HYPORETINOLEMIA, ILLNESS SYMPTOMS, AND ACUTE-PHASE PROTEIN RESPONSE IN PREGNANT-WOMEN WITH AND WITHOUT NIGHT BLINDNESS

We examined the association among elevations in acute phase proteins, reported illness, and hyporetinolemia in 234 pregnant Nepali women wit h (cases) and without (controls) night blindness. Serum alpha(1)-acid glycoprotein (AGP) and C-reactive protein (CRP) were inversely associa ted with serum retinol concentrations. Elevations in the concentration of CRP in both cases and controls and of AGP in cases were associated with significant reductions (approximate to 0.2-0.3 mu mol/L) in seru m retinol. The risk of a low serum retinol concentration (< 0.7 mu mol /L) with elevated AGP (greater than or equal to 1 g/L) and CRP (greate r than or equal to 5 mg/L) concentrations was significantly higher in cases (odds ratios = 8.6 and 4.3, respec tively) than in controls (odd ratios = 1.9 and 2.4, respectively). A 7-d morbidity history indicate d that cases were significantly more likely than controls to report sy mptoms of infections of the urinary, reproductive, and gastrointestina l tracts. Only a few of these symptoms (diarrhea, nausea, and vomiting ) were significantly associated with low serum retinol concentrations. Illness in the previous week and elevated CRP or AGP concentrations w ere synergistically associated with lower serum retinol, For example, the reduction in serum retinol in women with diarrhea and elevated AGP was 0.54 mu mol/L, compared with a reduction of 0.03 mu mol/L in thos e with diarrhea only. AGP and CRP may provide useful information about the effect of reported illness on hyporetinolemia in pregnancy. Infec tion-related hyporetinolemia may predispose women to night blindness d uring pregnancy in Nepal.