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Reply to‘Zero-filled values enhanced the performance of CRP vs RBP:TTR index in ELBW infants’ by Dr Rosales

Journal of Perinatology volume 26, page 320 (2006)Cite this article

We thank Dr Rosales for his interest in our article1 and we thank the editor for the opportunity to respond to the comments. As Dr Rosales correctly states, the RBP/TTR index was developed as a marker of vitamin A status, and not as a prognostic indicator. We demonstrated that the RBP/TTR index is not only a marker of vitamin A status, but is also a prognostic indicator in ELBW infants, thereby correlating vitamin A status to prognosis in these vulnerable infants.

Dr Rosales quite rightly also points out that CRP, being a well-known acute phase reactant would be a better predictor of poor outcome than the RBP/TTR index. This is precisely the rationale for selection of CRP as a ‘gold standard’ to compare with the RBP/TTR index. However, although it appears to be obvious, a review of the peer-reviewed literature will show that CRP has not been used so far as a prognostic indicator in the ELBW infant population. Therefore, our study was novel in that not only did we confirm CRP as a useful prognostic marker, but also showed that lower vitamin A status as estimated by the RBP/TTR index is associated with worse outcomes.

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References

  1. Ambalavanan N, Ross AC, Carlo WA . Retinol-binding protein, transthyretin, and C-reactive protein in extremely low birth weight (ELBW) infants. J Perinatol 2005; 25: 714–719.

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  2. Szalai AJ, Briles DE, Volanakis JE . Human C-reactive protein is protective against fatal Streptococcus pneumoniae infection in transgenic mice. J Immunol 1995; 155: 2557–2563.

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Authors and Affiliations

  1. Division of Neonatology, University of Alabama at Birmingham, 525 New Hillman Building, 619 South 19th Street, Birmingham, 35233, AL, USA

    N Ambalavanan, A C Ross & W Carlo

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  1. N Ambalavanan
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  2. A C Ross
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  3. W Carlo
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Correspondence to N Ambalavanan.

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Ambalavanan, N., Ross, A. & Carlo, W. Reply to‘Zero-filled values enhanced the performance of CRP vs RBP:TTR index in ELBW infants’ by Dr Rosales. J Perinatol 26, 320 (2006). https://doi.org/10.1038/sj.jp.7211502

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