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Modulation of Intestinal Immune and Barrier Functions by Vitamin A: Implications for Current Understanding of Malnutrition and Enteric Infections in Children
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Nutrients 2018, 10(9), 1240; https://doi.org/10.3390/nu10091240

Effects of Inflammation on Biomarkers of Vitamin A Status among a Cohort of Bolivian Infants

1
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
2
Nutrition Branch, Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control & Prevention, Atlanta, GA 30341, USA
3
Department of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
4
Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
5
Department of Pediatrics, Emory School of Medicine, Atlanta, GA 30322, USA
6
Servicio Departamental de Salud, La Paz, Bolivia
*
Author to whom correspondence should be addressed.
Received: 2 August 2018 / Revised: 24 August 2018 / Accepted: 31 August 2018 / Published: 5 September 2018
(This article belongs to the Special Issue Vitamin A, Infectious Diseases and the Immune Function)
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Abstract

Globally, vitamin A deficiency (VAD) affects nearly 200 million children with negative health consequences. VAD can be measured by a retinol-binding protein (RBP) and serum retinol concentrations. Their concentrations are not always present in a 1:1 molar ratio and are affected by inflammation. This study sought to quantify VAD and its impact on infant mortality and infectious morbidity during the first 18 months of life in a cohort of mother-infant dyads in El Alto, Bolivia, while accounting for the previously mentioned measurement issues. Healthy mother-infant dyads (n = 461) were enrolled from two hospitals and followed for 12 to 18 months. Three serum samples were collected (at one to two, six to eight, and 12 to 18 months of infant age) and analyzed for RBP, and a random 10% subsample was analyzed for retinol. Linear regression of RBP on retinol was used to generate RBP cut-offs equivalent to retinol <0.7 µmol/L. All measures of RBP and retinol were adjusted for inflammation, which was measured by a C-reactive protein and alpha (1)-acid glycoprotein serum concentrations using linear regression. Infant mortality and morbidity rates were calculated and compared by early VAD status at two months of age. Retinol and RBP were weakly affected by inflammation. This association varied with infant age. Estimated VAD (RBP < 0.7 µmol/L) decreased from 71.0% to 14.8% to 7.7% at two, six to eight, and 12 to 18 months of age. VAD was almost nonexistent in mothers. Early VAD was not significantly associated with infant mortality or morbidity rates. This study confirmed a relationship between inflammation and vitamin A biomarkers for some subsets of the population and suggested that the vitamin A status in early infancy improves with age and may not have significantly affected morbidity in this population of healthy infants. View Full-Text
Keywords: vitamin A deficiency; infant nutrition; micronutrient deficiencies; global micronutrient malnutrition vitamin A deficiency; infant nutrition; micronutrient deficiencies; global micronutrient malnutrition
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Burke, R.M.; Whitehead, R.D., Jr.; Figueroa, J.; Whelan, D.; Aceituno, A.M.; Rebolledo, P.A.; Revollo, R.; Leon, J.S.; Suchdev, P.S. Effects of Inflammation on Biomarkers of Vitamin A Status among a Cohort of Bolivian Infants. Nutrients 2018, 10, 1240.

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