Liver vitamin A in protein-calorie malnutrition

Zaklama, Mona S.; Gabr, Mohamed; Maraghy, Safinaz El; Patwardhan, V. N.

doi:10.1093/ajcn/25.4.412

Cited by 17 publications

(4 citation statements)

References 17 publications

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“…Though few other groups have presented their data in the same way as Golden, many other studies also recorded children’s plasma albumin concentrations when they presented with kwashiorkor and marasmus, 18 – 29 or when those with kwashiorkor were given appropriate dietary treatment, 19 , 22 , 24 , 30 – 36 in some cases whilst also comparing the efficacy of different milk formulas. 33 – 36 Many of these studies were designed to elucidate the roles of other specific elements, such as vitamin deficiencies, but also included the albumin data, either as a list, a statistical parameter, or a plot, which allowed me to present them in a common graphic format in Figure 3 .…”

Section: What Do Other Studies Of Albumin Levels In Kwashiorkor Show?mentioning

confidence: 99%

Oedema in kwashiorkor is caused by hypoalbuminaemia

Coulthard

2014

Paediatrics and International Child Health

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It has been argued that the oedema of kwashiorkor is not caused by hypoalbuminaemia because the oedema disappears with dietary treatment before the plasma albumin concentration rises. Reanalysis of this evidence and a review of the literature demonstrates that this was a mistaken conclusion and that the oedema is linked to hypoalbuminaemia. This misconception has influenced the recommendations for treating children with severe acute malnutrition. There are close pathophysiological parallels between kwashiorkor and Finnish congenital nephrotic syndrome (CNS) pre-nephrectomy; both develop protein-energy malnutrition and hypoalbuminaemia, which predisposes them to intravascular hypovolaemia with consequent sodium and water retention, and makes them highly vulnerable to develop hypovolaemic shock with diarrhoea. In CNS this is successfully treated with intravenous albumin boluses. By contrast, the WHO advise the cautious administration of hypotonic intravenous fluids in kwashiorkor with shock, which has about a 50% mortality. It is time to trial intravenous bolus albumin for the treatment of children with kwashiorkor and shock.

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Section: What Do Other Studies Of Albumin Levels In Kwashiorkor Show?mentioning

confidence: 99%

Oedema in kwashiorkor is caused by hypoalbuminaemia

Coulthard

2014

Paediatrics and International Child Health

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“…4 Vitamin A deficiency is seen in malnourished children due to impaired synthesis of RBP. 8 Reduced synthesis of RBP and transthyretin (TTR) are also seen in inflammatory conditions and hence retinol levels are low in such states. 9…”

Section: Metabolismmentioning

confidence: 99%

Role of vitamin a in child health and nutrition

Awasthi

Awasthi²

2020

Clinical Epidemiology and Global Health

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“…VA requirements are reduced when other dietary deficiencies limit growth. For example, low protein intake reduces tissue growth and hepatic mobilization of VA, because, in part [65], of a decreased synthesis of the carrier (retinolbinding) protein in the liver [66]. VA supplementation will not reverse faltering weight growth in the presence of insufficient dietary protein [67][68][69], although it may spare protein to some extent and retard the rate of weight loss [70].…”

Section: Weight Growthmentioning

confidence: 99%

“…Adding highquality protein (e.g. case in) without VA will initially accelerate weight gain, rapidly deplete liver VA stores [65], and exacerbate clinical signs of deficiency [71]. Growth failure rapidly ensues [71].…”

Section: Weight Growthmentioning

confidence: 99%

Dietary Vitamin-a Deficiency: Effects on Growth, Infection, and Mortality

West¹

1991

Food Nutr Bull

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Vitamin A (VA) has been experimentally linked in animals to growth in weight, host resistance to infection, and survival for nearly eight decades. These consistent findings appear to have their human correlate. VA-deficient children are more likely to have comorbidity and to be stunted in growth, and they have a higher risk of mortality. In several large field trials VA supplementation has reduced mortality by >= 30%. Presumably a similar or greater public health impact can be achieved by improving dietary VA intake. The relation between dietary imbalance and VA deficiency starts at a young age. Early cessation of breast-feeding, poor quality of the weaning diet, and infrequent consumption of VA-rich foods appear to underlie mild xerophthalmia. These dietary imbalances often coexist with food access. We must know how to alter detrimental food habits before dietary interventions can be formulated. Improving dietary quality to enhance VA nutriture will likely carry numerous other nutritional benefits to children.

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Liver vitamin A in protein-calorie malnutrition

Cited by 17 publications

References 17 publications

Oedema in kwashiorkor is caused by hypoalbuminaemia

Oedema in kwashiorkor is caused by hypoalbuminaemia

Role of vitamin a in child health and nutrition

Dietary Vitamin-a Deficiency: Effects on Growth, Infection, and Mortality

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