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Use of Compartmental Modeling and Retinol Isotope Dilution to Determine Vitamin A Stores in Young People with Sickle Cell Disease Before and After Vitamin A Supplementation

Lookup NU author(s): Dr Anthony OxleyORCiD, Professor Georg Lietz

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


Abstract

© 2023 The Authors. Background: Suboptimal plasma retinol concentrations have been documented in US children with sickle cell disease (SCD) hemoglobin SS type (SCD-HbSS), but little is known about vitamin A kinetics and stores in SCD. Objectives: The objectives were to quantify vitamin A total body stores (TBS) and whole-body retinol kinetics in young people with SCD-HbSS and use retinol isotope dilution (RID) to predict TBS in SCD-HbSS and healthy peers as well as after vitamin A supplementation in SCD-HbSS subjects. Methods: Composite plasma [13C10]retinol response data collected from 22 subjects with SCD-HbSS for 28 d after isotope ingestion were analyzed using population-based compartmental modeling (“super-subject” approach); TBS and retinol kinetics were quantified for the group. TBS was also calculated for the same individuals using RID, as well as for healthy peers (n = 20) and for the subjects with SCD-HbSS after 8 wk of daily vitamin A supplements (3.15 or 6.29 μmol retinol/d [900 or 1800 μg retinol activity equivalents/d]). Results: Model-predicted group mean TBS for subjects with SCD-HbSS was 428 μmol, equivalent to ∼11 mo of stored vitamin A; vitamin A disposal rate was 1.3 μmol/d. Model-predicted TBS was similar to that predicted by RID at 3 d postdosing (mean, 389 μmol; ∼0.3 μmol/g liver); TBS predictions at 3 compared with 28 d were not significantly different. Mean TBS in healthy peers was similar (406 μmol). RID-predicted TBS for subjects with SCD-HbSS was not significantly affected by vitamin A supplementation at either dose. Conclusions: Despite differences in plasma retinol concentrations, TBS was the same in subjects with SCD-HbSS compared with healthy peers. Because 56 d of vitamin A supplementation at levels 1.2 to 2.6 times the Recommended Dietary Allowance did not increase TBS in these subjects with SCD-HbSS, further work will be needed to understand the effects of SCD on retinol metabolism. This trial was registered as NCT03632876 at clinicaltrials.gov.


Publication metadata

Author(s): Ford JL, Green MH, Brownell JN, Green JB, Oxley A, Lietz G, Schall JI, Stallings VA

Publication type: Article

Publication status: Published

Journal: Journal of Nutrition

Year: 2023

Volume: 153

Issue: 9

Pages: 2762-2771

Print publication date: 01/09/2023

Online publication date: 17/07/2023

Acceptance date: 11/07/2023

Date deposited: 05/09/2023

ISSN (print): 0022-3166

ISSN (electronic): 1541-6100

Publisher: Elsevier BV

URL: https://doi.org/10.1016/j.tjnut.2023.07.004

DOI: 10.1016/j.tjnut.2023.07.004

Data Access Statement: Data described in the manuscript will be made available upon request pending publication and submission of an intended data use statement by a qualified investigator.

PubMed id: 37468045


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Funding

Funder referenceFunder name
Abbott Nutrition Advanced Fellowship in Pediatric Nutrition
Center for Human Phenomic Science
Comprehensive Sickle Cell Center, Children's Hospital of Philadelphia
Cortner Endowed Chair, Children's Hospital of Philadelphia
North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition
Nutrition Center,, Children's Hospital of Philadelphia
UL1TR001878

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