Vitamin A status, hospitalizations, and other outcomes in young children with sickle cell disease.
OBJECTIVE
To determine the relation of serum vitamin A status to growth, nutritional and hematologic status, and to the number of hospitalizations in children with sickle cell disease-SS (homozygous for the S allele, SCD-SS).


METHODS
Children (2-9.9 years of age) with SCD-SS were assessed for serum retinol, hemoglobin, hematocrit, reticulocyte count, height, weight, body mass index, and recalled dietary intake. Vitamin A status was defined on the basis of serum retinol concentration as suboptimal (<30 microg/dL) and normal (> or =30 microg/dL). Hospitalizations were determined for 1 year after vitamin A assessment.


RESULTS
Mean serum retinol was 26.7 +/- 6.8 microg/dL in 66 subjects (39 girls) and was suboptimal in 66% of children. Compared with those with normal status, children with suboptimal vitamin A had significantly lower body mass index z score (-0.7 +/- 1.0 vs -0.1 +/- 0.6) and hemoglobin (7.9 +/- 1.1 vs 8.5 +/- 1.1), and hematocrit (23.3 +/- 3.0 vs 25.1 +/- 3.8) and significantly more hospitalizations (2.8 +/- 2.0 vs 0.7 +/- 0.8). After adjusting for age and sex, suboptimal vitamin A status was associated with a 10-fold increased risk for hospitalization (OR, 10.5; 95% CI, 2.3, 48.6) and with increased pain (OR,5.3; 95% CI, 1.3, 21.6) and fever episodes (OR, 6.4; 95% CI, 1.7, 24.9) requiring hospitalization.


CONCLUSIONS
Suboptimal vitamin A status was prevalent in US children with SCD-SS and was associated with increased hospitalizations and poor growth and hematologic status.
Schall
Joan I
JI
Division of Gastroenterology and Nutrition, Department of Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, 19104, USA. schall@email.chop.edu
Zemel
Babette S
BS
Kawchak
Deborah A
DA
Ohene-Frempong
Kwaku
K
Stallings
Virginia A
VA
D000367:Age Factors; D000755:Anemia, Sickle Cell / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004032:Diet; D002149:Energy Intake / Q000502:physiology; D005260:Female; D005334:Fever / Q000150:complications; D006130:Growth Disorders / Q000097:blood / Q000209:etiology; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009752:Nutritional Status / Q000502:physiology; D010146:Pain / Q000150:complications; D015143:Philadelphia; D012737:Sex Factors; D014801:Vitamin A / Q000008:administration & dosage / Q000097:blood*
D006454:Hemoglobins; D014801:Vitamin A