Adelekan Delana A, Northrop-Clewes Christine A, Owa Joshua A, Oyedeji Adesola O, Owoeye Adedayo A, Thurnham David I
Department of Community Health, Obafemi Awolowo, University Ile-Ife, Nigeria.
Br J Nutr. 2003 Aug;90(2):353-61. doi: 10.1079/bjn2003907.
Using the World Health Organization criterion, the prevalence of sub-clinical vitamin A deficiency can be assessed using plasma retinol concentrations <0.7 micromol/l. However, plasma retinol can be depressed by infection; thus, the use of this criterion alone may overestimate deficiency. In the present study, we investigated the usefulness of the acute-phase proteins (APP) alpha1-antichymotrypsin (ACT) and alpha1-acid glycoprotein (AGP), plasma carotenoids and anthropometric and gestational indices to interpret plasma retinol in the blood of 192 apparently healthy Nigerian neonates collected randomly during days 1-20 postpartum. The mean weight (2.64 kg) and length (0.458 m) of the neonates and plasma concentrations (geometric mean, micromol/l) of retinol (0.54), alpha-carotene (0.072), ss-carotene (0.076) and lutein (0.080) were low. The prevalence of vitamin A deficiency was 72 %, indicating a severe public health problem. Babies who were of low birth weight (P<0.003) or premature and low birth weight (P<0.023) had significantly lower retinol concentrations than full-term normal weight babies. Thirty-two neonates had abnormal ACT and forty-four abnormal AGP concentrations. Positive correlations between retinol and ACT (r 0.186, P=0.05) and AGP (r 0.31, P=0.0001) during days 1-5 may be due to the increasing plasma retinol from maternal milk and a coincidental increasing capacity to synthesise APP. Subsequently, negative correlations between retinol and ACT (r -0.28, P=0.02) and AGP (r -0.29, P=0.018) from day 6 onwards reflected the continuing increase in plasma retinol, but no further increase in the APP. Overall, weight, ACT, lutein and age explained 30 % of the variance in retinol, but lutein was the most significant (r(2) 0.18, P<0.0001). Hence, the distribution of plasma retinol concentrations in this group of neonates was more strongly linked with nutrition (via the surrogate marker lutein) than infection.
采用世界卫生组织的标准，可通过血浆视黄醇浓度<0.7微摩尔/升来评估亚临床维生素A缺乏的患病率。然而，感染会使血浆视黄醇水平降低；因此，仅使用这一标准可能会高估维生素A缺乏的情况。在本研究中，我们调查了急性期蛋白（APP）α1 -抗糜蛋白酶（ACT）和α1 -酸性糖蛋白（AGP）、血浆类胡萝卜素、人体测量指标和妊娠指标在解读192名产后1 - 20天随机收集的表面健康的尼日利亚新生儿血液中血浆视黄醇方面的作用。新生儿的平均体重（2.64千克）和身长（0.458米）以及视黄醇（0.54）、α -胡萝卜素（0.072）、β -胡萝卜素（0.076）和叶黄素（0.080）的血浆浓度（几何平均值，微摩尔/升）均较低。维生素A缺乏的患病率为72%，表明存在严重的公共卫生问题。低出生体重（P<0.003）或早产且低出生体重（P<0.023）的婴儿视黄醇浓度显著低于足月正常体重的婴儿。32名新生儿的ACT异常，44名新生儿的AGP浓度异常。在第1 - 5天期间，视黄醇与ACT（r 0.18, P = 0.05）和AGP（r 0.31, P = 0.0001）之间呈正相关，这可能是由于母乳中血浆视黄醇增加以及同时合成APP的能力增强。随后，从第6天起，视黄醇与ACT（r -0.28, P = 0.02）和AGP（r -0.29, P = 0.018）之间呈负相关，这反映了血浆视黄醇持续增加，但APP没有进一步增加。总体而言，体重、ACT、叶黄素和年龄解释了视黄醇变异的30%，但叶黄素是最显著的因素（r² 0.18, P<0.0001）。因此，这组新生儿血浆视黄醇浓度的分布与营养（通过替代标志物叶黄素）的关联比与感染的关联更强。
