A comparative study on indicators of vitamin A status and risk factors for sensitivity and specificity of the methods to detect vitamin A deficiency.

IF 3.9 2区医学 Q2 NUTRITION & DIETETICS Nutrition & Metabolism Pub Date : 2023-11-16 DOI:10.1186/s12986-023-00768-7

Olivier O Sombié, Augustin N Zeba, Jérome W Somé, Adama Kazienga, Michael Grahn, Sherry A Tanumihardjo, Stefaan De Henauw, Souheila Abbeddou

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Abstract

Background: Serum retinol (SR) and retinol-binding protein (RBP) are commonly used indicators, but they are affected by infections and inflammation. This study aimed to assess the sensitivity and specificity of VA indicators to detect vitamin A deficiency (VAD) in 36-59-month-old children living in a rural area in Burkina Faso.

Methods: In a community-based study, two cross-sectional surveys were carried out from November 2016 to September 2017 in the health district of Dandé in Burkina Faso. The surveys included 115 children 36-59 months old. Indicators of VA and inflammation assessed in all children included SR, RBP and total liver VA reserves (TLR) estimated by retinol isotope dilution, and inflammation markers (C-reactive protein (CRP) and alpha 1-acid glycoprotein (AGP)). We calculated the sensitivity, specificity, positive and negative predictive values. In addition, the effects of inflammation, helminth infection, and season on sensitivity and specificity were assessed.

Results: The prevalence of VAD assessed by SR (< 0.7 µmol/L), RBP (< 0.7 µmol/L), and TLR (< 0.1 µmol/g liver) were, respectively, 30.9%, 33.3%, and 0%. Compared to TLR, the specificity, positive predictive value, and negative predictive value of SR were 71.1%, 0%, and 100%, and of RBP, were 68.9%, 0%, and 100%, respectively. The sensitivity was indeterminable for SR and RBP. The specificity of SR and RBP was lower during the dry season. Elevated CRP (> 5.0 mg/L) and AGP (> 1.0 g/L) were detected in 1.9% and 28.6% of children, respectively. The adjustment of VA indicators for inflammation improved SR's specificity to 75.9% and decreased RBP's specificity to 67.8%.

Conclusion: No cases of VAD were identified by TLR. However, (inflammation-adjusted) SR and RBP had varying accuracy in the estimation of VAD.

Trial registration: The study was registered, retrospectively, on 22 March 2018 as a clinical trial with the Pan African Clinical Trials Registry under the number Cochrane South Africa; PACTR201803002999356.

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维生素A状态指标及危险因素对维生素A缺乏症检测方法敏感性和特异性的比较研究

背景:血清视黄醇(SR)和视黄醇结合蛋白(RBP)是常用的指标，但受感染和炎症的影响。本研究旨在评估VA指标在布基纳法索农村地区36-59个月儿童中检测维生素A缺乏症(VAD)的敏感性和特异性。方法:以社区为基础，于2016年11月至2017年9月在布基纳法索dand卫生区进行了两次横断面调查。调查对象包括115名年龄在36-59个月之间的儿童。所有患儿的VA和炎症指标包括:视黄醇同位素稀释法估计的SR、RBP和总肝脏VA储备(TLR)，以及炎症标志物(c反应蛋白(CRP)和α 1-酸性糖蛋白(AGP))。计算敏感性、特异性、阳性预测值和阴性预测值。此外，还评估了炎症、寄生虫感染和季节对敏感性和特异性的影响。结果:以SR (5.0 mg/L)和AGP (> 1.0 g/L)评估的VAD患病率分别为1.9%和28.6%。调整VA炎症指标后，SR特异性提高至75.9%，RBP特异性降低至67.8%。结论:TLR未发现VAD病例。然而，(炎症调整)SR和RBP在VAD估计中的准确性不同。试验注册:该研究于2018年3月22日作为临床试验在泛非临床试验注册中心回顾性注册，编号为Cochrane South Africa;PACTR201803002999356。

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来源期刊

Nutrition & Metabolism 医学-营养学

CiteScore

8.40

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： Nutrition & Metabolism publishes studies with a clear focus on nutrition and metabolism with applications ranging from nutrition needs, exercise physiology, clinical and population studies, as well as the underlying mechanisms in these aspects. The areas of interest for Nutrition & Metabolism encompass studies in molecular nutrition in the context of obesity, diabetes, lipedemias, metabolic syndrome and exercise physiology. Manuscripts related to molecular, cellular and human metabolism, nutrient sensing and nutrient–gene interactions are also in interest, as are submissions that have employed new and innovative strategies like metabolomics/lipidomics or other omic-based biomarkers to predict nutritional status and metabolic diseases. Key areas we wish to encourage submissions from include: -how diet and specific nutrients interact with genes, proteins or metabolites to influence metabolic phenotypes and disease outcomes; -the role of epigenetic factors and the microbiome in the pathogenesis of metabolic diseases and their influence on metabolic responses to diet and food components; -how diet and other environmental factors affect epigenetics and microbiota; the extent to which genetic and nongenetic factors modify personal metabolic responses to diet and food compositions and the mechanisms involved; -how specific biologic networks and nutrient sensing mechanisms attribute to metabolic variability.