The acute phase response affected traditional measures of micronutrient status in rural Zambian children during a randomized, controlled feeding trial.

Autor:	Bresnahan KA; Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI., Chileshe J; Tropical Diseases Research Center, Ndola, Zambia; and., Arscott S; Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI., Nuss E; Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI., Surles R; Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI., Masi C; National Food and Nutrition Commission of Zambia, Lusaka, Zambia., Kafwembe E; Tropical Diseases Research Center, Ndola, Zambia; and., Tanumihardjo SA; Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI sherry@nutrisci.wisc.edu.
Jazyk:	angličtina
Zdroj:	The Journal of nutrition [J Nutr] 2014 Jun; Vol. 144 (6), pp. 972-8. Date of Electronic Publication: 2014 Apr 09.
DOI:	10.3945/jn.114.192245
Abstrakt:	The acute phase response (APR) to infection can alter blood-based indicators of micronutrient status. Data from a 3-mo randomized, controlled feeding trial in rural Zambian children (n = 181, aged 3-5 y) were used to determine the impact of the APR on indicators of vitamin A and iron status using baseline and final blood samples. Concentrations of acute phase proteins were categorized as raised C-reactive protein (CRP; >5 and >10 mg/L) only, both raised CRP and α1-acid glycoprotein (AGP; >1.2 g/L), raised AGP only, and neither CRP nor AGP raised to identify the respective stages of infection: incubation, early convalescence, convalescence, and healthy state. Data were insufficient to examine the incubation stage of infection. A CRP concentration of >5 mg/L was an effective elevation cutoff point in this population to show impact on micronutrient markers. Time did not affect hemoglobin, serum ferritin, or serum retinol concentrations (P > 0.05). During early convalescence, hemoglobin decreased (14-16%; P ≤ 0.05), serum ferritin increased (279-356%; P ≤ 0.05), and serum retinol decreased (20-30%; P ≤ 0.05). Serum retinol concentrations did not change during convalescence; however, hemoglobin remained depressed (4-9%) and serum ferritin was elevated (67-132%) (both P ≤ 0.05). Modified relative dose response values were unaffected by the APR (P > 0.05) but increased between time points (16%; P ≤ 0.05), indicating a decrease in liver vitamin A reserves on the background of a semiannual vitamin A supplementation program. The observed prevalence of anemia and vitamin A deficiency assessed by serum retinol concentration was higher during the APR (P ≤ 0.05). It is important to consider the impact of infection on dietary interventions and to adjust for acute phase proteins when assessing iron status or vitamin A status by serum retinol concentration alone in children. (© 2014 American Society for Nutrition.)
Databáze:	MEDLINE
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