Current developments in nutrition · 2026
Inflammation Does Not Mediate Relationships between BMI/BMI-for-Age Z-Score and Retinol or Retinol-Binding Protein in Adult Women or Young Children without Underweight, Wasting, or Malaria: An Analysis of 24 Surveys.
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Davis Jennie N, Williams Anne, Arnold Charles D, Addo Yaw, Oaks Brietta M, Wirth James P, Suchdev Parminder S, Young Melissa F, Engle-Stone Reina
Аннотация
BACKGROUND: The extent to which inflammation from overweight or obesity influences interpretation of commonly used vitamin A status biomarkers is uncertain.
OBJECTIVES: We examined relationships among weight status, inflammation, and retinol or retinol-binding protein (RBP) among women (15-49 y) and children (6-59 mo) with normal weight to overweight or obesity.
METHODS: Cross-sectional data were separately analyzed from 24 surveys representing 24 countries (n = 16,771 women in 13 surveys and n = 24,707 children in 22 surveys) from the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project, excluding observations with underweight, wasting, pregnancy, or malaria. Relationships were assessed between BMI (women) or BMI-for-age z-score (BAZ, children), inflammatory biomarkers C-reactive protein (CRP) and/or α1-acid glycoprotein (AGP), and retinol or RBP by linear regression. We also examined potential mediation by CRP and/or AGP in relationships between BMI/BAZ and retinol/RBP with structural equation modeling. Regression and mediation models accounted for complex survey designs and were adjusted for potential confounders.
RESULTS: Among women, BMI was positively associated with retinol/RBP in 5 of 13 surveys and positively associated with CRP and/or AGP in 10 of 13 surveys; associations between biomarkers of inflammation and retinol/RBP varied in direction and magnitude. Among children, BAZ was positively associated with retinol/RBP in 3 of 22 surveys and positively associated with CRP in 1 survey (none with AGP); inflammation biomarkers were consistently negatively associated with retinol/RBP. In 3 of 13 women's surveys and 1 of 22 children's surveys, inflammation partially mediated the relationship between BMI/BAZ and retinol/RBP; however, the direction of associations varied.
CONCLUSIONS: In these surveys limited to individuals without undernutrition or malaria, inflammation associated with overweight or obesity does not appear to impact vitamin A assessment when measured with retinol/RBP. However, findings support measurement of biomarkers reflecting inflammation (of any source) to interpret vitamin A status, particularly among children.
OBJECTIVES: We examined relationships among weight status, inflammation, and retinol or retinol-binding protein (RBP) among women (15-49 y) and children (6-59 mo) with normal weight to overweight or obesity.
METHODS: Cross-sectional data were separately analyzed from 24 surveys representing 24 countries (n = 16,771 women in 13 surveys and n = 24,707 children in 22 surveys) from the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project, excluding observations with underweight, wasting, pregnancy, or malaria. Relationships were assessed between BMI (women) or BMI-for-age z-score (BAZ, children), inflammatory biomarkers C-reactive protein (CRP) and/or α1-acid glycoprotein (AGP), and retinol or RBP by linear regression. We also examined potential mediation by CRP and/or AGP in relationships between BMI/BAZ and retinol/RBP with structural equation modeling. Regression and mediation models accounted for complex survey designs and were adjusted for potential confounders.
RESULTS: Among women, BMI was positively associated with retinol/RBP in 5 of 13 surveys and positively associated with CRP and/or AGP in 10 of 13 surveys; associations between biomarkers of inflammation and retinol/RBP varied in direction and magnitude. Among children, BAZ was positively associated with retinol/RBP in 3 of 22 surveys and positively associated with CRP in 1 survey (none with AGP); inflammation biomarkers were consistently negatively associated with retinol/RBP. In 3 of 13 women's surveys and 1 of 22 children's surveys, inflammation partially mediated the relationship between BMI/BAZ and retinol/RBP; however, the direction of associations varied.
CONCLUSIONS: In these surveys limited to individuals without undernutrition or malaria, inflammation associated with overweight or obesity does not appear to impact vitamin A assessment when measured with retinol/RBP. However, findings support measurement of biomarkers reflecting inflammation (of any source) to interpret vitamin A status, particularly among children.