title: Predictors of serum retinol in children with shigellosis.
abstract: BACKGROUND
  Low serum retinol can be useful as an indicator of depleted liver vitamin A stores, particularly in population-based studies. However, serum retinol concentrations decrease transiently during infection, independent of any changes in liver stores. The magnitude of the decrease in serum retinol is often proportional to indicators of disease severity.
  
  
  OBJECTIVE
  We examined the relation of serum retinol in children with culture-positive shigellosis with severity of illness, anthropometric indicators of nutritional status, urinary retinol excretion, and serum concentrations of C-reactive protein, alpha1-acid glycoprotein, retinol binding protein, and transthyretin.
  
  
  METHODS
  This was a prospective study assessing the clinical and laboratory measurements at admission and recovery of 90 children with dysentery (66 with shigellosis) hospitalized in Bangladesh.
  
  
  RESULTS
  Serum retinol concentrations were low at admission but were significantly greater at discharge even though no vitamin A supplements were given during the illness (0.36 +/- 0.22 compared with 1.15 +/- 0.50 micromol/L, P < 0.001). Serum retinol concentrations were lower in children with Shigella dysenteriae type 1 infection than in children with shigellosis due to less virulent strains of Shigella. Low serum retinol was independently associated with S. dysenteriae type 1, high serum C-reactive protein concentrations, and low weight-forage in multiple regression analysis.
  
  
  CONCLUSIONS
  This study showed that shigellosis was associated with a significant, transient decrease in serum retinol concentrations of approximately 0.8 micromol/L, and that this change was significantly associated with severity of disease and poor underlying nutritional status, particularly low weight-for-age.
authors.affiliation: Department of International Health, The University of Alabama at Birmingham, USA.
authors.forename: A K
authors.initials: AK
authors.lastname: Mitra
authors.forename: J O
authors.initials: JO
authors.lastname: Alvarez
authors.forename: M A
authors.initials: MA
authors.lastname: Wahed
authors.forename: G J
authors.initials: GJ
authors.lastname: Fuchs
authors.forename: C B
authors.initials: CB
authors.lastname: Stephensen
mesh_terms: D000886:Anthropometry; D002097:C-Reactive Protein / Q000378:metabolism; D002675:Child, Preschool; D004405:Dysentery, Bacillary / Q000097:blood* / Q000145:classification; D006801:Humans; D007223:Infant; D016014:Linear Models; D008099:Liver / Q000378:metabolism; D009752:Nutritional Status; D009961:Orosomucoid / Q000378:metabolism; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012177:Retinol-Binding Proteins / Q000378:metabolism; D012720:Severity of Illness Index; D012762:Shigella dysenteriae / Q000302:isolation & purification; D014801:Vitamin A / Q000097:blood* / Q000652:urine
chemical_list: D009961:Orosomucoid; D012177:Retinol-Binding Proteins; D014801:Vitamin A; D002097:C-Reactive Protein