FAILURE-TO-THRIVE AND ITS RELATIONSHIP TO SERUM VITAMIN-A LEVELS AND DIET

Serum vitamin A and retinol-binding protein (REP) levels were determin ed in a group of 34 children between 1 and 4 years of age with failure to thrive and in 34 age- and sex-matched controls, Both groups of chi ldren were also assessed in respect of anthropometry and diet. Vitamin A levels in patients (0 -32,2 mu g/100 ml; median 16,9 mu g/100 ml) d id not differ significantly from controls (6,4 - 47,2 mu g/100 ml; med ian 16,1 mu g/100 ml), Fourteen patients (42%) and 4 controls (12%) ha d vitamin A levels below 10 mu g/100 ml, REP levels in patients (0,45 - 3,50 mg/100 ml; median 2,17 mg/100 ml) also did not differ significa ntly from those in controls (1,21 - 3,66 mg/100 ml; median 2,06 mg/100 ml), No clinical features of vitamin A deficiency were detected, Weig ht and height for age, weight for height, mid-upper arm circumference and head circumference differed significantly between patients and con trols (P < 0,0001 in each instance), Although within the recommendatio ns for intake, patients had a significantly lower intake of the essent ial fatty acid C 18:2 (N = 6) (linoleic acid) and vitamin A. In view o f the current proposed relationship between vitamin A status and infec tious diseases, the prevalence of biochemical vitamin A deficiency in children in the Cape Town community studied may contribute to the morb idity and mortality associated with infectious diseases in the area to a greater degree than has been suspected.