ArticleClinical nutrition (Edinburgh, Scotland)2021
Vitamin A status, inflammation adjustment, and immunologic response in the context of acute febrile illness: A pilot cohort study among pediatric patients.
Article in Clinical nutrition (Edinburgh, Scotland), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 8 citations in OpenAlex.
- Application of an Ecological Approach to Assessment of Nutrition in School-Aged Children-A Report from the "Biomarkers of Nutrition for Development: Knowledge Indicating Dietary Sufficiency (BOND-KIDS)" Project Working Group 3.The Journal of nutrition · 2025Review
- Advances in artificial intelligence and precision nutrition approaches to improve maternal and child health in low resource settings.Nature communications · 2025Review
- The ABCDs of Nutritional Assessment in Infectious Diseases Research.The Journal of infectious diseases · 2025Review
- The standardization and efficacy of fermentedOpen veterinary journal · 2024Article
- Biomarkers of Micronutrients and Phytonutrients and Their Application in Epidemiological Studies.Nutrients · 2023Review
- Nutraceuticals for Complementary Treatment of Multisystem Inflammatory Syndrome in Children: A Perspective from Their Use in COVID-19.Life (Basel, Switzerland) · 2022Review
- Update on the management of vitamins and minerals in cystic fibrosis.Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition · 2022Review
- Lack of iron, zinc, and vitamins as a contributor to the etiology of atopic diseases.Frontiers in nutrition · 2022Review
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Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundVitamin A is necessary for an adequate immune response to infections. Infection also alters vitamin A biomarkers, which interferes with assessment of vitamin A deficiency and thus impairs clinical management. Here we apply multiple strategies to adjust vitamin A biomarkers for inflammation during acute infection and evaluate associations between adjusted vitamin A status and immunologic response markers.
methodsWe measured biomarkers in pediatric patients presenting with acute febrile illness in Guayaquil, Ecuador at paired acute and convalescent visits. Four adjustment strategies were applied to retinol-binding protein (RBP) concentrations: Thurnham correction factor (TCF), BRINDA regression correction (BRC), CRP-only adjustment factor (CRP), and proof-of-concept for a proposed interleukin 6 regression model (IL-6 RM). Adjusted RBP concentrations were compared between visits using the paired Wilcoxon signed-rank test. Multivariate regression analysis was used to assess associations between adjusted vitamin A status and immunologic response markers.
resultsA sample of 57 participants completed the acute visit 1, and 18 of these individuals completed the convalescent visit 2. The IL-6 RM was the only strategy resulting in adjusted RBP concentrations that were not significantly different between paired visits (p = 0.20). Following RBP adjustment, 0.0% of participants were classified as vitamin A deficient (RBP ≤ 0.70 μmol/L) and 14.0% were classified as vitamin A insufficient (RBP ≤ 1.05 μmol/L). Adjusted vitamin A insufficiency was associated with an increase in macrophage inflammatory protein 1-alpha (MIP-1α, p = 0.03) and a pro-inflammatory immune response profile (p = 0.03) during the acute visit.
conclusionsWe introduce a strategy for adjusting vitamin A in the context of clinical illness based on IL-6 concentrations that will need to be validated in larger studies. Assessment of vitamin A during infection allows for further understanding of how vitamin A status modulates immunopathology and enables targeted strategies for vitamin A supplementation in the context of infection among children in settings with high burdens of undernutrition and infectious diseases.
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