Serum retinol, the acute phase response, and the apparent misclassification of vitamin A status in the third National Health and Nutrition Examination Survey

C. B. Stephensen, G. Gildengorin

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132 Scopus citations

Abstract

Background: Serum retinol decreases transiently during the acute phase response and can thus result in misclassification of vitamin A status. Objective: Our objective was to determine the prevalence of acute phase response activation in a representative sample of the US population, identify the factors associated with this activation, and determine whether persons with an active acute phase response have lower serum retinol concentrations. Design: Data from the third National Health and Nutrition Examination Survey (NHANES III) were analyzed. A serum C-reactive protein (CRP) concentration > 10 mg/L indicated an active acute phase response. Results: Mean serum retinol was lowest in subjects aged < 10 y and increased with age. Concentrations were higher in males than in females aged 20-59 y. The prevalence of a CRP concentration ≥ 10 mg/L was lowest in subjects aged < 20 y (≤ 4%) and increased with age to a maximum of nearly 15%. An elevated CRP concentration was 2.4-fold greater in females than in males aged 20-59 y. Serum retinol was lower in subjects with elevated CRP concentrations. Conclusions: Serum retinol increases with age and males have higher mean values than do females aged 20-59 y. The prevalence of a CRP concentration ≥ 10 mg/L also increases with age, is 2-fold greater in females than in males aged 20-69 y, and is associated with common inflammatory conditions. Thus, inflammation appeared to contribute to the misclassification of vitamin A status in the NHANES III population, and serum CRP is useful in identifying subjects who may be misclassified.

Original languageEnglish (US)
Pages (from-to)1170-1178
Number of pages9
JournalAmerican Journal of Clinical Nutrition
Volume72
Issue number5
StatePublished - 2000

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Keywords

  • Acute phase response
  • C-reactive protein
  • CRP
  • Infection
  • Inflammation
  • NHANES III
  • Retinol
  • Third National Health and Nutrition Examination Survey
  • Vitamin A

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Food Science

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