Liver levels of retinol in unselected necropsy specimens: a prevalence survey of vitamin A deficiency in Recife, Brazil

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Abstract
Total retinol was analyzed in 517 necropsy specimens from children 0 to 14 yr of age, deceased of various causes in Recife, Brazil, and from eight persons, 10 to 59 yr of age, who died violently. Age and nutritional status, in that order, were found to be the major determinants of the prevalence of low reserves, children less than 1 yr of age showing the highest prevalence of deficient values. These data were extrapolated to the live population less than 5 yr of age, categorized by age and nutritional status. By using the criteria that liver reserves of vitamin A less than 5 and 20 µg/g denote states of high risk and inadequacy, respectively, approximately 3 and 17% of children 0 to 4 yr of age in the live population of Recife were estimated to fall in the high risk and inadequate status group, respectively. None of the persons who died violently was at high risk and only one had inadequate reserves. These estimates agree well with previous prevalence figures from clinical and biochemical surveys. Thus, the direct assessment of concentrations of vitamin A in the liver at necropsy is a simple, inexpensive, and noninvasive procedure for estimating the vitamin A status of children.