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Confirm the diagnosis of carotenoderma; detect fat malabsorption; depressed carotene levels may be found in cases of steatorrhea.
High levels are useful to rule out steatorrhea but lower values lack specificity. There is poor sensitivity. High in the serum of those ingesting large amounts of vegetables. The gold standard for confirmation of a diagnosis of malabsorption remains fat measurement of a 72-hour stool specimen.
Vitamin A serum levels do not correlate well with liver stores. Carotenemia may be confused with jaundice. It is also reported high with some cases of diabetes mellitus, myxedema, chronic nephritis, nephrotic syndrome,1,2 liver disease, hypothyroidism, type I, IIA, and IIB hyperlipoproteinemia, and in a group of amenorrheic hypogonadotropic women.1 An inverse relationship between serum β-carotene and the risk of bronchogenic squamous cell carcinoma is reported.3 The highest carotene levels are found in the serum of faddists ingesting large amounts of vegetables.4 Oral leukoplakia responds well to β-carotene therapy.5 Low β-carotene levels are associated with oral contraceptives and smoking.6
1. Kemmann E, Pasquale SA, Skaf R. Amenorrhea associated with carotenemia. JAMA. 1983 Feb 18; 249(7):926-929. PubMed 6823046
2. McNeely MD. Gastrointestinal function. In: Sonnenwirth AC, Jarett L, eds. Gradwohl's Clinical Laboratory Methods and Diagnosis. 8th ed. St Louis, Mo: Mosby-Year Book Inc;1980: 517-536.
3. Menkes MS, Comstock GW, Vuilleumier JP, Helsing KJ, Rider AA, Brookmeyer R. Serum beta-carotene, vitamins A and E, selenium, and the risk of lung cancer. N Engl J Med. 1986 Nov 13; 315(20):1250-1254. PubMed 3773937
4. Gerard SK. Serum carotene: A screening test for malabsorption. Pathologist. 1986 Apr; 36-37.
5. Garewal HS, Meyskens FL Jr, Killen D, et al. Response of oral leukoplakia to beta-carotene. J Clin Oncol. 1990 Oct; 8(10):1715-1720. PubMed 2213107
6. Palan PR, Romney SL, Vermund SH, Mikhail MG, Basu J. Effects of smoking and oral contraception on plasma beta-carotene levels in healthy women. Am J Obstet Gynecol. 1989; 161(4):881-885. PubMed 2801833
