title: Vitamin A and retinol-binding protein deficiency among chronic liver disease patients.
abstract: OBJECTIVE
  Vitamin A deficiency (VAD) is associated with the progression of chronic liver disease (CLD). The aim in this study was to assess levels of serum retinol and retinol-binding protein (RBP) as well as liver vitamin A stores in the presence of liver cirrhosis and hepatocellular carcinoma.
  
  
  METHODS
  We ascertained the serum retinol and RBP levels of randomly selected CLD patients divided into two groups, one given 1500 UI (n = 89) and the other receiving 2500 UI (n = 89) doses of retinyl palmitate for the relative dose response test. Blood samples were collected in a fasting state and 5 and 7 h after supplementation.
  
  
  RESULTS
  The prevalence of VAD was 62.4%. There was a progressive drop in serum retinol (P < 0.001) and RBP (P = 0.002) according to the severity of the liver disease, and a greater prevalence of severe VAD was noted in cirrhosis Child & Pugh C (52.8%). Fifty percent of the patients presented a low availability of RBP relative to retinol concentration, and there was no peak in RBP levels regardless of the dose of retinyl palmitate administered.
  
  
  CONCLUSIONS
  Our findings suggest serum retinol and RBP are relevant as indicators of vitamin A nutritional status in the presence of CLD. Liver vitamin A store cannot be evaluated using the RDR test because CLD causes a reduction in RBP synthesis and interferes with the mobilization of endogenous vitamin A. Considering how the patients already showed a drop in RBP relative to retinol concentrations, it is reasonable to assume vitamin A supplementation may trigger harmful effects in CLD patients.
authors.affiliation: Department of Nutrition and Dietetics, Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address: gabrielavc@gmail.com.
authors.forename: Gabriela Villaça
authors.initials: GV
authors.lastname: Chaves
authors.affiliation: Department of Nutrition and Dietetics, Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Wilza Arantes Ferreira
authors.initials: WA
authors.lastname: Peres
authors.affiliation: Department of Medicine, Faculty of Pharmacy, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Gonçalves
authors.affiliation: Department of Social and Applied Nutrition, Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Andréa
authors.initials: A
authors.lastname: Ramalho
mesh_terms: D000328:Adult; D000368:Aged; D004224:Diterpenes; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000097:blood / Q000150:complications*; D008297:Male; D008661:Metabolism, Inborn Errors / Q000097:blood / Q000178:diet therapy* / Q000209:etiology; D008875:Middle Aged; D009752:Nutritional Status / Q000187:drug effects; D012177:Retinol-Binding Proteins / Q000032:analysis* / Q000172:deficiency*; D000084562:Retinyl Esters; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014801:Vitamin A / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000097:blood* / Q000627:therapeutic use; D014802:Vitamin A Deficiency / Q000097:blood / Q000178:diet therapy* / Q000209:etiology
chemical_list: D004224:Diterpenes; D012177:Retinol-Binding Proteins; D000084562:Retinyl Esters; D014801:Vitamin A; C014794:retinol palmitate
keywords: Liver disease; RDR test; Retinol-binding protein; Vitamin A nutritional status