Declining prevalence of hepatitis B virus infection in Catalonia (Spain) 12 years after the introduction of universal vaccination

AIMS: To analyze the prevalence of hepatitis B virus infection markers and hepatitis B vaccination in a representative sample of the juvenile and adult population of Catalonia and to evaluate the changes with respect to seroepidemiological surveys carried out in 1989 and 1996. DESIGN: In all subjects anti-HBc and anti-HBs antibodies and HBsAg were determined using an ELISA test. The possible association between sociodemographic variables and the prevalence of markers was analysed by calculating the adjusted odd ratio (simple logistic regression). SETTING: The study was carried out in 2002 in representative samples of the juvenile (5-14 years) and adult population (>or= 15 years) of Catalonia (Spain). MAIN RESULTS: In 2002 the global prevalence of HBsAg+ was 0.7% (95% CI: 0.4-1.0) and that of anti-HBc+ 8.7% (95% CI: 7.6-9.8), values higher than those obtained in 1989 of 1.5% (95% CI: 1.0-2.1) and 15.6 (95% CI: 13.9-17.3). The prevalence of markers of infection increased with age. The only sociodemographic variable significantly associated with the prevalence of hepatitis B virus infection was the place of birth. The risk of infection was twice as high in subjects born outside Catalonia (p<0.01), adjusted OR 2.0 (95% CI: 1.34-2.98) compared with those born in Catalonia. CONCLUSIONS: The results of this study show that the prevalence of hepatitis B virus infection (anti-HBc+) in Catalonia (Spain) is currently the lowest it has ever been and suggest that there has been a change in the pattern of endemicity of hepatitis B virus infection in Catalonia, which has become a country of low endemicity.     

The prevalence of hepatitis B virus markers in dental personnel in Singapore

A seroepidemiological survey of the prevalence of hepatitis B virus (HBV) markers was conducted in a group of 693 dental personnel in Singapore where HBV infection is endemic. The overall prevalence of HBsAg (4.5%) and anti-HBc (29%) was no higher than that in the general population. However, dentists had a significantly higher HBsAg prevalence (11.4%) compared with that in the general population (4.2%) (P less than 0.01) and of other categories of dental personnel (3.1%) (P less than 0.001). Similarly, the anti-HBc prevalence of the dentists (45.6%) was significantly higher than that of the general population (29.7%) (P less than 0.01) and of other categories of dental personnel (25.7%) (P less than 0.0001). It appears that dentists in the endemic area have a definite occupational risk of acquiring HBV infection.     

Hepatitis-C and hepatitis-B co-infections in patients with human immunodeficiency virus in Tehran, Iran

We carried out a study to determine the seroprevalence of HBV and HCV infections in HIV positive patients at a main referral center for HIV/AIDS in Iran. Serum samples from 201 HIV positive patients referring to a referral center for HIV/AIDS were analyzed for the presence of some hepatitis B (HBsAg, anti-HBc, anti-HBs) and Hepatitis C (anti-HCV) markers, during 2004- 2005. HBsAg was positive in 27 patients (13.4%), anti-HBc was positive in 60 patients (29.8%) and anti-HBs in 23 patients (11.4%). Anti-HCV Ab was positive in 135 of 201 (67.2%). HBV and HCV coinfection was observed in 73 of 201 (36.3%). The maximum prevalence of HBV-HIV and HCV-HIV coinfections were seen in intravenous drug users; 61.2% and 85.1%, respectively (P<0.0001). The minimum prevalence of HBV-HIV and HCV-HIV were seen in HIV patients' wife (HIV(+) patients who were infected by monogamous sexual contact with their HIV positive husband) both of them were 8% (P<0.0001). This study showed that HBV-HIV and HCV-HIV coinfections are significant in patients with HIV/AIDS in Iran. A greater relevance was observed in the association between HCV and HIV. This study suggests that it is necessary to investigate risk factors and risk groups for these infections in Iran.     

An investigation into factors associated with Helicobacter pylori infection

This study aims to estimate the prevalence of Helicobacter pylori in Glasgow, and to provide a systematic analysis of factors associated with this prevalence. The data used are from a random population sample of 793 men and 838 women aged 25-64 years conducted in 1995. The prevalence is estimated to be 66% (95% confidence interval: 63-68%); a level that is more typical of developing countries. Prevalence increases with age and social deprivation (P<0.0001) and is slightly higher in men than women (P = 0.07). After adjustment for age, social class, and sex group, H. pylori prevalence increases with increased cotinine (tobacco consumption) (P = 0.0005), increased number of siblings (P<0.0001), and decreased height (P = 0.03). Prevalence of coronary heart disease, hypertension, diabetes and intermittent claudication, alcohol consumption, fibrinogen, total serum cholesterol, HDL cholesterol, triglycerides, marital status, systolic and diastolic blood pressure had no independent association. The infection seems to be spread more readily in deprived, relatively crowded living conditions in childhood. The independent relationship with smoking suggests a possible second source of spread of infection in later years. The high degree of social deprivation in Glasgow is suggested as a major explanation of the high H. pylori prevalence found there.     

