Relation of serum retinol to acute phase proteins and malarial morbidity in Papua New Guinea children

Francisco J. Rosales, James D. Topping, John E. Smith, Anu H. Shankar, A. Catharine Ross

Research output: Contribution to journalArticlepeer-review

52 Scopus citations


Background: Acute phase proteins (APPs) are associated with malaria- induced hyporetinemia (serum retinol <0.70 μmol/L); however, the degree of the association is not well documented. Objective: The association between malaria-induced hyporetinemia and APPs was assessed. Design: In a cross- sectional study, 90 children with serum retinol concentrations from <0.35 to >1.05 μmol/L were selected from children in a clinical trial of vitamin A supplementation. Serum was collected before treatment allocation. Retinol binding protein (RBP) concentrations were determined by radioimmunoassays, and transthyretin, α1-acid glycoprotein (AGP), α1-antichymotrypsin, C- reactive protein (CRP), haptoglobin, and albumin concentrations by radial immunodiffusion assays. Results: Children in the subsample had high rates of splenomegaly and Plasmodium-positive blood-smear slides (P < 0.01); AGP (Pearson's r = -0.40, P < 0.001) and CRP (r = -0.21, P = 0.04) were inversely correlated with retinol. The negative APPs RBP, transthyretin, and albumin were positively and significantly associated with retinol. All APPs, except β1-antichymotrypsin, were significantly correlated with splenomegaly. Of the positive APPs, AGP correlated with CRP (r = 0.37, P < 0.001), indicating chronic inflammation. In a stepwise regression analysis, 73% of retinol's variability was explained by RBP and transthyretin. The model predicted that a 1-SD increase in RBP or transthyretin increases retinol by ≃0.38 or 0.47 μmol/L, respectively, whereas an equivalent increase in AGP decreases retinol by 0.12 μmol/L Conclusions: The RBP-transthyretin transport complex of retinol is not altered by inflammation. Positive APPs are useful markers of type and severity of inflammation; however, except for AGP, it is unlikely that they can correct for malaria-induced hyporetinemia.

Original languageEnglish (US)
Pages (from-to)1582-1588
Number of pages7
JournalAmerican Journal of Clinical Nutrition
Issue number6
StatePublished - Jun 2000

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Nutrition and Dietetics


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