The role of retinol-binding protein in protein-calorie malnutrition.

Plasma RBP is decreased to 1.62 mg plus or minus 0.71/100 ml, or 31.1 percent of normal, in the acute stage of kwashiorkor. RBP doubles its plasma level after 1 wk and triples after 2 wk of appropriate refeeding. The return to normal of RPB runs in close parallel with prealbumin (PA), implying that both components remain bound by 1:1 molar ratio in the PA-RBP complex. Low values recorded on admission for RBP seem to be the result of reduced liver biosynthesis. On the other hand, a high correlation persists between RBP and retinol plasma level along the successive steps of clinical recovery, suggesting that RBP acts as the limiting factor for retinol transport.