Association between Biomarkers of Inflammation and Total Liver Vitamin A Reserves Estimated by 13C-Retinol Isotope Dilution among Preschool Children in 5 African Countries

Devika J Suri; Olivier O Sombié; Augustin N Zeba; Gabriel Medoua Nama; Tesfaye Hailu Bekele; Meseret Woldeyohannes; Martha E van Stuijvenberg; Muhammad A Dhansay; Elisaphinate M Urio; Cornelia U Loechl; Bryan M Gannon; Christopher R Davis; Michael Grahn; Parminder S Suchdev; Sherry A Tanumihardjo

doi:10.1016/j.tjnut.2022.10.012

Association between Biomarkers of Inflammation and Total Liver Vitamin A Reserves Estimated by ¹³C-Retinol Isotope Dilution among Preschool Children in 5 African Countries

J Nutr. 2023 Mar;153(3):622-635. doi: 10.1016/j.tjnut.2022.10.012. Epub 2022 Dec 26.

Authors

Devika J Suri¹, Olivier O Sombié², Augustin N Zeba², Gabriel Medoua Nama³, Tesfaye Hailu Bekele⁴, Meseret Woldeyohannes⁴, Martha E van Stuijvenberg⁵, Muhammad A Dhansay⁶, Elisaphinate M Urio⁷, Cornelia U Loechl⁸, Bryan M Gannon⁹, Christopher R Davis⁹, Michael Grahn⁹, Parminder S Suchdev¹⁰, Sherry A Tanumihardjo¹¹

Affiliations

¹ Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA. Electronic address: dsuri@wisc.edu.
² Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso.
³ Center for Food and Nutrition Research, Yaoundé, Cameroon.
⁴ Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
⁵ Non-Communicable Diseases Research Unit, South African Medical Research Council, South Africa; Division of Human Nutrition, Stellenbosch University, South Africa.
⁶ Division of Human Nutrition, Stellenbosch University, South Africa; Burden of Disease Research Unit, South African Medical Research Council, South Africa; Department of Paediatrics and Child Health, Stellenbosch University, South Africa.
⁷ Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania.
⁸ Division of Human Health, International Atomic Energy Agency, Vienna, Austria.
⁹ Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA.
¹⁰ Emory University, Atlanta, GA, USA.
¹¹ Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA. Electronic address: sherry@nutrisci.wisc.edu.

PMID: 36931745
DOI: 10.1016/j.tjnut.2022.10.012

Abstract

Background: Vitamin A (VA) assessment is important for targeting public health programs. Retinol isotope dilution (RID) is a sensitive method to estimate total body VA stores (TBSs) and total liver reserves (TLRs), but the impact of subclinical inflammation on RID is unclear.

Objective: We determined the association between TBSs and TLRs, estimated by RID, and inflammation among preschool children without clinical infection in Burkina Faso, Cameroon, Ethiopia, South Africa, and Tanzania.

Methods: Five studies (n = 532; 47.9 ± 8.3 mo; 49.0% male) included ¹³C-RID and measurement of inflammation markers, CRP, and α₁-acid glycoprotein (AGP). Spearman correlations were used to evaluate TBSs and TLRs with inflammation biomarkers. Wilcoxon and Kruskal-Wallis tests were used to compare TBSs and TLRs by inflammation categories [normal vs. elevated CRP (>5 mg/L) or AGP (>1 g/L)] and inflammation stage [reference, incubation (elevated CRP), early convalescence (elevated CRP and AGP), and late convalescence (elevated AGP)].

Results: Complete data were available for 439 children. Median (Q1, Q3) TLRs ranged from 0.12 (0.07, 0.18) μmol/g in Ethiopia to 1.10 (0.88, 1.38) μmol/g in South Africa. Elevated CRP ranged from 4% in Burkina Faso to 42% in Cameroon, and elevated AGP from 20% in Tanzania to 58% in Cameroon. Pooled analysis (excluding Cameroon) showed a negative correlation between TBSs and AGP (ρ = -0.131, P = 0.01). Children with elevated AGP had higher probability of having lower TBSs (probability = 0.61, P = 0.002). TBSs differed among infection stages (P = 0.020). Correlations between TLRs and CRP or AGP were not significant.

Conclusions: No indication of systematic bias in RID-estimated TLRs was found due to subclinical inflammation among preschool children. The inverse relationship between TBSs and AGP may reflect decreased stores after infection or an effect of inflammation on isotope partitioning. Further research should investigate potential confounding variables to improve TBS-estimate validity.

Keywords: African countries; inflammation; preschool children; retinol isotope dilution; stable isotope.

Publication types

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

MeSH terms

Biomarkers
Child, Preschool
Convalescence
Female
Humans
Inflammation
Isotopes
Liver / chemistry
Male
Orosomucoid / analysis
South Africa
Vitamin A Deficiency*
Vitamin A*

Substances

Vitamin A
Biomarkers
Isotopes
Orosomucoid