Document Detail

The effectiveness of relative dose response to retinol intake as an evaluation of vitamin A status of cirrhotic patients.
MedLine Citation:
PMID:  20487170     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The liver is the main organ involved in homeostasis, metabolism and the storage of retinol. During the fibrotic process, hepatic stellate cells lose their lipid drops, and retinol reserves may deplete. Thus, the present study aimed to evaluate serum retinol levels (RL), hepatic retinol storage and dietary vitamin A intake in cirrhotic patients.
METHODS: RL were measured by high-performance liquid chromatography in fifty-eight cirrhotic patients. Fasting RL <1.05 μmol L⁻¹ indicates vitamin A deficiency (VAD). A relative dose response (RDR) to oral retinol ≥20% indicates an inadequate hepatic retinol reserve (positive test). Severe malnutrition was defined as a mid-arm muscle circumference (MAMC) and/or triceps skinfold thickness (TSF) below the 5th percentile and moderate malnutrition as MAMC and/or TSF below the 10th percentile. Vitamin A daily intake was estimated by a specific questionnaire. The Child-Pugh classification of liver disease severity and the Model for End-Stage Liver Disease were used.
RESULTS: Low RL were found in 60% of the patients. Twenty-three cirrhotic patients had adequate fasting RL (RL = 1.34; 1.05-2.12 μmol L⁻¹) and negative RDR, indicating efficient liver stores. Among thirty-five cirrhotic patients with low RL, 43% had negative RDR (RL = 0.42; 0.06-0.82 μmol L⁻¹) and 57% had positive RDR (RL = 0.45; 0.09-0.93 μmol L⁻¹). Malnutrition (36%) and inadequate vitamin A intake (55%) were not associated with fasting RL or RDR.
CONCLUSIONS: VAD was highly prevalent in cirrhotic patients. However, in those with low serum RL and negative RDR, factors other than inadequate vitamin A intake, such as impaired hepatic vitamin A mobilization and intestinal vitamin A malabsorption, which were not examined in the present study, could have influenced the negative results obtained by the RDR method.
T P de Paula; A Ramalho; V B Braulio
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of human nutrition and dietetics : the official journal of the British Dietetic Association     Volume:  23     ISSN:  1365-277X     ISO Abbreviation:  J Hum Nutr Diet     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-10-29     Completed Date:  2011-01-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8904840     Medline TA:  J Hum Nutr Diet     Country:  England    
Other Details:
Languages:  eng     Pagination:  583-9     Citation Subset:  IM    
Copyright Information:
© 2010 The Authors. Journal compilation © 2010 The British Dietetic Association Ltd.
Division of Metabolism and Nutrition, University Hospital, Federal University of Rio de Janeiro, RJ, Brazil.
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MeSH Terms
Dose-Response Relationship, Drug
Liver Cirrhosis / blood*,  complications
Malnutrition / complications,  diagnosis
Middle Aged
Nutritional Status*
Severity of Illness Index
Vitamin A / administration & dosage*,  blood*,  diagnostic use
Vitamin A Deficiency / complications,  diagnosis*
Reg. No./Substance:
11103-57-4/Vitamin A

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