Assessment of vitamin A status of preschool children in Indonesia using plasma retinol-binding protein

Although plasma retinol-binding protein (RBP) has been proposed as an indicator of vitamin A status of populations in less technologically developed settings, potential factors which could influence this indicator include inflammation and protein energy status. Plasma RBP, retinol, α₁-acid glycoprotein (AGP), C-reactive protein (CRP), and albumin were measured in a study of 236 preschool children in Bandung, Indonesia. Spearman correlation coefficient between plasma RBP and retinol concentrations was 0.55 (p < 0.0001). By linear regression, 0.70 μmol/l retinol was equivalent to 0.69 μmol/l RBP. With these cut-off points for defining vitamin A deficiency and plasma retinol as the standard for comparison, RBP had a sensitivity and specificity of 75.0 per cent and 63.2 per cent, respectively. The correlation between RBP and retinol was not affected by plasma AGP, CRP, or albumin concentration. Measurement of plasma RBP by radial immunodiffusion is simple and inexpensive, and this test can be used as a simple surrogate measure for vitamin A concentrations in large field studies.