Vitamin A deficiency and factors associated with retinol levels in public school students

LIMA, Adeíldes Bezerra Moura de; GARCÊZ, Laís Spíndola; OLIVEIRA, Iara Katrynne Fonseca; SANTOS, Marize Melo dos; DA PAZ, Suzana Maria Rebelo Sampaio; PAIVA, Adriana de Azevedo

doi:10.1590/1678-98652017000500006

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ORIGINAL ARTICLES • Rev. Nutr. 30 (05) • Sep-Oct 2017 • https://doi.org/10.1590/1678-98652017000500006 copy

Vitamin A deficiency and factors associated with retinol levels in public school students

Deficiência de vitamina A e aspectos associados aos níveis de retinol em estudantes de escolas públicas

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

To estimate the prevalence of vitamin A deficiency and determine the socioeconomic and demographic factors associated with serum retinol levels in public school students.

Methods

This cross-sectional study included 245 students from the urban and rural areas of the city of Teresina, Piauí, Brazil. Socioeconomic data were collected using a form. Serum retinol level was determined by high-performance liquid chromatography and classified according to the cut-off points provided by the World Health Organization. All statistical tests had a significance level of 5%.

Results

The prevalence of vitamin A deficiency (retinol level <0.70µmol/L) was 9.8% (95%CI=7.9-10.0). The prevalences of low and acceptable retinol levels (<1.05mol/L) were higher in students aged 12-14 years living in households without piped water supply (p>0.05). Water well or other untreated water sources were the factors most strongly associated with low retinol levels (OR=3.28; 95%CI=1.48-7.28; p=0.003).

Conclusion

Vitamin A deficiency was characterized as a mild public health problem in the students, indicating the need of actions that address this issue in schools and of studies with larger samples to investigate the problem at the municipal and state levels. Untreated water intake, a possible source of waterborne illnesses, contributed to lower retinol levels.

Keywords:
Indicators; Students; Vitamin A; Vitamin A deficiency

Variables	Retinol levels				^* OR_crude (95%CI)	p
	<1.05µmol/L		≥1.05µmol/L		^* OR_crude (95%CI)	p
	n	%	n	%
Sex
Male	47	42.3	64	57.7	1	0.280
Female	66	49.2	68	50.8	0.76 (0.46-1.26)	0.280
Age group
8-9 years	3	15.8	16	84.2	1
10-11 years	68	43.0	90	57.0	0.25 (0.07-0.89)	0.032
12-14 years	42	61.8	26	38.2	0.12 (0.03-0.44)	0.001
Maternal education level
Up to eight years	52	43.3	68	56.7	1
>eight years	61	49.2	63	50.8	0.79 (0.48-3.31)	0.359
Per capita income
≤1/2 MS	96	45.3	116	54.7	1
>1/2 MS	17	51.5	16	48.5	0.78 (0.37-1.62)	0.505
School location
Urban	92	45.1	112	54.9	1
Rural	21	51.2	20	48.8	0.78 (0.40-1.53)	0.474
Home construction material
Masonry (finished or not)	104	45.6	124	54.4	1
Other	9	52.9	8	47.1	0.74 (0.28-2.00)	0.560
Water source
Piped water supply	104	50.5	102	49.5	1
Well or other	9	23.7	29	76.3	3.28 (1.48-7.28)	0.003
Type of sewage
Sanitary sewer	97	46.4	112	53.6	1
Other	16	45.7	19	54.3	1.03 (0.50-2.11)	0.939
Garbage disposal system
City collection service	103	47.9	112	52.1	1
Other	10	34.5	19	65.5	1.75 (0.78-3.93)	0.177

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[1] Correspondência para/Correspondence to: AA PAIVA. E-mail: <aapaiva@ufpi.edu.br>.

Variables	n	%
Sex
Male	111	45.3
Female	134	54.7
Age group (years)
8 to 9	19	07.8
10 to 11	158	64.4
12 to 14	68	27.8
Mean (95%CI)	11.0 years (10.8-11.1 years)
School location
Urban	204	83.3
Rural	41	16.7
Maternal education level ^*
Up to eight years	120	49.2
>eight years	124	50.8
Mean (95%CI)	8.0 years in school (7.6-8.4 years in school)
Per capita income
Income ≤1/4 MS	93	38.0
1/4 MS <income ≤1/2 MS	119	48.5
Income >1/2 MS	33	13.5
Mean (95%CI)	204.7 reais (189.3-220.0 reais)
Home construction material
Masonry (finished)	143	58.4
Masonry (unfinished)	85	34.7
Other	17	06.9
Water source ^*
Piped water supply	206	84.4
Well or other	38	15.6
Type of sewage ^*
Sanitary sewer	209	85.7
Other	35	14.3
Garbage disposal system ^*
City collection service	215	88.1
Other	29	11.9

Serum retinol	Deficient (SR <0.70µmol/L)		Acceptable (0.70µmol/L ≤SR <1.05µmol/L)		Normal (SR ≥1.05µmol/L)		p
Serum retinol	n	%	n	%	n	%
Sex
Male	12	10.8	35	31.5	64	57.7	0.361^*
Female	12	9.0	54	40.3	68	50.7	0.361^*
Age group (years)
8 to 9	2	10.5	1	5.3	16	84.2	0.001^**
10 to 11	15	9.5	53	33.5	90	57.0
12 to 14	7	10.3	35	51.5	26	38.2
Total	24	9.8	89	36.3	132	53.9