The epidemiology of hypertension and its associated risk factors in the city of Debrecen,Hungary

The purpose of this work was to estimate the prevalence of hypertension and cardiovascular risk factors and its association with sociodemographic, behavioural and lifestyle characteristics among the adult population of the city of Debrecen, Hungary.A cross-sectional study was conducted in 1996. Amongst 21 800 inhabitants aged 30-65 y risk screening for cardiovascular disease (CVD) was estimated by a questionnaire that included sociodemographic, lifestyle characteristics, family history of CVD and results of self-reported data of body weight, height and blood pressure.Of the total of 19 961 surveyed sample, 37.02% were considered to be hypertensive, 53.73% were overweight, 32.18% were current smokers and 58.85% were physically inactive. Hypertensives were older than normotensives (50.81+/-9.01 vs 44.78+/-8.97 y, P<0.001). The prevalence of various risk factors amongst hypertensives as compared to normotensives were overweight (68.49 vs 45.06%, P<0.0001), current smoking (28.38 vs 34.41%, P<0.0001), physical inactivity (64.78 vs 55.36%, P<0.001), and high alcohol consumption (1.91 vs 1.06%, P<0.01). Of the hypertensives 37.11% were on drug therapy. Of those on therapy, only 17.03% had normal blood pressure. Being overweight and having low physical activity was positively associated with hypertension (OR=2.25, CI=2.11-2.40) and (OR=1.26, CI=1.15-1.38). Manual work, a family history of CVD, low education, and the male gender were also associated with hypertension and more CVD risk factors.These findings illustrate a very high prevalence of hypertension and CVD risk factors in Debrecen, indicating the importance of the need for more effective prevention programmes and control of hypertension in Hungary.     

Hepatitis B and workers in institutions for the mentally retarded: risk of infection for staff in patient care

In the fall of 1982, we conducted a serosurvey of 920 of 933 employees in a large residential institution for the mentally retarded in Salem, Oregon. This survey demonstrated an overall prevalence of 10% for antibody to hepatitis B core antigen (anti-HBc), a marker of present or previous hepatitis B virus infection. Antibody positivity was significantly associated with a history of ever having worked in a position involving direct patient care (adjusted odds ratio = 3.1, 95% confidence interval 2.6-4.2). The length of time employed at the institution was significantly associated with an increasing prevalence of anti-HBc positivity among those persons who had ever worked in direct patient care (chi 2 for linear trend = 19.3, P less than .00001, one tail), but not among those employees who had never worked in patient contact. This evidence supports the Immunization Practices Advisory Committee (ACIP) recommendation of hepatitis B virus screening and, where appropriate, vaccinations for those workers in institutions for the mentally retarded who work closely with patients.     

Hepatitis B virus infection in general population in Madagascar: evidence for different epidemiological patterns in urban and in rural areas.

To describe the features of hepatitis B virus (HBV) infection in Madagascar, a randomized sero-epidemiological survey was undertaken in the general population > or = 1 year old of two provinces which represents 45% of the total population. In the 921 sera tested, the prevalence of HBV markers was 20.5% for HBsAg, 38.2% for anti-HBc and 6.9% for HBeAg. HBsAg and anti-HBc prevalence rates were significantly higher in males. A large difference in HBsAg prevalence was observed between urban (5.3%) and rural areas (26.0%). The same contrast in prevalence was noticed for the other HBV markers. In rural areas, HBV infection was more frequently acquired early in infancy, which suggests predominantly perinatal or postnatal transmission. The presence of HBV markers was not significantly associated with a history of blood transfusion, surgery or parenteral injection. High infectivity carriers represented 5.3% and the overall frequency of chronic carriers was 10.4%. These results place Madagascar among areas of high endemicity.     

