Optimising nuclear techniques to assess vitamin A status in population surveys – from deficiency to excess (Phase II)

Closed for proposals

Project Type

Coordinated Research Project

Project Code

E43035

CRP

2195

Approved Date

23 June 2021

Status

3 - Active - Ongoing

Start Date

21 October 2021

Expected End Date

31 December 2026

Participating Countries

Burkina Faso
Cameroon
Mexico
Senegal
Uganda
United Kingdom of Great Britain and Northern Ireland
Zambia

Description

Vitamin A deficiency (VAD) remains a leading cause of childhood blindness and is a major contributor to infectious disease morbidity and mortality among pre-school children. As a response to the population risk, supplementation as well as fortification with vitamin A (VA) are in place in many low-income countries, but unfortunately there is rarely any coordination to avoid overlap of interventions or to monitor long-term effects. Despite VA deficiency still being widespread in some communities, there are concerns about inadvertent chronic excessive VA intakes in other population groups.
Serum retinol is widely used as a biomarker for VAD, but due to its tight homeostatic control, it cannot reflect changes in status when VA stores are adequate or excessive. Assessment of population VA status and evaluation of VA programmes require a biomarker that can estimate risk of VA deficiency as well as excess. The retinol isotope dilution (RID) technique, a nuclear technique, is the only method that can quantitatively measure VA status over the entire spectrum from deficiency to excess without the need for a liver biopsy.
The priorities for the proposed CRP are to optimise the RID for use in population surveys and to further optimise the field procedures, calculations, and interpretations for use by non-experts. This will support the monitoring of vitamin A programmes in the context of a dual risk of VA malnutrition - deficiency as well as excess.
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Objectives

The overall objective is to provide new knowledge on how to use the retinol isotope dilution technique in larger population surveys to assess vitamin A status from deficiency to excess.

Specific objectives

To establish cut-off values of the RID outputs to define vitamin A deficiency and excess

To explore how the retinol isotope dilution (RID) technique is affected by inflammation at the time of dosing

To generate coefficients for accurate calculation of vitamin A status in various population groups

To examine how the existing methodology can be simplified to suit population surveys without loss of accuracy

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