Serum retinyl esters are not associated with biochemical markers of liver dysfunction in adult participants in the third National Health and Nutrition Examination Survey (NHANES III), 1988-1994

Background: Serum retinyl ester concentrations are elevated in hypervitamin osis A. It was suggested that retinyl esters > 10% of total serum vitamin A indicate potential hypervitaminosis, but this cutoff was derived from smal l clinical samples that may not he representative of the general population . Objective: We sought to examine the distribution of serum retinyl eater con centrations and associations between retinyl eater concentrations and bioch emical markers of liver dysfunction in a nationally representative sample. Design: We assessed the: associations between serum retinyl ester concentra tions and 5 biochemical indexes of liver dysfunction by using multivariate linear and multiple logistic regression techniques and controlling for age, sex, use of supplements containing vitamin A, alcohol consumption, smoking status, and use of exogenous estrogens in 6537 adults aged greater than or equal to 18 y in the third National Health and Nutrition Examination Surve y (NHANES III), 1988-1994. Results: Thirty-seven percent of the sample had serum retinyl ester concent rations > 10% of total serum vitamin A and 10% of the sample had serum reti nyl esters > 15% of total vitamin A. We found no associations between serum retinyl eater concentrations and 1) concentrations of any biochemical vari able (multiple linear regression) or 2) risk of having biochemical variable s above the reference range (multiple logistic regression). We did not find a serum retinyl eater value with statistically significant sensitivity and specificity for predicting increases in biochemical indexes of liver dysfu nction. Conclusions: The prevalence of serum retinyl ester concentrations > 10% of the total vitamin A concentration in the NHANES III sample was substantiall y higher than expected but elevated retinyl ester concentrations were not a ssociated with abnormal liver function.