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Vitamin A status, hospitalizations, and other outcomes in young children with sickle cell disease.

Abstract

OBJECTIVE

To determine the relation of serum vitamin A status to growth, nutritional and hematologic status, and to the number of hospitalizations in children with sickle cell disease-SS (homozygous for the S allele, SCD-SS).

STUDY DESIGN

Children (2-9.9 years of age) with SCD-SS were assessed for serum retinol, hemoglobin, hematocrit, reticulocyte count, height, weight, body mass index, and recalled dietary intake. Vitamin A status was defined on the basis of serum retinol concentration as suboptimal (<30 microg/dL) and normal (> or =30 microg/dL). Hospitalizations were determined for 1 year after vitamin A assessment.

RESULTS

Mean serum retinol was 26.7 +/- 6.8 microg/dL in 66 subjects (39 girls) and was suboptimal in 66% of children. Compared with those with normal status, children with suboptimal vitamin A had significantly lower body mass index z score (-0.7 +/- 1.0 vs -0.1 +/- 0.6) and hemoglobin (7.9 +/- 1.1 vs 8.5 +/- 1.1), and hematocrit (23.3 +/- 3.0 vs 25.1 +/- 3.8) and significantly more hospitalizations (2.8 +/- 2.0 vs 0.7 +/- 0.8). After adjusting for age and sex, suboptimal vitamin A status was associated with a 10-fold increased risk for hospitalization (OR, 10.5; 95% CI, 2.3, 48.6) and with increased pain (OR,5.3; 95% CI, 1.3, 21.6) and fever episodes (OR, 6.4; 95% CI, 1.7, 24.9) requiring hospitalization.

CONCLUSIONS

Suboptimal vitamin A status was prevalent in US children with SCD-SS and was associated with increased hospitalizations and poor growth and hematologic status.

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  • Publisher Full Text
  • Authors

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    Source

    The Journal of pediatrics 145:1 2004 Jul pg 99-106

    MeSH

    Age Factors
    Anemia, Sickle Cell
    Body Mass Index
    Body Weight
    Case-Control Studies
    Child
    Child, Preschool
    Diet
    Energy Intake
    Female
    Fever
    Growth Disorders
    Hematocrit
    Hemoglobins
    Hospitalization
    Humans
    Male
    Nutritional Status
    Pain
    Philadelphia
    Sex Factors
    Vitamin A

    Pub Type(s)

    Journal Article
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    15238915

    Citation

    TY - JOUR T1 - Vitamin A status, hospitalizations, and other outcomes in young children with sickle cell disease. AU - Schall,Joan I, AU - Zemel,Babette S, AU - Kawchak,Deborah A, AU - Ohene-Frempong,Kwaku, AU - Stallings,Virginia A, PY - 2004/7/9/pubmed PY - 2004/9/3/medline PY - 2004/7/9/entrez SP - 99 EP - 106 JF - The Journal of pediatrics JO - J. Pediatr. VL - 145 IS - 1 N2 - OBJECTIVE: To determine the relation of serum vitamin A status to growth, nutritional and hematologic status, and to the number of hospitalizations in children with sickle cell disease-SS (homozygous for the S allele, SCD-SS). STUDY DESIGN: Children (2-9.9 years of age) with SCD-SS were assessed for serum retinol, hemoglobin, hematocrit, reticulocyte count, height, weight, body mass index, and recalled dietary intake. Vitamin A status was defined on the basis of serum retinol concentration as suboptimal (<30 microg/dL) and normal (> or =30 microg/dL). Hospitalizations were determined for 1 year after vitamin A assessment. RESULTS: Mean serum retinol was 26.7 +/- 6.8 microg/dL in 66 subjects (39 girls) and was suboptimal in 66% of children. Compared with those with normal status, children with suboptimal vitamin A had significantly lower body mass index z score (-0.7 +/- 1.0 vs -0.1 +/- 0.6) and hemoglobin (7.9 +/- 1.1 vs 8.5 +/- 1.1), and hematocrit (23.3 +/- 3.0 vs 25.1 +/- 3.8) and significantly more hospitalizations (2.8 +/- 2.0 vs 0.7 +/- 0.8). After adjusting for age and sex, suboptimal vitamin A status was associated with a 10-fold increased risk for hospitalization (OR, 10.5; 95% CI, 2.3, 48.6) and with increased pain (OR,5.3; 95% CI, 1.3, 21.6) and fever episodes (OR, 6.4; 95% CI, 1.7, 24.9) requiring hospitalization. CONCLUSIONS: Suboptimal vitamin A status was prevalent in US children with SCD-SS and was associated with increased hospitalizations and poor growth and hematologic status. SN - 0022-3476 UR - https://www.unboundmedicine.com/medline/citation/15238915/full_citation L2 - http://linkinghub.elsevier.com/retrieve/pii/S0022-3476(04)00264-1 ER -