Predictors of serum retinol in children with shigellosis
Predictors of serum retinol in children with shigellosis
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DOI：
10.1093/ajcn/68.5.1088
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发表时间：
1998-11-01
影响因子：
7.1
通讯作者：
Stephensen, CB
中科院分区：
文献类型：
--
作者：
Mitra, AK;Alvarez, JO;Stephensen, CB
背景：低血清视黄醇可作为肝脏维生素 A 储备耗尽的指标，特别是在基于人群的研究中。然而，血清视黄醇浓度在感染期间短暂降低，与肝脏储存的任何变化无关。血清视黄醇下降的幅度通常与疾病严重程度的指标成正比。 目的：我们研究了培养阳性志贺氏菌病儿童的血清视黄醇与疾病严重程度、营养状况的人体测量指标、尿视黄醇排泄以及 C 反应蛋白、α(1)-酸性糖蛋白、视黄醇结合蛋白和运甲状腺素蛋白的血清浓度的关系。 设计：这是一项前瞻性研究，评估了入院和康复时的临床和实验室测量结果。孟加拉国住院的 90 名痢疾儿童（其中 66 名患有志贺菌病）。结果：即使在患病期间未补充维生素 A，血清视黄醇浓度在入院时较低，但在出院时明显较高（0.36 +/- 0.22 与 1.15 +/- 0.50 μmol/L 相比，P < 0.001）。由于志贺氏菌菌株毒性较低，1 型痢疾志贺氏菌感染儿童的血清视黄醇浓度低于志贺氏菌病儿童。在多元回归分析中，低血清视黄醇与 1 型痢疾沙门氏菌、高血清 C 反应蛋白浓度和低年龄别体重独立相关。 结论：这项研究表明，志贺氏菌病与血清视黄醇浓度显着、短暂下降约 0.8 μmol/L 相关，并且这种变化与疾病的严重程度和基础营养状况不良（尤其是低年龄别体重）显着相关。
Background: Low serum retinol can be useful as an indicator of depleted liver vitamin A stores, particularly in population-based studies. However, serum retinol concentrations decrease transiently during infection, independent of any changes in liver stores. The magnitude of the decrease in serum retinol is often proportional to indicators of disease severity.Objective: We examined the relation of serum retinol in children with culture-positive shigellosis with severity of illness, anthropometric indicators of nutritional status, urinary retinol excretion, and serum concentrations of C-reactive protein, alpha(1)-acid glycoprotein, retinol binding protein, and transthyretin.Design: This was a prospective study assessing the clinical and laboratory measurements at admission and recovery of 90 children with dysentery (66 with shigellosis) hospitalized in Bangladesh.Results: Serum retinol concentrations were low at admission but were significantly greater at discharge even though no vitamin A supplements were given during the illness (0.36 +/- 0.22 compared with 1.15 +/- 0.50 mu mol/L, P < 0.001). Serum retinol concentrations were lower in children with Shigella dysenteriae type 1 infection than in children with shigellosis due to less virulent strains of Shigella. Low serum retinol was independently associated with S. dysenteriae type 1, high serum C-reactive protein concentrations, and low weight-for age in multiple regression analysis.Conclusions: This study showed that shigellosis was associated with a significant, transient decrease in serum retinol concentrations of approximate to 0.8 mu mol/L, and that this change was significantly associated with severity of disease and poor underlying nutritional status, particularly low weight-for-age.