Aflatoxin B₁ albumin adducts in plasma and aflatoxin M₁ in urine are associated with plasma concentrations of vitamins A and E

Background: Although aflatoxin exposure has been associated with micronutrient deficiency in animals, there are few investigations on the effects of aflatoxin exposure on micronutrient metabolism in humans. Objective: To examine the relationship between aflatoxin B₁ (AFB₁) albumin adducts (AF-ALB) in plasma and the aflatoxin M₁ (AFM₁) metabolite in urine and plasma concentrations of retinol (vitamin A) and alpha-tocopherol (vitamin E) in Ghanaians. Methods: A cross-sectional study of 147 adult participants was conducted. Blood and urine samples were tested for aflatoxin and vitamins A and E levels. Results: Multivariable analysis showed that participants with high AF-ALB (>= 0.80 pmol/mg albumin) had increased odds of having vitamin A deficiency compared to those with lower AF-ALB [Odds Ratio (OR) = 2.61; CI = 1.03 - 6.58; p = 0.04]. Participants with high AF-ALB also showed increased odds of having vitamin E deficiency but this was not statistically significant (OR = 2.4; CI = 0.96 - 6.05; p = 0.06). Conversely, those with higher AFM₁ values had a statistically nonsignificant reduced odds of having vitamin A deficiency (OR = 0.31; CI = 0.09 - 1.02; p = 0.05) and a statistically significant reduced odds of having vitamin E deficiency (OR = 0.31; CI = 0.10 - 0.97; p = 0.04). Participants with high AF-ALB or high AFM₁ (>= 437.95 pg/dL creatinine) were almost 6 times more likely to be hepatitis B virus surface antigen (HBsAg)-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: These data indicate that aflatoxin may modify plasma micronutrient status. Thus, preventing aflatoxin exposure may reduce vitamin A and E deficiencies.