Serum vitamin A, retinol-binding protein, and prealbumin concentrations in protein-calorie malnutrition

Abstract

The serum retinol transport system has been studied in eight Central American children with marasmic kwashiorkor treated with protein, calories, and supplemental vitamin A. With therapy, the serum concentrations of vitamin A, retinol-binding protein (RBP), and prealbumin (PA) all increased significantly as did the concentrations of serum albumin and total protein and the creatinine-height index (CHI). The levels of vitamin A, RBP, and PA were highly significantly correlated with each other (P < 0.001) over the wide concentration range observed during treatment, suggesting that the RBP holo-protein and PA were similarly influenced by the nutritional therapy. The serum concentrations of vitamin A, RBP, and PA failed to correlate with the concentration of serum albumin or with the CHI. Whereas the concentrations of serum albumin and total protein and the CHI rose progressively in most patients throughout the period of therapy, the vitamin A, RBP, and PA concentrations generally rose to a maximum at approximately days 20 to 40, then decreased by days 60 to 90. Factors in addition to the availability of amino acid and protein substrate influence serum retinol transport in protein-calorie malnutrition.