背景:血清视黄醇(SR)和视黄醇结合蛋白(RBP)是常用的指标,但是它们受到感染和炎症的影响。这项研究旨在评估VA指标在布基纳法索农村地区36-59个月大的儿童中检测维生素A缺乏症(VAD)的敏感性和特异性。
方法:在一项基于社区的研究中,2016年11月至2017年9月,在布基纳法索Dandé卫生区进行了两项横断面调查.调查包括115名36-59个月大的儿童。所有儿童评估的VA和炎症指标包括SR,通过视黄醇同位素稀释估计的RBP和总肝脏VA储备(TLR),和炎症标志物(C反应蛋白(CRP)和α1-酸性糖蛋白(AGP))。我们计算了灵敏度,特异性,阳性和阴性预测值。此外,炎症的影响,蠕虫感染,并对敏感性和特异性进行了季节评估。
结果:通过SR评估的VAD患病率(<0.7µmol/L),RBP(<0.7µmol/L),和TLR(<0.1μmol/g肝脏),分别,30.9%,33.3%,和0%。与TLR相比,特异性,正预测值,SR的阴性预测值为71.1%,0%,100%,以及RBP,68.9%,0%,100%,分别。SR和RBP的灵敏度不确定。在旱季,SR和RBP的特异性较低。在1.9%和28.6%的儿童中检测到CRP(>5.0mg/L)和AGP(>1.0g/L)升高,分别。对炎症的VA指标的调整将SR的特异性提高到75.9%,将RBP的特异性降低到67.8%。
结论:TLR未发现VAD病例。然而,(炎症调整的)SR和RBP在VAD的估计中具有不同的准确性。
背景:该研究已注册,回顾性地,2018年3月22日,作为泛非临床试验注册中心的一项临床试验,编号为Cochrane南非;PACTR201803002999356。
BACKGROUND: Serum retinol (SR) and retinol-binding protein (RBP) are commonly used indicators, but they are affected by infections and inflammation. This
study aimed to assess the sensitivity and specificity of VA indicators to detect vitamin A deficiency (VAD) in 36-59-month-old children living in a rural area in Burkina Faso.
METHODS: In a community-based
study, two cross-sectional surveys were carried out from November 2016 to September 2017 in the health district of Dandé in Burkina Faso. The surveys included 115 children 36-59 months old. Indicators of VA and inflammation assessed in all children included SR, RBP and total liver VA reserves (TLR) estimated by retinol isotope dilution, and inflammation markers (C-reactive protein (CRP) and alpha 1-acid glycoprotein (AGP)). We calculated the sensitivity, specificity, positive and negative predictive values. In addition, the effects of inflammation, helminth infection, and season on sensitivity and specificity were assessed.
RESULTS: The prevalence of VAD assessed by SR (< 0.7 µmol/L), RBP (< 0.7 µmol/L), and TLR (< 0.1 µmol/g liver) were, respectively, 30.9%, 33.3%, and 0%. Compared to TLR, the specificity, positive predictive value, and negative predictive value of SR were 71.1%, 0%, and 100%, and of RBP, were 68.9%, 0%, and 100%, respectively. The sensitivity was indeterminable for SR and RBP. The specificity of SR and RBP was lower during the dry season. Elevated CRP (> 5.0 mg/L) and AGP (> 1.0 g/L) were detected in 1.9% and 28.6% of children, respectively. The adjustment of VA indicators for inflammation improved SR\'s specificity to 75.9% and decreased RBP\'s specificity to 67.8%.
CONCLUSIONS: No cases of VAD were identified by TLR. However, (inflammation-adjusted) SR and RBP had varying accuracy in the estimation of VAD.
BACKGROUND: The
study was registered, retrospectively, on 22 March 2018 as a clinical
trial with the Pan African Clinical Trials Registry under the number Cochrane South Africa; PACTR201803002999356.