The Acute Phase Response Affected Traditional Measures of Micronutrient Status in Rural Zambian Children during a Randomized, Controlled Feeding Trial  

Oleh:

Bresnahan, Kara A. ; Chileshe, Justin ; Arscott, Sara ; Nuss, Emily ; Surles, Rebecca

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: JN: The Journal of Nutrition vol. 144 no. 06 (Jun. 2014), page 972-978.

Ketersediaan

Perpustakaan FK Nomor Panggil: J42.K.2014.01 Non-tandon: 1 (dapat dipinjam: 1) Tandon: tidak ada

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Isi artikel

The acute phase response (APR) to infection can alter blood-based indicators of micronutrient status. Data from a 3-mo randomized, controlled feeding trial in rural Zambian children (n = 181, aged 3–5 y) were used to determine the impact of the APR on indicators of vitamin A and iron status using baseline and final blood samples. Concentrations of acute phase proteins were categorized as raised C-reactive protein (CRP; >5 and >10 mg/L) only, both raised CRP and a1–acid glycoprotein (AGP; >1.2 g/L), raised AGP only, and neither CRP nor AGP raised to identify the respective stages of infection: incubation, early convalescence, convalescence, and healthy state. Data were insufficient to examine the incubation stage of infection. A CRP concentration of >5 mg/L was an effective elevation cutoff point in this population to show impact on micronutrient markers. Time did not affect hemoglobin, serum ferritin, or serum retinol concentrations (P > 0.05). During early convalescence, hemoglobin decreased (14–16%; P = 0.05), serum ferritin increased (279–356%; P = 0.05), and serum retinol decreased (20–30%; P = 0.05). Serum retinol concentrations did not change during convalescence; however, hemoglobin remained depressed (4–9%) and serum ferritin was elevated (67–132%) (both P = 0.05). Modified relative dose response values were unaffected by the APR (P > 0.05) but increased between time points (16%; P = 0.05), indicating a decrease in liver vitamin A reserves on the background of a semiannual vitamin A supplementation program. The observed prevalence of anemia and vitamin A deficiency assessed by serum retinol concentration was higher during the APR (P = 0.05). It is important to consider the impact of infection on dietary interventions and to adjust for acute phase proteins when assessing iron status or vitamin A status by serum retinol concentration alone in children.

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