Proxy markers of serum retinol concentration, used alone and in combination, to assess population vitamin A status in Kenyan children: a cross-sectional study
Background: Serum retinol concentration determined by high-performance liquid chromatography (HPLC) is recommended by the World Health Organization to assess population vitamin A status. This assay is expensive, technically demanding and rarely available in developing countries. Our objective was a)...
| Main Authors: | , , , , , |
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| Format: | Journal Article |
| Language: | Inglés |
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Springer
2015
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| Online Access: | https://hdl.handle.net/10568/150041 |
| _version_ | 1855528294673285120 |
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| author | Talsma, E.F. Verhoef, H. Brouwer, Inge D. Mburu-de Wagt, A.S. Hulshof, P.J.M. Melse-Boonstra, A. |
| author_browse | Brouwer, Inge D. Hulshof, P.J.M. Mburu-de Wagt, A.S. Melse-Boonstra, A. Talsma, E.F. Verhoef, H. |
| author_facet | Talsma, E.F. Verhoef, H. Brouwer, Inge D. Mburu-de Wagt, A.S. Hulshof, P.J.M. Melse-Boonstra, A. |
| author_sort | Talsma, E.F. |
| collection | Repository of Agricultural Research Outputs (CGSpace) |
| description | Background: Serum retinol concentration determined by high-performance liquid chromatography (HPLC) is recommended by the World Health Organization to assess population vitamin A status. This assay is expensive, technically demanding and rarely available in developing countries. Our objective was a) to assess the diagnostic performance of proxy markers in detecting vitamin A deficiency and b) to derive decision rules based on these markers to estimate vitamin A deficiency prevalence.
Methods: A survey was conducted in 15 rural primary schools in Eastern Province, Kenya, with 375 children aged 6 to 12 years (25 randomly selected per school). Serum retinol concentration <0.70 μmol/L by HPLC was used to define vitamin A deficiency. Proxy markers for vitamin A deficiency were serum concentrations of retinol binding protein (RBP), transthyretin, retinol measured by fluorometry and RBP:transthyretin molar ratio.
Results: The prevalence of vitamin A deficiency (HPLC) was 18%. Transthyretin and RBP showed the best diagnostic performance individually, with area-under-the-curve (AUC) values of 0.96 and 0.93. When combined, and with C-reactive protein added, the AUC increased to 0.98. A simple decision rule {(−15.277 × [RBP, μmol/L] - 7.013 × [Transthyretin, μmol/L] + 0.367 × [C-reactive protein, mg/L] + 24.714) > 0.496} yielded prevalence estimates of vitamin A deficiency that is unbiased by diagnostic error.
Conclusions: The combination of transthyretin, RBP and C-reactive protein concentrations could eventually replace retinol concentration by HPLC in resource-poor settings as the preferred method to assess the population burden of vitamin A deficiency. |
| format | Journal Article |
| id | CGSpace150041 |
| institution | CGIAR Consortium |
| language | Inglés |
| publishDate | 2015 |
| publishDateRange | 2015 |
| publishDateSort | 2015 |
| publisher | Springer |
| publisherStr | Springer |
| record_format | dspace |
| spelling | CGSpace1500412025-04-07T18:17:15Z Proxy markers of serum retinol concentration, used alone and in combination, to assess population vitamin A status in Kenyan children: a cross-sectional study Talsma, E.F. Verhoef, H. Brouwer, Inge D. Mburu-de Wagt, A.S. Hulshof, P.J.M. Melse-Boonstra, A. discriminant analysis senses diagnosis micronutrient deficiencies retinol inflammation retinols Background: Serum retinol concentration determined by high-performance liquid chromatography (HPLC) is recommended by the World Health Organization to assess population vitamin A status. This assay is expensive, technically demanding and rarely available in developing countries. Our objective was a) to assess the diagnostic performance of proxy markers in detecting vitamin A deficiency and b) to derive decision rules based on these markers to estimate vitamin A deficiency prevalence. Methods: A survey was conducted in 15 rural primary schools in Eastern Province, Kenya, with 375 children aged 6 to 12 years (25 randomly selected per school). Serum retinol concentration <0.70 μmol/L by HPLC was used to define vitamin A deficiency. Proxy markers for vitamin A deficiency were serum concentrations of retinol binding protein (RBP), transthyretin, retinol measured by fluorometry and RBP:transthyretin molar ratio. Results: The prevalence of vitamin A deficiency (HPLC) was 18%. Transthyretin and RBP showed the best diagnostic performance individually, with area-under-the-curve (AUC) values of 0.96 and 0.93. When combined, and with C-reactive protein added, the AUC increased to 0.98. A simple decision rule {(−15.277 × [RBP, μmol/L] - 7.013 × [Transthyretin, μmol/L] + 0.367 × [C-reactive protein, mg/L] + 24.714) > 0.496} yielded prevalence estimates of vitamin A deficiency that is unbiased by diagnostic error. Conclusions: The combination of transthyretin, RBP and C-reactive protein concentrations could eventually replace retinol concentration by HPLC in resource-poor settings as the preferred method to assess the population burden of vitamin A deficiency. 2015-02-20 2024-08-01T02:50:32Z 2024-08-01T02:50:32Z Journal Article https://hdl.handle.net/10568/150041 en Open Access Springer Talsma, E.F.; Verhoef, H.; Brouwer, I.D.; Mburu-de Wagt, A.S.; Hulshof, P.J.M.; and Melse-Boonstra, A. 2015. Proxy markers of serum retinol concentration, used alone and in combination, to assess population vitamin A status in Kenyan children: a cross-sectional study. BMC Medicine 13(30) https://doi.org/10.1186/s12916-014-0256-5 |
| spellingShingle | discriminant analysis senses diagnosis micronutrient deficiencies retinol inflammation retinols Talsma, E.F. Verhoef, H. Brouwer, Inge D. Mburu-de Wagt, A.S. Hulshof, P.J.M. Melse-Boonstra, A. Proxy markers of serum retinol concentration, used alone and in combination, to assess population vitamin A status in Kenyan children: a cross-sectional study |
| title | Proxy markers of serum retinol concentration, used alone and in combination, to assess population vitamin A status in Kenyan children: a cross-sectional study |
| title_full | Proxy markers of serum retinol concentration, used alone and in combination, to assess population vitamin A status in Kenyan children: a cross-sectional study |
| title_fullStr | Proxy markers of serum retinol concentration, used alone and in combination, to assess population vitamin A status in Kenyan children: a cross-sectional study |
| title_full_unstemmed | Proxy markers of serum retinol concentration, used alone and in combination, to assess population vitamin A status in Kenyan children: a cross-sectional study |
| title_short | Proxy markers of serum retinol concentration, used alone and in combination, to assess population vitamin A status in Kenyan children: a cross-sectional study |
| title_sort | proxy markers of serum retinol concentration used alone and in combination to assess population vitamin a status in kenyan children a cross sectional study |
| topic | discriminant analysis senses diagnosis micronutrient deficiencies retinol inflammation retinols |
| url | https://hdl.handle.net/10568/150041 |
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