@article{DanquahDobruckyFranketal.2015,
  author    = {Danquah, Ina and Dobrucky, C. Lydia and Frank, Laura K. and Henze, Andrea and Amoako, Yaw A. and Bedu-Addo, George and Raila, Jens and Schulze, Matthias Bernd and Mockenhaupt, Frank P. and Schweigert, Florian J.},
  title     = {Vitamin A: potential misclassification of vitamin A status among patients with type 2 diabetes and hypertension in urban Ghana},
  series = {The American journal of clinical nutrition : a publication of the American Society for Nutrition, Inc.},
  volume    = {102},
  journal   = {The American journal of clinical nutrition : a publication of the American Society for Nutrition, Inc.},
  number    = {1},
  publisher = {American Society for Nutrition, Inc.},
  address   = {Bethesda},
  issn      = {0002-9165},
  doi       = {10.3945/ajcn.114.101345},
  pages     = {207 -- 214},
  year      = {2015},
  abstract  = {Background: Sub-Saharan Africa is facing a double burden of malnutrition: vitamin A deficiency (VAD) prevails, whereas the nutrition-related chronic conditions type 2 diabetes (T2D) and hypertension are emerging. Serum retinol a VAD marker increases in kidney disease and decreases in inflammation, which can partly be attributed to alterations in the vitamin A transport proteins retinol-binding protein 4 (RBP4) and prealbumin. Kidney dysfunction and inflammation commonly accompany T2D and hypertension. Objective: Among urban Ghanaians, we investigated the associations of T2D and hypertension with serum retinol as well as the importance of kidney function and inflammation in this regard. Design: A hospital-based, case-control study in individuals for risk factors of T2D, hypertension, or both was conducted in Kumasi, Ghana (328 controls, 197 with T2D, 354 with hypertension, and 340 with T2D plus hypertension). In 1219 blood samples, serum retinol, RBP4, and prealbumin were measured. Urinary albumin and estimated glomerular filtration rate (eGFR) defined kidney function. C-reactive protein (CRP) >5 mg/L indicated inflammation. We identified associations of T2D and hypertension with retinol by linear regression and calculated the contribution of RBP4, prealbumin, urinary albumin, eGFR, and CRP to these associations as the percentages of the explained variance of retinol. Results: VAD (retinol <1.05 mu mol/L) was present in 10\% of this predominantly female, middle-aged, overweight, and deprived population. Hypertension, but not T2D, was positively associated with retinol (beta: 0.12; 95\% CI: 0.08, 0,17), adjusted for age, sex, socioeconomic factors, anthropometric measurements, and lifestyle. In addition to RBP4 (72\%) and prealbumin (22\%), the effect of increased retinol on individuals with hypertension was mainly attributed to impaired kidney function (eGFR: 30\%; urinary albumin: 5\%) but not to inflammation. Conclusions: In patients with hypertension, VAD might be underestimated because of increased serum retinol in the context of kidney dysfunction. Thus, the interpretation of serum retinol in sub-Saharan Africa should account for hypertension status.},
  language  = {en}
}
@article{AlickeBoakyeAppiahAbdulJaliletal.2017,
  author    = {Alicke, Marie and Boakye-Appiah, Justice K. and Abdul-Jalil, Inusah and Henze, Andrea and van der Giet, Markus and Schulze, Matthias Bernd and Schweigert, Florian J. and Mockenhaupt, Frank P. and Bedu-Addo, George and Danquah, Ina},
  title     = {eAdolescent health in rural Ghana: A crosssectional study on the co-occurrence of infectious diseases, malnutrition and cardiometabolic risk factors},
  series = {PLoS one},
  volume    = {12},
  journal   = {PLoS one},
  publisher = {PLoS},
  address   = {San Fransisco},
  issn      = {1932-6203},
  doi       = {10.1371/journal.pone.0180436},
  pages     = {4463 -- 4477},
  year      = {2017},
  abstract  = {In sub-Saharan Africa, infectious diseases and malnutrition constitute the main health problems in children, while adolescents and adults are increasingly facing cardio-metabolic conditions. Among adolescents as the largest population group in this region, we investigated the co-occurrence of infectious diseases, malnutrition and cardio-metabolic risk factors (CRFs), and evaluated demographic, socio-economic and medical risk factors for these entities. In a cross-sectional study among 188 adolescents in rural Ghana, malarial infection, common infectious diseases and Body Mass Index were assessed. We measured ferritin, C-reactive protein, retinol, fasting glucose and blood pressure. Socio-demographic data were documented. We analyzed the proportions (95\% confidence interval, CI) and the cooccurrence of infectious diseases (malaria, other common diseases), malnutrition (underweight, stunting, iron deficiency, vitamin A deficiency [VAD]), and CRFs (overweight, obesity, impaired fasting glucose, hypertension). In logistic regression, odds ratios (OR) and 95\% CIs were calculated for the associations with socio-demographic factors. In this Ghanaian population (age range, 14.4-15.5 years; males, 50\%), the proportions were for infectious diseases 45\% (95\% CI: 38-52\%), for malnutrition 50\% (43-57\%) and for CRFs 16\% (11- 21\%). Infectious diseases and malnutrition frequently co-existed (28\%; 21-34\%). Specifically, VAD increased the odds of non-malarial infectious diseases 3-fold (95\% CI: 1.03, 10.19). Overlap of CRFs with infectious diseases (6\%; 2-9\%) or with malnutrition (7\%; 3-11\%) was also present. Male gender and low socio-economic status increased the odds of infectious diseases and malnutrition, respectively. Malarial infection, chronic malnutrition and VAD remain the predominant health problems among these Ghanaian adolescents. Investigating the relationships with evolving CRFs is warranted.},
  language  = {en}
}