Serum vitamin A in protein—calorie malnutrition

This study describes the result of an investigation on the serum levels of retinol in PCM and the effect of treatment with a high protein diet, virtually devoid of vitamin A or its precursors. The significance of the findings is discussed. 1) The average serum protein levels determined in kwashiorkor cases before treatment were lower than those observed in marasmic cases. These levels were lower than those in a control group of apparently healthy children from the same age group and socioeconomic background. 2) The average serum retinol level of kwashiorkor cases before treatment (12 µg/100 ml) was lower than that of marasmic cases before treatment (20 µg/100 ml). Retinol levels in the latter group were not significantly different from those of the controls (22 µg/100 ml). 3) Treatment of kwashiorkor cases resulted in an increase in the serum retinol to a mean level of 21 µg/100 ml after 2 weeks and maintenance of a constant level thereafter. This rise was associated with an increase in serum albumin concentration from 1.7 g/100 ml before treatment to 3.5 g/100 ml after 5 to 6 weeks. 4) Treatment of marasmic cases was not followed by significant changes in the serum concentrations of retinol, total protein, or albumin. It is suggested that varying amounts of a carrier protein in serum may determine the levels of retinol in PCM.