Document Detail

The importance of controlling for the acute-phase response in the population-based assessment of vitamin A status: a study in children of pre-school age in Uganda.
MedLine Citation:
PMID:  23021569     Owner:  NLM     Status:  Publisher    
OBJECTIVE: To improve estimates of vitamin A deficiency in children of pre-school age in the 2006 Uganda Demographic and Health Survey (UDHS 2006). DESIGN: A cross-sectional study in which dried blood spot samples were analysed for C-reactive protein (CRP). Retinol-binding protein (RBP) had previously been analysed using a commercial enzyme immunoassay. SETTING: A population-based study in Uganda. SUBJECTS: A systematically selected subset of the dried blood spot samples collected from children aged 6-59 months for UDHS 2006. Children were categorized into 'normal CRP' (Group A) and 'raised CRP' (Group B) using a CRP cut-off of 5 mg/l. A correction factor was calculated to adjust the Group B RBP values for the influence of the acute-phase response. RESULTS: Geometric mean CRP was 6·2 (95 % CI 5·5, 7·0) mg/l, 1·6 (95 % CI 1·5, 1·8) mg/l and 17·9 (95 % CI 16·4, 19·6) mg/l in all children, in Group A and in Group B, respectively. Geometric mean RBP in all children, in Group A and in Group B was 1·18 (95 % CI 1·14, 1·22) μmol/l, 1·26 (95 % CI 1·20, 1·33) μmol/l and 1·12 (95 % CI 1·07, 1·17) μmol/l, respectively, before correction. Correction increased mean RBP in Group B to 1·26 (95 % CI 1·21, 1·31) μmol/l. The prevalence of vitamin A deficiency (RBP < 0·825 μmol/l) reduced from 18·4 % (95 % CI 17·2, 23·0 %) to 13·9 % (95 % CI 11·3, 16·5 %). CONCLUSIONS: Correcting for the acute-phase response significantly reduced the prevalence of vitamin A deficiency; thus, the acute-phase response should be considered when vitamin A status is assessed using RBP in order to improve population-level estimates of vitamin A deficiency.
Rhona Baingana; Dennis Matovu-Kasozi; Dean Garrett
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-1
Journal Detail:
Title:  Public health nutrition     Volume:  -     ISSN:  1475-2727     ISO Abbreviation:  Public Health Nutr     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9808463     Medline TA:  Public Health Nutr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1-8     Citation Subset:  -    
1 Department of Biochemistry, Makerere University, PO Box 7062, Kampala, Uganda.
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