ABSTRACT
AIM: To investigate the clinical value of serum vitamin A(Vit A)and basic fibroblast growth factor(bFGF)levels predicting retinopathy of prematurity(ROP).METHODS: Prospective cohort studies. A total of 411 premature or low birth weight infants with gestational age less than 37 wk or birth weight less than 2 500 g who were delivered in Hainan Branch, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine from January 2020 to December 2022 were selected as subjects. The Vit A and bFGF levels in peripheral blood were detected at 7 d and 35 d after birth, respectively.RESULTS: A total of 392 premature infants or low birth weight infants completed clinical study, including 51 cases in stage 1-2 ROP group, 23 cases in stage 3-5 ROP group and 318 cases in the group without ROP. At 7 d postnatal, the serum Vit A(0.44±0.17 μmol/L)and bFGF(0.53±0.16 ng/L)levels in stage 1-2 ROP group were lower than those in the group without ROP(0.50±0.12 μmol/L and 0.63±0.15 ng/L; all P<0.05). The serum Vit A(0.34±0.18 μmol/L)and bFGF(0.44±0.18 ng/L)levels in stage 3-5 ROP group were lower than those in the group without ROP(P<0.05). The serum Vit A and bFGF levels in stage 3-5 ROP group were lower than those in stage 1-2 ROP group(P<0.05). At 35d postnatal, the serum Vit A(0.33±0.19 μmol/L)and bFGF(0.39±0.19 ng/L)levels in stage 3-5 ROP group were lower than those in stage 1-2 ROP group(0.43±0.16 μmol/L and 0.48±0.17 ng/L; all P<0.05). According to the ROC curve drawn by serum Vit A, the AUC value was 0.853, the maximum Youden index was 0.68, the best sensitivity was 73%, and the best specificity was 95%. According to the ROC curve drawn by serum bFGF, the AUC value was 0.828, the maximum Youden index was 0.58, the best sensitivity was 90%, and the best specificity was 68%. According to the ROC curve drawn by serum Vit A combined with bFGF, the AUC value was 0.917, the maximum Youden index was 0.70, the best sensitivity was 70%, and the best specificity was 100%.CONCLUSION: Serum Vit A and bFGF levels are sensitive and effective indicators for predicting ROP. If the serum Vit A or bFGF levels are lower in premature infants or low birth weight infants, it may indicate the higher probability of ROP and its pathological stages. In addition, the clinica value of serum Vit A combined with bFGF in the diagnosis of ROP is higher than that of Vit A or bFGF alone, and the misdiagnosis rate is reduced.
ABSTRACT
Summary: Vitamin A is an essential micronutrient needed by the body for various physiological functions. Its deficiency is associated with several functional disorders. The objective of this study is to determine blood vitamin A levels in malnourished and healthy children. Methods: It is a cross-sectional analytical study, consisting of determining the vitamin A content in the blood of children suffering from malnutrition and those in good nutritional status. Our sampling was casual and 59 children aged 6 to 59 months were retained. Among them 30 healthy children chosen from those attending preschool consultation at U HC and 29 malnourished children from those followed at M TNU for the management of malnutrition. The serum vitamin A assay was performed according to the method described by Tietz. Children with serum vitamin A level below 30 μg / 100 ml had vitamin A deficiency and those with a serum level greater than or equal to 30 μg / 100 ml had good vitamin A status. Percent, average and standard deviation calculations were performed. The Chi square statistical test was used to compare serum vitamin A content in healthy and malnourished children, as well as other maternal parameters for a significance level of 0.05. Results: from 59 children examined, 30 or 50.8% were 6-17 months old, the average age was 21.9 ± 13 months. 45.7% had a serum retinol level between 50-59 μg/100 ml; the average value was 46.84 μg ± 14.27. The prevalence of VAD was 20.3% and this deficit was more marked in children aged 6-17 months that is 50% (P<0.014). Among 12 children with VAD, 10 or 83.3% were the wealthy and two were the malnourished, the difference was statically significant (P< 0.011). Conclusion: Vitamin A deficiency remains a major health problem in the DRC. This affect all children regardless of their current nutritional status. Supplementation with this vitamin remains one of the palliative solutions.
ABSTRACT
An improved microfluorimetric method for determination of serum vitamin A was presented. In this method, the excitation wavelength 345nm and emission maximum 480nm were selected, and cyclohexane as solvent for extraction of saponified vitamin A in the serum samples to be tested was used. The sensitivity was sufficient for measurement of vitamin A content in 20*l serum taken from normal fasting blood without elimination of interference. The recovery averaged 99.0% (93.0-105.5).When this method was applied to laboratory study or field work, practically, the results showed that the values of vitamin A obtained seemed to correlate with its nutritional status of experimental animals or subjects investigated. The procedure was simple, reproducible and easily acceptable, espicially in the field work.