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No improvement in suboptimal vitamin A status with a randomized, double-blind, placebo-controlled trial of vitamin A supplementation in children with sickle cell disease.

Abstract

BACKGROUND

Suboptimal vitamin A status is prevalent in children with type SS sickle cell disease (SCD-SS) and is associated with hospitalizations and poor growth and hematologic status. The supplemental vitamin A dose that optimizes suboptimal vitamin A status in this population is unknown.

OBJECTIVE

The efficacy of Recommended Dietary Allowance (RDA) doses (based on age and sex) of vitamin A (300, 400, or 600 μg retinyl palmitate/d) or vitamin A + zinc (10 or 20 mg zinc sulfate/d) compared with placebo to optimize vitamin A status was assessed in children aged 2.0-12.9 y with SCD-SS and a suboptimal baseline serum retinol concentration (<30 μg/dL).

DESIGN

In this randomized, double-blind, placebo-controlled trial, vitamin A status (serum retinol, prealbumin, retinol-binding protein, and relative-dose-response test) and disease-related illness events were assessed.

RESULTS

Twelve months of vitamin A supplementation at the doses recommended for healthy US children (based on age and sex) failed to improve serum retinol values in either group (vitamin A: n = 23; vitamin A + zinc: n = 18) compared with placebo (n = 21). By 12 mo, the increase (±SD) in serum retinol (3.6 ± 2.8 μg/dL) in those taking 600 μg vitamin A/d was significantly different from the decrease (±SD; -2.8 ± 2.4 μg/dL) in those taking 300 μg/d, which possibly suggests a dose-response relation (P < 0.05) with RDA doses.

CONCLUSIONS

Compared with placebo, 12 mo of vitamin A supplementation at the RDA for healthy children did not improve serum retinol values in children with SCD-SS, which possibly suggests that higher doses are needed. However, the existence of alternative conclusions emphasizes the need for future research.

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  • Authors+Show Affiliations

    ,

    Divisions of Gastroenterology, Hepatology and Nutrition and Hematology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA. doughertyk@email.chop.edu

    , , , , ,

    Source

    MeSH

    Anemia, Sickle Cell
    Child
    Child, Preschool
    Dietary Supplements
    Double-Blind Method
    Female
    Hemoglobin, Sickle
    Homozygote
    Humans
    Male
    Nutritional Requirements
    Nutritional Status
    Pilot Projects
    Prevalence
    Severity of Illness Index
    United States
    Vitamin A
    Vitamin A Deficiency
    Zinc Sulfate

    Pub Type(s)

    Comparative Study
    Journal Article
    Multicenter Study
    Randomized Controlled Trial
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    22952182

    Citation

    TY - JOUR T1 - No improvement in suboptimal vitamin A status with a randomized, double-blind, placebo-controlled trial of vitamin A supplementation in children with sickle cell disease. AU - Dougherty,Kelly A, AU - Schall,Joan I, AU - Kawchak,Deborah A, AU - Green,Michael H, AU - Ohene-Frempong,Kwaku, AU - Zemel,Babette S, AU - Stallings,Virginia A, Y1 - 2012/09/05/ PY - 2012/9/7/entrez PY - 2012/9/7/pubmed PY - 2012/12/12/medline SP - 932 EP - 40 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 96 IS - 4 N2 - BACKGROUND: Suboptimal vitamin A status is prevalent in children with type SS sickle cell disease (SCD-SS) and is associated with hospitalizations and poor growth and hematologic status. The supplemental vitamin A dose that optimizes suboptimal vitamin A status in this population is unknown. OBJECTIVE: The efficacy of Recommended Dietary Allowance (RDA) doses (based on age and sex) of vitamin A (300, 400, or 600 μg retinyl palmitate/d) or vitamin A + zinc (10 or 20 mg zinc sulfate/d) compared with placebo to optimize vitamin A status was assessed in children aged 2.0-12.9 y with SCD-SS and a suboptimal baseline serum retinol concentration (<30 μg/dL). DESIGN: In this randomized, double-blind, placebo-controlled trial, vitamin A status (serum retinol, prealbumin, retinol-binding protein, and relative-dose-response test) and disease-related illness events were assessed. RESULTS: Twelve months of vitamin A supplementation at the doses recommended for healthy US children (based on age and sex) failed to improve serum retinol values in either group (vitamin A: n = 23; vitamin A + zinc: n = 18) compared with placebo (n = 21). By 12 mo, the increase (±SD) in serum retinol (3.6 ± 2.8 μg/dL) in those taking 600 μg vitamin A/d was significantly different from the decrease (±SD; -2.8 ± 2.4 μg/dL) in those taking 300 μg/d, which possibly suggests a dose-response relation (P < 0.05) with RDA doses. CONCLUSIONS: Compared with placebo, 12 mo of vitamin A supplementation at the RDA for healthy children did not improve serum retinol values in children with SCD-SS, which possibly suggests that higher doses are needed. However, the existence of alternative conclusions emphasizes the need for future research. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/22952182/full_citation L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.112.035725 ER -