185265 Relationship between aflatoxin B1 albumin adducts in plasma, aflatoxin M1 in urine and vitamin A and E concentrations in Ghanaians

Monday, October 27, 2008

Francis A. Obuseh, DrPH, MPH, MS , Public Health Division, 436th Aeromedical-Dental Squadron, United States Air Force, Dover, DE
Pauline Jolly, PhD, MPH , Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL
Andrzej Kulczycki, PhD , Department of Maternal and Child Health, The University of Alabama at Birmingham, Birmingham, AL
Chandrika Piyathilake, PhD , Nutritional Biochemistry & Genomics, University of Alabama at Birmingham, Birmingham, AL
William Ellis, PhD , Department of Biochemistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
Yi Jiang, MD, MPH , Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL
Jia-Sheng Wang, MD, PhD , Department of Environmental Toxicology, Texas Tech University, Lubbock, TX
Jonathan Williams, PhD , College of Agricultural and Environmental Sciences, University of Georgia, Griffin, GA
Background: Large proportions of the populations in developing tropical countries are exposed to aflatoxin in their diet and also suffer from micronutrient deficiencies.

Objective: We examined the relationship between AFB1 albumin adducts in plasma and the AFM1 metabolite in urine and plasma vitamin A and vitamin E concentrations.

Methods: We conducted a cross-sectional survey using descriptive frequencies, chi-square and logistic regression to explore the relationships.

Results: Thirty-one percent of participants were deficient in vitamin A (plasma retinol < 20 ug/dL) and 71.3% were vitamin E deficient (plasma á-tocopherol < 0.5 mg/dL). Vitamin A concentration was highly correlated to vitamin E concentration (r=0.47, p= <.0001). Univariate analysis showed that participants with high AFB1 had lower vitamin A concentrations (p=0.01) and higher alanine transaminase (p=0.003) and total protein (p=0.05) levels. Multivariate analysis demonstrated that study participants with high AFB1 had significantly lower vitamin A concentrations (OR = 2.61; CI = 1.03 – 6.58; p=0.04). AFB1 was marginally associated with vitamin E (OR = 2.4; CI = 0.96-6.05; p = 0.06). Conversely, AFM1 was positively associated with vitamin A (OR = 0.31; CI = 1.15-0.09; p=0.05) and vitamin E (OR = 0.31; CI = 0.1 – 0.97; p = 0.04). Participants with high AFB1 or high AFM1 were at almost 6 times greater risk of being HBV positive (OR = 5.88; CI = 1.71-20.14; p = 0.005) and (OR = 5.84; CI = 1.15-29.54; p = 0.03) respectively.

Conclusions: The results indicate that micronutrient status may be modified by aflatoxin exposure. Preventing aflatoxin exposure may greatly reduce the occurrence of vitamins A and E deficiencies in countries such as Ghana.

Learning Objectives:
identify socio-demographic risk factors associated with exposure and consumption of aflatoxins and micronutrient levels determine the impact of aflatoxins on vitamin A and E status examine the relationship between AF biomarkers (AFB1 and AFM1) levels and micronutrient (vitamin A and E) levels

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Degree Year Department School MS 1992 Human Nutrition University of Ibadan, Nigeria. MPH 2003 Epidemiology University of Alabama, US. DrPH 2007 Public Health University of Alabama, US.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.