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Vitamin A and retinol-binding protein deficiency among chronic liver disease patients.

Abstract

OBJECTIVE

Vitamin A deficiency (VAD) is associated with the progression of chronic liver disease (CLD). The aim in this study was to assess levels of serum retinol and retinol-binding protein (RBP) as well as liver vitamin A stores in the presence of liver cirrhosis and hepatocellular carcinoma.

METHODS

We ascertained the serum retinol and RBP levels of randomly selected CLD patients divided into two groups, one given 1500 UI (n = 89) and the other receiving 2500 UI (n = 89) doses of retinyl palmitate for the relative dose response test. Blood samples were collected in a fasting state and 5 and 7 h after supplementation.

RESULTS

The prevalence of VAD was 62.4%. There was a progressive drop in serum retinol (P < 0.001) and RBP (P = 0.002) according to the severity of the liver disease, and a greater prevalence of severe VAD was noted in cirrhosis Child & Pugh C (52.8%). Fifty percent of the patients presented a low availability of RBP relative to retinol concentration, and there was no peak in RBP levels regardless of the dose of retinyl palmitate administered.

CONCLUSIONS

Our findings suggest serum retinol and RBP are relevant as indicators of vitamin A nutritional status in the presence of CLD. Liver vitamin A store cannot be evaluated using the RDR test because CLD causes a reduction in RBP synthesis and interferes with the mobilization of endogenous vitamin A. Considering how the patients already showed a drop in RBP relative to retinol concentrations, it is reasonable to assume vitamin A supplementation may trigger harmful effects in CLD patients.

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  • Authors+Show Affiliations

    ,

    Department of Nutrition and Dietetics, Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address: gabrielavc@gmail.com.

    ,

    Department of Nutrition and Dietetics, Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.

    ,

    Department of Medicine, Faculty of Pharmacy, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.

    Department of Social and Applied Nutrition, Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.

    Source

    MeSH

    Adult
    Aged
    Female
    Humans
    Liver Diseases
    Male
    Metabolism, Inborn Errors
    Middle Aged
    Nutritional Status
    Retinol-Binding Proteins
    Severity of Illness Index
    Treatment Outcome
    Vitamin A
    Vitamin A Deficiency

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    25837210

    Citation

    Chaves, Gabriela Villaça, et al. "Vitamin a and Retinol-binding Protein Deficiency Among Chronic Liver Disease Patients." Nutrition (Burbank, Los Angeles County, Calif.), vol. 31, no. 5, 2015, pp. 664-8.
    Chaves GV, Peres WA, Gonçalves JC, et al. Vitamin A and retinol-binding protein deficiency among chronic liver disease patients. Nutrition. 2015;31(5):664-8.
    Chaves, G. V., Peres, W. A., Gonçalves, J. C., & Ramalho, A. (2015). Vitamin A and retinol-binding protein deficiency among chronic liver disease patients. Nutrition (Burbank, Los Angeles County, Calif.), 31(5), pp. 664-8. doi:10.1016/j.nut.2014.10.016.
    Chaves GV, et al. Vitamin a and Retinol-binding Protein Deficiency Among Chronic Liver Disease Patients. Nutrition. 2015;31(5):664-8. PubMed PMID: 25837210.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Vitamin A and retinol-binding protein deficiency among chronic liver disease patients. AU - Chaves,Gabriela Villaça, AU - Peres,Wilza Arantes Ferreira, AU - Gonçalves,José Carlos, AU - Ramalho,Andréa, Y1 - 2014/11/04/ PY - 2014/07/01/received PY - 2014/10/26/revised PY - 2014/10/27/accepted PY - 2015/4/4/entrez PY - 2015/4/4/pubmed PY - 2016/1/6/medline KW - Liver disease KW - RDR test KW - Retinol-binding protein KW - Vitamin A nutritional status SP - 664 EP - 8 JF - Nutrition (Burbank, Los Angeles County, Calif.) JO - Nutrition VL - 31 IS - 5 N2 - OBJECTIVE: Vitamin A deficiency (VAD) is associated with the progression of chronic liver disease (CLD). The aim in this study was to assess levels of serum retinol and retinol-binding protein (RBP) as well as liver vitamin A stores in the presence of liver cirrhosis and hepatocellular carcinoma. METHODS: We ascertained the serum retinol and RBP levels of randomly selected CLD patients divided into two groups, one given 1500 UI (n = 89) and the other receiving 2500 UI (n = 89) doses of retinyl palmitate for the relative dose response test. Blood samples were collected in a fasting state and 5 and 7 h after supplementation. RESULTS: The prevalence of VAD was 62.4%. There was a progressive drop in serum retinol (P < 0.001) and RBP (P = 0.002) according to the severity of the liver disease, and a greater prevalence of severe VAD was noted in cirrhosis Child & Pugh C (52.8%). Fifty percent of the patients presented a low availability of RBP relative to retinol concentration, and there was no peak in RBP levels regardless of the dose of retinyl palmitate administered. CONCLUSIONS: Our findings suggest serum retinol and RBP are relevant as indicators of vitamin A nutritional status in the presence of CLD. Liver vitamin A store cannot be evaluated using the RDR test because CLD causes a reduction in RBP synthesis and interferes with the mobilization of endogenous vitamin A. Considering how the patients already showed a drop in RBP relative to retinol concentrations, it is reasonable to assume vitamin A supplementation may trigger harmful effects in CLD patients. SN - 1873-1244 UR - https://www.unboundmedicine.com/medline/citation/25837210/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0899-9007(14)00454-7 DB - PRIME DP - Unbound Medicine ER -