Predictors of serum retinol in children with shigellosis

Amal K. Mitra, Jose O. Alvarez, M. A. Wahed, George J. Fuchs, Charles B. Stephensen

Research output: Contribution to journalArticlepeer-review

65 Scopus citations


Background: Low serum retinol can be useful as an indicator of depleted liver vitamin A stores, particularly in population-based studies. However, serum retinol concentrations decrease transiently during infection, independent of any changes in liver stores. The magnitude of the decrease in serum retinol is often proportional to indicators of disease severity. Objective: We examined the relation of serum retinol in children with culture-positive shigellosis with severity of illness, anthropometric indicators of nutritional status, urinary retinol excretion, and serum concentrations of C-reactive protein, α1-acid glycoprotein, retinol binding protein, and transthyretin. Design: This was a prospective study assessing the clinical and laboratory measurements at admission and recovery of 90 children with dysentery (66 with shigellosis) hospitalized in Bangladesh. Results: Serum retinol concentrations were low at admission but were significantly greater at discharge even though no vitamin A supplements were given during the illness (0.36 ± 0.22 compared with 1.15 ± 0.50 μmol/L, P < 0.001). Serum retinol concentrations were lower in children with Shigella dysenteriae type 1 infection than in children with shigellosis due to less virulent strains of Shigella. Low serum retinol was independently associated with S. dysenteriae type 1, high serum C-reactive protein concentrations, and low weight-forage in multiple regression analysis. Conclusions: This study showed that shigellosis was associated with a significant, transient decrease in serum retinol concentrations of ≃0.8 μmol/L, and that this change was significantly associated with severity of disease and poor underlying nutritional status, particularly low weight-for-age.

Original languageEnglish
Pages (from-to)1088-1094
Number of pages7
JournalAmerican Journal of Clinical Nutrition
Issue number5
StatePublished - Nov 1998


  • Acute phase protein
  • Bangladesh
  • Children
  • Malnutrition
  • Prealbumin
  • Retinol
  • Retinol binding protein
  • Shigella dysenteriae
  • Shigellosis
  • Transthyretin
  • α-acid glycoprotein

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics


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