Objective To assess the reliability and validity of dried blood spot(DBS) in the diagnosis of marginal vitamin A deficiency(MVAD) in preschoolers, in order to provide reference for scientifically assessing vitamin A nutritional status. Methods A total of 130 children aged 2 to 7 years were selected in the Zhao county in 2018 and their capillary bloods were collected to prepare DBS, of whom 48 children also collected venous plasma at the same time. The retinol levels in the 2 biological matrices were measured using high-performance liquid chromatography-tandem mass spectrometry method(HPLC-MS/MS). Two calibration methods were applied to convert DBS retinol to its homologous plasma retinol level. The agreement of the converted retinol with plasma retinol level was assessed using the intra-group correlation coefficient(ICC) and Bland-Altman analysis. The validity for the diagnosis of MVAD was assessed by sensitivity, specificity, accuracy index(AI), positive predictive value(PPV) and negative predictive value(NPV). Results After correction, DBS retinol was in good agreement with the level in homologous plasma, with ICC values greater than 0.8. Factor-corrected DBS retinol was closer to its plasma level. The prevalence of MVAD in the target population diagnosed by factor-corrected DBS retinol was 45.00%, which was close to the prevalence of MVAD diagnosed by plasma retinol(45.83%). The sensitivity, specificity, AI, PPV and NPV of factor-corrected DBS retinol predicting MVAD were 77.78%, 81.82%, 80.00%, 77.78% and 81.82%, respectively. The prevalence rates of VAD and MVAD in 130 children aged 2 to 7 years in Zhao county were 3.08% and 45.38%, respectively. Children aged 5 to 7 years had a higher prevalence rate of MVAD(51.22%, t=1.975, P=0.359). Conclusion Corrected DBS retinol can be used in the diagnosis of MVAD and the prevalence rate of MVAD is high in preschoolers in Zhao county.
Key words
dried blood spot /
retinol /
vitamin A nutritional status assessment /
preschooler /
sensitivity /
specificity
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