Infection by hepatitis B and C virus in non-intravenous drug using female prostitutes in Spain

We have studied the prevalence of hepatitis B (HBV) and hepatitis C virus (HCV) serologic markers in female blood donors and in female prostitutes and the relationship of antibodies to hepatitis B core antigen (anti-HBc) and of antibodies to HCV (anti-HCV) with the presence of treponemal antibodies (FTA-ABS) in non-intravenous drug using female prostitutes. Hepatitis B surface antigen (HBsAg) was found in 1.0% of the female blood donors, anti-HBc in 15.6% and anti-HCV in 0.7%. In the prostitutes, the prevalence of HBsAg was 6.1%, anti-HBc was positive in 29.0% and anti-HCV in 8.8%. No significant statistical association between the prevalence of anti-HBc or anti-HCV and the age of prostitutes (p = 0.9111 and p = 0.8254 respectively) or the length of time as prostitutes (p = 0.3583 and p = 0.5770) was found. FTA-ABS positive prostitutes had a significantly higher prevalence of anti-HCV than FTA-ABS negative prostitutes (p < 0.001). No statistical association was found between anti-HBc antibodies and positive FTA-ABS prostitutes (p = 0.336).Corresponding author.     

Prevalence of hepatitis B markers in patients with hepatitis C infection in north-eastern Poland: Risk factors and vaccine use

We evaluated the prevalence of hepatitis B virus (HBV) markers and established HBV vaccination status among 111 patients with hepatitis C virus (HCV) infection. A history of HBV immunisation was recorded in 30 patients (27.0%) and only 17/30 (66.7%) had anti-HBs level 10 mIU/ml. All patients were HBsAg-negative and 22.2% of nonvaccinated subjects had evidence of HBV infection as determined by anti-HBc presence. Among patients with anti-HBc in 7/18 cases (38.9%) anti-HBc was the only marker of HBV infection (without anti-HBs). The prevalence of anti-HBc was significantly higher among patients who reported a history of acute hepatitis. In conclusion the prevalence of HBV markers in patients with HCV infection in north-eastern Poland is similar to the prevalence in general population, which suggests no increased risk for nosocomial HBV infection among those individuals. HCV infection seems to favour unusual serological pattern of HBV infection with anti-HBc as the only marker. HBV vaccine use is low among patients with HCV infection in north-eastern Poland.     

Prevalence of hepatitis B markers in the population of catalonia (Spain). Rationale for universal vaccination of adolescents

The prevalence of hepatitis B markers was determined in a representative sample of the general population of Catalonia (Spain). HBsAg was found in 0.5% of children (less than 15 years of age) and in 1.7% of adults (more than 15 years of age), and anti HBs in 1.6% and 18%, respecitvely. Age-specific prevalence for both markers showed a low risk for hepatitis B before puberty, and a progressive rise since adolescence, suggesting that perinatal transmission and horizontal transmission in children are relatively uncommon in Spain. Prevalence of hepatitis B markers was significantly higher among subjects with low education level, residing in an urban area and born outside Catalonia, but in the stratified analysis, a statistical significant difference was only maintained in the prevalence of HBV markers between those who live in urban and rural areas, and between those who were born outside Catalonia and in Catalonia. These data may be used as a basis for a strategy of hepatitis B prevention in Spain which include universal vaccination of adolescents, passive-active immunization of newborns to HBsAg positive mothers and vaccination of susceptible adults subjects from high-risk groups.Preventive Medicine Unit.Liver Unit.Corresponding author.     

Prevalence and risk factors of HIV,hepatitis B and hepatitis C in a forensic population of rapists and child molesters

The aim of the present study was to assess the prevalence as well as the possible risk factors of HIV, hepatitis B and hepatitis C, in 194 male prisoners who had been convicted for rape (n = 105) or child molestation (n = 89). HBsAg, HBeAg, anti-HBc, anti-HBs, anti-HCV and anti-HIV-1/2 were tested for. The participants also completed a standard sociodemographic questionnaire, indicating possible risk factors, the Barratt Impulsiveness Scale, and the life-time history of aggression. Anti-HIV antibodies were not found in any of the prisoners. HBsAg was found in 25 (13%), anti-HBc in 94 (49%), anti-HBs in 40 (21%) and anti-HCV in 13 (6.5%) subjects. Logistic regression analysis showed that anti-HCV positivity was associated with intravenous drug use (OR 20.7, 95% CI 1.1-4.9, P<0.001), while HBsAg positivity was associated separately with being foreign (OR 4.0, 95% CI 0.2-2.5, P<0.1), as well as with impulsiveness score (OR 1.06, 95% CI 0.01-0.11, P<0.02). The prevalence of HBV and HCV infection in this sex offender sample was highly increased in relation to the general population. Since it has been proved that sex offenders are a high-risk group for reoffending, monitoring their health is a necessary step towards prevention of sexually transmitted diseases being spread.     

