Liver vitamin A in protein-calorie malnutrition

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Abstract
1) Vitamin A has been determined in liver biopsies obtained from 14 cases of kwashiorkor, 7 cases of nutritional marasmus, and 5 cases of marasmic kwashiorkor soon after admission to the hospital. Retinyl ester and retinol fractions were separately estimated after chromatography on activated alumina. 2) The concentration of liver vitamin A in PCM varied between 2 and 140 µg/g; the average value was 43 µg/g. There was no significant difference in the average vitamin A content per gram liver between kwashiorkor, marasmus, and marasmic kwashiorkor. 3) Free retinol (A) in kwashiorkor livers varied a great deal in relation to total vitamin A (T) and the percent A/T values ranged from 0 to 96 with an average of 31. On the other hand, in marasmus and marasmic kwashiorkor the A/T values did not exceed 10%. This difference was observed irrespective of the concentration of total vitamin A in liver. 4) Weanling albino rats were placed on vitamin A-free diets containing 3 and 18% casein. One-half of the rats in each group received 5 µg vitamin A/rat per day as an oral supplement and the other half received 50 µg/rat per day. Rats were killed in the 8th week of feeding and retinyl ester and retinol fractions in liver were determined. Experimentally induced protein deficiency by itself did not influence the relation between total vitamin A and free retinol. Only when the rat livers were severely depleted of vitamin A (4 µg/g and less) was this relationship disturbed and the deficiency or adequacy of dietary protein was without influence. fluence. 5) The significance of these findings is discussed. It is concluded that some unknown factor(s) may be responsible for the differences in the pattern of vitamin A storage seen in kwashiorkor on the one hand and marasmus on the other.

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