Jacobson D M, Berg R, Wall M, Digre K B, Corbett J J, Ellefson R D
Department of Neurology, Marshfield Clinic, WI 54449, USA.
Neurology. 1999 Sep 22;53(5):1114-8. doi: 10.1212/wnl.53.5.1114.
The primary purpose was to investigate whether serum vitamin A concentration is associated with idiopathic intracranial hypertension (IIH). The secondary aim was to obtain pilot data regarding the amount of vitamin A ingested by patients and controls.
Vitamin A is an attractive candidate mediator of IIH as many of the symptoms and signs of hypervitaminosis A mimic those of IIH.
We prospectively determined serum retinol and retinyl ester concentration in 16 women with IIH and 70 healthy young women. Using a survey instrument, we also determined the average daily vitamin A ingestion in a convenience sample of patients and controls.
Serum retinol concentration was significantly higher in the patient group (median 752 ug/L) compared with the control group (median 530 ug/L), even after adjusting for age and body mass index (p < 0.001). Retinyl ester concentration, however, was similar in the patient (median 48 ug/L) and control (median 41 ug/L) groups (p = 0.32). There was no significant correlation between serum retinol concentration and body mass index in the patients (r = 0.16) or controls (r = -0.02). Finally, there was no significant difference in the amounts of vitamin A ingested by the patients or controls, although the small number of subjects in both groups reduced the power of this conclusion.
Elevated serum retinol concentration is associated with IIH. Obesity, by itself, does not explain these higher levels. Patients may ingest an abnormally large amount of vitamin A, metabolize it abnormally, or be unusually sensitive to its effects. Alternatively, elevated level of serum retinol may reflect an epiphenomenon of another variable we did not measure or a nonspecific effect of elevated retinol binding capacity.
主要目的是研究血清维生素A浓度是否与特发性颅内高压（IIH）相关。次要目的是获取患者和对照组维生素A摄入量的初步数据。
维生素A是IIH一个有吸引力的潜在介导因素，因为维生素A过多症的许多症状和体征与IIH相似。
我们前瞻性地测定了16例IIH女性患者和70名健康年轻女性的血清视黄醇和视黄酯浓度。我们还使用一份调查问卷，测定了患者和对照组方便样本中维生素A的平均每日摄入量。
即使在对年龄和体重指数进行校正后，患者组的血清视黄醇浓度（中位数752微克/升）仍显著高于对照组（中位数530微克/升）（p<0.001）。然而，视黄酯浓度在患者组（中位数48微克/升）和对照组（中位数41微克/升）中相似（p = 0.32）。患者组（r = 0.16）和对照组（r = -0.02）的血清视黄醇浓度与体重指数之间均无显著相关性。最后，患者和对照组的维生素A摄入量没有显著差异，尽管两组受试者数量较少降低了该结论的说服力。
血清视黄醇浓度升高与IIH相关。肥胖本身并不能解释这些较高水平。患者可能摄入了异常大量的维生素A，对其代谢异常，或对其作用异常敏感。或者，血清视黄醇水平升高可能反映了我们未测量的另一个变量的附带现象或视黄醇结合能力升高的非特异性效应。
