SIGNIFICANCE OF VERY-LOW RETINOL LEVELS DURING SEVERE PROTEIN-ENERGY MALNUTRITION

In developing countries, severe vitamin A deficiency is associated wit h increased child mortality, In Kivu, Zare, child mortality rate is ap proximately 50 per 1000 per year and protein calorie malnutrition is e ndemic. To evaluate vitamin A status in this population, we measured p lasma retinol levels in 28 severely malnourished hospitalized children (plasma albumin level below 3 g/dl), and in 153 outpatients (mean pla sma albumin level: 3.19+/-0.7 g/dl) as controls. Sixty per cent of inp atients and 37 per cent of out-patients had retinol levels below 10 mu g/dl (P=0.02) suggesting a high prevalence of severe vitamin A defici ency in this population. We found that plasma retinol levels were corr elated with low retinol binding protein plasma levels (r=0.77), We con clude that although vitamin A deficiency probably exists in this malno urished population, low retinol levels could at least partly be relate d to decreased levels of its carrier protein.