FACTORS ALTERING CONCENTRATION OF CAROTENOIDS 507 



out that the plasma vitamin A of residents of Newfoundland increased 

 from 20.0 ± 2.0 microgram per cent in 1944, to 45.0 ± 2.0 microgram 

 per cent in 1948. They attribute this result to the dissemination of infor- 

 mation on the importance of vitamin A from a nutritional standpoint. 

 Hospital patients may, in some instances, have lower average blood caro- 

 tene and vitamin A levels than do non-hospital patients 839 ' 841 - 848 ; this re- 

 flects the lower quality of the diets in these cases as contrasted with those 

 of the controls. 



e. Plasma Carotene and Vitamin A Levels in Abnormal Conditions. 

 Some abnormalities such as folliculosis, xerophthalmia, keratosis, and 

 nyctalopia develop because of vitamin A deficiency. Conversely, a vita- 

 min A deficiency may develop as a secondary condition following a dis- 

 eased condition. 



(a) Plasma Carotene and Vitamin A Levels in Diabetes. One of the main 

 conditions associated with diabetes mellitus is the faulty metabolism of 

 carotene and vitamin A. As a result of the inability of the liver to me- 

 tabolize carotene effectively, a carotenemia obtains which is frequently 

 associated with low values for the plasma vitamin A. 928-933 On the other 

 hand, Kimble et al., 93i studying deviations in blood levels, were unable to 

 demonstrate any tendency toward carotenemia or to a low level of plasma 

 vitamin A in 116 unselected cases of diabetes, prior to hospital treatment. 



However, in a number of instances, not only was a fasting carotenemia 

 demonstrated, but also the blood carotene tolerance curve reached higher 

 than normal levels, and remained elevated over a longer period than in 

 normal patients. 880 ' 928 Ralli and her collaborators 880 also reported that the 

 carotene levels were higher in the liver of diabetics than in this organ of 

 patients with other diseases. Although there is no physiological evidence 

 that the destruction of carotene is associated with the utilization of carbo- 

 hydrate, it is open to question as to whether or not carotenemia is directly 

 concerned with the diabetic disorder. 202 Rabinowitch 931 is of the opinion 

 that carotenemia is directly correlated with the severity of the diabetes. 

 Since it has been shown that acetonemia in cows is associated with a low 



928 E. P. Ralli, A. C. Pariente, H. Brandaleone, and S. Davidson, J. Am. Med. Assoc, 

 106, 1975-1978 (1936). 



929 G. H. Stueck, G. Flaum, and E. P. Ralli, J. Am. Med. Assoc, 109, 343-344 (1937). 



930 W. Heymann, J. Am. Med. Assoc, 106, 2050-2052 (1936). 

 931 1. M. Rabinowitch, Arch. Internal Med., 45, 586-592 (1930). 



932 H. Brandaleone and E. P. Ralli, Proc. Soc Exptl. Biol. Med., 82, 200-201 (1934). 



933 J. G. Brazer and A. C. Curtis, Arch. Internal Med., 65, 90-105 (1940). 



934 M. S. Kimble, O. A. Germek, and E. L. Sevringhaus, Am. J. Med. Sci., 212, 574- 

 585 (1946). 



