in 1989. Serum retinol was significantly lower in the children with diarrhea (mean +/- SD: 0.51 +/- 0.48 mumol/L) than in those without diarrhea (1.00 +/- 0.32 mumol/L; 1 mumol/L retinol = 28.6 micrograms/dL). The multivariate estimate of the effect of diarrhea (-0.464 mumol/L) in a model that incorporated age, sex, and acute malnutrition (ie, weight-for-height) as confounding variables was essentially the same as the unadjusted difference (-0.492 mumol/L). Thus, this model showed that the retinol concentration in the serum depends greatly on the presence of diarrhea. These findings suggest that diarrhea, as has been shown for other infections, may lead to lower circulating retinol concentrations and perhaps to its depletion.