Vitamin A status of alcoholics upon admission and after two weeks of hospitalization

The purpose of this study was to determine the vitamin A status of alcoholics upon admission and after a brief in-patient stay. Fasting blood was drawn from 28 randomly selected subjects who were presumed to represent a wide range of liver disease severity. Admission laboratory tests revealed hypozincemia in 14.8% of subjects, while serum retinol and retinol-binding protein (RBP) were depressed below normal range in 15 (57.1%) and 7 (25%) of the subjects, respectively. Significant linear correlations were found between serum retinol and RBP (r = 0.90, p < or = 0.0001), serum retinol and albumin (r = 0.76, p < or = 0.0001), serum retinol and serum zinc (r = 0.56, p < or = 0.0003), and serum retinol and serum triglycerides (r = 0.42, p < or = 0.006). All subjects with elevated serum bilirubin levels demonstrated depressed serum retinol levels. However, elevated molar ratios of retinol to RBP suggest that the carrying capacity of RBP was at times exceeded, even with low serum retinol levels. Follow-up of 12 subject after 2 weeks of hospitalization revealed significant individual changes in blood chemistry, but no general trends. Although this study emphasizes the need for individual evaluation and treatment, elevated bilirubin levels may be indicative of low serum retinol levels in the alcoholic. Caution in levels of vitamin A therapy in these cases is advised, and consideration should instead be given to beta-carotene supplementation.