title: Assessment of indicators of vitamin A status in non-cirrhotic chronic hepatitis C patients.
abstract: Subjects with chronic liver disease are susceptible to hypovitaminosis A due to several factors. Therefore, identifying patients with vitamin deficiency and a requirement for vitamin supplementation is important. Most studies assessing vitamin A in the context of hepatic disorders are conducted using cirrhotic patients. A cross-sectional study was conducted in 43 non-cirrhotic patients with chronic hepatitis C to evaluate markers of vitamin A status represented by serum retinol, liver retinol, and serum retinol-binding protein levels. We also performed the relative dose-response test, which provides an indirect estimate of hepatic vitamin A reserves. These vitamin A indicators were assessed according to the stage of liver fibrosis using the METAVIR score and the body mass index. The sample study was predominantly composed of male subjects (63%) with mild liver fibrosis (F1). The relative dose-response test was <20% in all subjects, indicating vitamin A sufficiency. Overweight or obese patients had higher serum retinol levels than those with a normal body mass index (2.6 and 1.9 µmol/L, respectively; P<0.01). Subjects with moderate liver fibrosis (F2) showed lower levels of serum retinol (1.9 vs 2.5 µmol/L, P=0.01) and retinol-binding protein levels compared with those with mild fibrosis (F1) (46.3 vs 67.7 µg/mL, P<0.01). These results suggested an effect of being overweight on serum retinol levels. Furthermore, more advanced stages of liver fibrosis were related to a decrease in serum vitamin A levels.
authors.affiliation: Divisão de Infectologia, Departamento de Clínica Médica, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
authors.forename: R C
authors.initials: RC
authors.lastname: Santana
authors.affiliation: Divisão de Infectologia, Departamento de Clínica Médica, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
authors.forename: A A
authors.initials: AA
authors.lastname: Machado
authors.affiliation: Divisão de Gastroenterologia, Departamento de Clínica Médica, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
authors.forename: A L C
authors.initials: AL
authors.lastname: Martinelli
authors.affiliation: Divisão de Nutrologia e Nutrição, Departamento de Clínica Médica, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
authors.forename: A A
authors.initials: AA
authors.lastname: Jordão
authors.affiliation: Departamento de Patologia, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
authors.forename: L N Z
authors.initials: LN
authors.lastname: Ramalho
authors.affiliation: Divisão de Nutrologia e Nutrição, Departamento de Clínica Médica, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
authors.forename: H
authors.initials: H
authors.lastname: Vannucchi
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D004305:Dose-Response Relationship, Drug; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008099:Liver / Q000737:chemistry; D008103:Liver Cirrhosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D063305:Organ Dysfunction Scores; D050177:Overweight / Q000097:blood; D012177:Retinol-Binding Proteins / Q000032:analysis; D014801:Vitamin A / Q000032:analysis*; D014802:Vitamin A Deficiency / Q000150:complications / Q000175:diagnosis*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D012177:Retinol-Binding Proteins; D014801:Vitamin A