Retinol-binding protein, transthyretin, and C-reactive protein in extremely low birth weight (ELBW) infants

Namasivayam Ambalavanan, A. Catharine Ross, Waldemar A. Carlo

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background: Vitamin A deficiency reduces retinol binding protein (RBP) but not transthyretin (TTR), while inflammation reduces both RBP and TTR and increases C-reactive protein (CRP), an acute phase reactant. Objective: To estimate serum RBP, TTR, and CRP in ELBW infants to test the hypotheses that (a) TTR is a negative acute phase reactant and (b) a higher RBP/TTR ratio or CRP is associated with death/BPD by 36 weeks corrected age. Design/Methods: Serum RBP, TTR, and CRP were measured in 79 ELBW infants at 28 days. Area under the curve (AUC) of receiver operating characteristic curve analysis evaluated the predictive value of TTR, the RBP/TTR ratio, and CRP for death/BPD at 36 weeks. Results: (1) TTR inversely correlated with CRP (r = -0.45, p<0.0001) consistent with TTR being a negative acute phase reactant. (2) The RBP/ TTR ratio predicted death/BPD (AUC 0.68 (CI 0.57 to 0.78)). (3) CRP strongly predicted death/BPD (AUC 0.85 (CI 0.76 to 0.92)), even after exclusion of sepsis. Conclusions: A higher CRP and RBP/TTR molar ratio on day 28 are associated with death/BPD at 36 weeks in ELBW infants. Lower TTR and maintained RBP/TTR ratios suggest inflammation rather than vitamin A deficiency as the cause for lower serum vitamin A levels in ELBW infants.

Original languageEnglish (US)
Pages (from-to)714-719
Number of pages6
JournalJournal of Perinatology
Volume25
Issue number11
DOIs
StatePublished - Nov 1 2005

Fingerprint

Extremely Low Birth Weight Infant
Retinol-Binding Proteins
Prealbumin
Protein C
C-Reactive Protein
Acute-Phase Proteins
Area Under Curve
Vitamin A Deficiency
Cellular Retinol-Binding Proteins
Serum
Inflammation

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

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title = "Retinol-binding protein, transthyretin, and C-reactive protein in extremely low birth weight (ELBW) infants",
abstract = "Background: Vitamin A deficiency reduces retinol binding protein (RBP) but not transthyretin (TTR), while inflammation reduces both RBP and TTR and increases C-reactive protein (CRP), an acute phase reactant. Objective: To estimate serum RBP, TTR, and CRP in ELBW infants to test the hypotheses that (a) TTR is a negative acute phase reactant and (b) a higher RBP/TTR ratio or CRP is associated with death/BPD by 36 weeks corrected age. Design/Methods: Serum RBP, TTR, and CRP were measured in 79 ELBW infants at 28 days. Area under the curve (AUC) of receiver operating characteristic curve analysis evaluated the predictive value of TTR, the RBP/TTR ratio, and CRP for death/BPD at 36 weeks. Results: (1) TTR inversely correlated with CRP (r = -0.45, p<0.0001) consistent with TTR being a negative acute phase reactant. (2) The RBP/ TTR ratio predicted death/BPD (AUC 0.68 (CI 0.57 to 0.78)). (3) CRP strongly predicted death/BPD (AUC 0.85 (CI 0.76 to 0.92)), even after exclusion of sepsis. Conclusions: A higher CRP and RBP/TTR molar ratio on day 28 are associated with death/BPD at 36 weeks in ELBW infants. Lower TTR and maintained RBP/TTR ratios suggest inflammation rather than vitamin A deficiency as the cause for lower serum vitamin A levels in ELBW infants.",
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Retinol-binding protein, transthyretin, and C-reactive protein in extremely low birth weight (ELBW) infants. / Ambalavanan, Namasivayam; Ross, A. Catharine; Carlo, Waldemar A.

In: Journal of Perinatology, Vol. 25, No. 11, 01.11.2005, p. 714-719.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Retinol-binding protein, transthyretin, and C-reactive protein in extremely low birth weight (ELBW) infants

AU - Ambalavanan, Namasivayam

AU - Ross, A. Catharine

AU - Carlo, Waldemar A.

PY - 2005/11/1

Y1 - 2005/11/1

N2 - Background: Vitamin A deficiency reduces retinol binding protein (RBP) but not transthyretin (TTR), while inflammation reduces both RBP and TTR and increases C-reactive protein (CRP), an acute phase reactant. Objective: To estimate serum RBP, TTR, and CRP in ELBW infants to test the hypotheses that (a) TTR is a negative acute phase reactant and (b) a higher RBP/TTR ratio or CRP is associated with death/BPD by 36 weeks corrected age. Design/Methods: Serum RBP, TTR, and CRP were measured in 79 ELBW infants at 28 days. Area under the curve (AUC) of receiver operating characteristic curve analysis evaluated the predictive value of TTR, the RBP/TTR ratio, and CRP for death/BPD at 36 weeks. Results: (1) TTR inversely correlated with CRP (r = -0.45, p<0.0001) consistent with TTR being a negative acute phase reactant. (2) The RBP/ TTR ratio predicted death/BPD (AUC 0.68 (CI 0.57 to 0.78)). (3) CRP strongly predicted death/BPD (AUC 0.85 (CI 0.76 to 0.92)), even after exclusion of sepsis. Conclusions: A higher CRP and RBP/TTR molar ratio on day 28 are associated with death/BPD at 36 weeks in ELBW infants. Lower TTR and maintained RBP/TTR ratios suggest inflammation rather than vitamin A deficiency as the cause for lower serum vitamin A levels in ELBW infants.

AB - Background: Vitamin A deficiency reduces retinol binding protein (RBP) but not transthyretin (TTR), while inflammation reduces both RBP and TTR and increases C-reactive protein (CRP), an acute phase reactant. Objective: To estimate serum RBP, TTR, and CRP in ELBW infants to test the hypotheses that (a) TTR is a negative acute phase reactant and (b) a higher RBP/TTR ratio or CRP is associated with death/BPD by 36 weeks corrected age. Design/Methods: Serum RBP, TTR, and CRP were measured in 79 ELBW infants at 28 days. Area under the curve (AUC) of receiver operating characteristic curve analysis evaluated the predictive value of TTR, the RBP/TTR ratio, and CRP for death/BPD at 36 weeks. Results: (1) TTR inversely correlated with CRP (r = -0.45, p<0.0001) consistent with TTR being a negative acute phase reactant. (2) The RBP/ TTR ratio predicted death/BPD (AUC 0.68 (CI 0.57 to 0.78)). (3) CRP strongly predicted death/BPD (AUC 0.85 (CI 0.76 to 0.92)), even after exclusion of sepsis. Conclusions: A higher CRP and RBP/TTR molar ratio on day 28 are associated with death/BPD at 36 weeks in ELBW infants. Lower TTR and maintained RBP/TTR ratios suggest inflammation rather than vitamin A deficiency as the cause for lower serum vitamin A levels in ELBW infants.

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