Hyporetinolemia and acute phase proteins in children with and without xerophthalmia

Background: The relations among hyporetinolemia. acute phase proteins, and vitamin A status in children are unclear. Objective: The objective was to examine the relations between acute phase p roteins and plasma retinol concentrations in children with and without clin ical vitamin A deficiency (Bitot spots and night blindness). Design: The study was a nonconcurrent analysis of acute phase protein conce ntrations and other data fi om a previous clinical trial. Preschool childre n, 3-6 y of age, with (n = 118) and without (n = 118) xerophthalmia were as signed to receive oral vitamin A (60 mg retinol equivalent) or placebo and were seen at 5 wk. All children received oral vitamin A (60 mg retinol equi valent) at 5 wk. Results: At baseline, alpha(1)-acid glycoprotein (AGP) was elevated in 42.9 % and 23.5% (P < 0.003) and C-reactive protein (CRP) was: elevated in 17.7% and 13.7% (NS) of children with and without xerophthalmia, respectively. H yporetinolemia (retinol < 0.7 mu mol/L) occurred in 61.0%, and 47.4% (P < 0 .04) of children with and without xerophthalmia, respectively. A history of fever, a history of cough, and nasal discharge noted on examination were e ach associated with elevated acute phase proteins. Vitamin A supplementatio n increased plasma retinol at 5 wk but had no significant effect on concent rations of acute phase proteins. Conclusions: Elevated acute phase protein concentrations and infectious dis ease morbidity are closely associated during vitamin A deficiency.