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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Vitamin A supplementation in children with poor vitamin A and iron status increases erythropoietin and hemoglobin concentrations without changing total body iron
American Journal of Clinical Nutrition, Volume 84, No. 3, Year 2006
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Description
Background: Vitamin A deficiency impairs iron metabolism; vitamin A supplementation of vitamin A-deficient populations may reduce anemia. The mechanism of these effects is unclear. In vitro and in animal models, vitamin A treatment increases the production of erythropoietin (EPO), a stimulant of erythropoiesis. Objective: We measured the effect of vitamin A supplementation on hemoglobin, iron status, and circulating EPO concentrations in children with poor iron and vitamin A status. Design: In a double-blind, randomized trial, Moroccan schoolchildren (n = 81) were given either vitamin A (200 000 IU) or placebo at baseline and at 5 mo. At baseline, 5 mo, and 10 mo, hemoglobin, indicators of iron and vitamin A status, and EPO were measured. Results: At baseline, 54% of children were anemic; 77% had low vitamin A status. In the vitamin A group at 10 mo, serum retinol improved significantly compared with the control group (P < 0.02). Vitamin A treatment increased mean hemoglobin by 7 g/L (P < 0.02) and reduced the prevalence of anemia from 54% to 38% (P < 0.01). Vitamin A treatment increased mean corpuscular volume (P < 0.001) and decreased serum transferrin receptor (P < 0.001), indicating improved iron-deficient erythropoiesis. Vitamin A decreased serum ferritin (P < 0.02), suggesting mobilization of hepatic iron stores. Calculated from the ratio of transferrin receptor to serum ferritin, overall body iron stores remained unchanged. In the vitamin A group at 10 mo, we observed an increase in EPO (P < 0.05) and a decrease in the slope of the regression line of log 10(EPO) on hemoglobin (P < 0.01). Conclusion: In children deficient in vitamin A and iron, vitamin A supplementation mobilizes iron from existing stores to support increased erythropoiesis, an effect likely mediated by increases in circulating EPO. © 2006 American Society for Nutrition.
Authors & Co-Authors
Zimmermann, Michaël Bruce
Switzerland, Zurich
Eth Zürich
Biebinger, Ralf
Switzerland, Zurich
Eth Zürich
Rohner, Fabian
Switzerland, Zurich
Eth Zürich
Dib, Abdeljawad
Morocco, Agdal Rabat
Ministry of Health, Morocco
Zeder, Christophe
Switzerland, Zurich
Eth Zürich
Hurrell, Richard F.
Switzerland, Zurich
Eth Zürich
Chaouki, Noureddine
Morocco, Agdal Rabat
Ministry of Health, Morocco
Statistics
Citations: 170
Authors: 7
Affiliations: 2
Identifiers
Doi:
10.1093/ajcn/84.3.580
ISSN:
00029165
Research Areas
Disability
Food Security
Maternal And Child Health
Study Design
Randomised Control Trial
Cross Sectional Study