On question (1): Retinol is transported in plasma bound to RBP which is
synthesised in the liver; zinc is an essential co-factor for RBP synthesis.
RBP synthesis is also dependent on adequate nutrition. RBP is a negative
acute phase protein. Low serum retinol concentrations could be secondary to
an acute phase reaction or to retinol deficiency and/or protein calorie
malnutrition. Therefore interpretation of low serum retinol concentration
requires quantification of RBP and an indicator of an 'acute phase' such as
CRP. Zinc concentrations are also helpful. Note also that RBP is cleared by
the kidney so that elevated concentrations of retinol and RBP could be
secondary to impaired renal function.
On question (2): Vitamin E is transported in plasma bound to lipoproteins.
Therefore changes in plasma vitamin E concentration could be secondary to
changes in plasma lipoprotein concentration. We report both vitamin E
concentration and a vitamin E to total lipid ratio. "Total lipid" is the
sum of cholesterol, triglyceride and phospholipid concentrations.
Nuala McCarroll
Department of Clinical Biochemistry
St James's Hospital
Dublin 8
Ireland
-----Original Message-----
From: Peter Stromberg [mailto:[log in to unmask]]
Sent: 13 July 2001 10:07
To: [log in to unmask]
Subject: CF STANDARD SETTING CONFERENCE--LONDON
One of our paediatricians come back from the above with lots of questions.
1>If plasma retinol is low measure RBP and if this is low check and give
Zinc and check Zinc again .Does anyone know the science behind this?
2>Vitamin e to fasting lipids ratio?
3>Vitamin K .Protein induced vitamin k PIVKA11
I am quite interested to know the detail of the new cystic fibrosis
monitoring standards.
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