Prevalence of blood-borne viral hepatitis in different communities in Yemen

It is generally believed that hepatitis B (HBV) and C (HCV) viruses are highly prevalent in the Republic of Yemen. This study investigated the prevalence of HBV and HCV markers in 494 blood donors from Aden, 493 blood donors from Sana'a, 97 residents from an African ethnic minority in Sana'a and 99 residents of Soqotra Island. There were significant differences in the prevalence of HBV carriage (HBsAg: 6.7, 15, 19.6 and 26.3% respectively; P < 0.001); past HBV infection (anti-HBc: 17.4, 18.5, 30.9 and 59.6% respectively; P < 0.001); susceptibility to HBV (absence of HBV markers: 73.3, 61.9, 38.1 and 9.1% respectively; P < 0.001), infectivity of HBV carriers (HBV DNA: 51.5, 33.8, 52.6 and 65.4% respectively; P = 0.028) and HCV antibodies (RIBA confirmed or indeterminate: 0.6, 0.2, 5.2 and 5.1% respectively; P < 0.001). A significant difference in HBV carrier rate and a borderline significant difference in the prevalence of natural infection was observed between males and females in the African community (P = 0.02 and 0.06 respectively). In contrast, in Soqotra Island, there was no significant sex difference in HBV carrier rate but susceptibility was significantly more prevalent in males (P = 0.03). This study illustrates that significant difference in prevalence and epidemiology exists among different communities within the same country, reflecting political, geographical and social differences. Control strategies should take these differences into account.     

Anti-hepatitis B core antibody is not required for prevaccination screening in healthcare workers

Vaccination against hepatitis B virus (HBV) is recommended for health care workers (HCWs), but it is not clear whether HBV vaccination is required for HCWs who have isolated antibody to hepatitis B core antigen (anti-HBc), or whether prevaccination screening for anti-HBc is needed in HCWs. Among 1812 HCWs, subjects with isolated anti-HBc and those with no HBV markers (control) were screened. The anamnestic response (antibody to hepatitis B surface antigen over 50 mIU/mL after the first vaccine injection) was compared prospectively between the two groups. The prevalence of isolated anti-HBc was 2.3%. Their anamnestic response was lower than that of controls (27.5% vs. 46.9%, P = 0.020). The subjects who had isolated anti-HBc were older and predominantly male, compared with the controls. Multivariate analysis revealed that age (odds ratio [OR], 0.67; confidence interval [CI], 0.51-0.90) and prior vaccination (OR, 3.36; CI, 2.04-5.54) were independent predictors of the anamnestic response, regardless of the anti-HBc status. Serum HBV DNA was not detected in any subject. Anti-HBs seroconversion was achieved in most of the anti-HBc-positive subjects after full vaccination, and the rate was comparable with controls (89.5% vs. 96.6%, P = 0.067). Isolated anti-HBc-positive HCWs are rare and most of them respond to vaccination. Anti-HBc testing is not a prerequisite for vaccination. This serology suggests a loss of acquired anti-HBs rather than occult HBV infection. Their reduced immunity to vaccination may be related to old age.     

Prevalence study of different hepatitis markers among pregnant Albanian refugees in Greece

Aim of the study was to record the prevalence of the various types of viral hepatitis, especially hepatitis B, in pregnant Albanian refugees in Greece. The study comprised 500 pregnant refugees of mean age 25:1 ± 4,6 years. In Albania, all women had lived in overcrowded houses and had been exposed to non throw-away needles and syringes. Various indices for all hepatitis types were determined. The prevalence of HBsAg was 13.4%, of anti-HBs 53%, of total anti-HBc 70.8%, of anti-HBc IgM 0.4%, of HBeAg 1.2%, of anti-HBe 58.6%, of anti-HAV 96.2%, of anti-HAV IgM 1%, of anti-HDV 0.4%, of anti-HCV 0.6% and of anti-HEV 2%. HBeAg was found positive in 7.5% of HBsAg carriers. Prevalence of hepatitis B markers, as determined by HBsAg and/or anti-HBs and/or total anti-HBc was significantly higher in those with a history of previous hospitalization in Albania (p = 0.01) and those with previous history of hepatitis (p = 0.02). The high prevalence of hepatitis B markers in pregnant Albanian refugees proves that HBV infection is highly endemic in Albania and the possibility of perinatal transmission to the offsprings urges for HBV vaccination programmes. On the other hand improvements in the socioeconomic conditions and the sanitation system in Albania is anticipated to reduce the incidence of HAV and HBV infections.     

Determinants of quitting smoking in Catalonia, Spain

OBJECTIVE: While trends in the prevalence of smoking and ex-smoking in Catalonia, Spain have been monitored, the characteristics of those smokers who quit have not been investigated. The aim of this investigation was to analyze the prevalence of cessation, or quit ratio, in Catalonia and to study its sociodemographic, life-style, and smoking correlates. SUBJECTS AND METHODS: We analyzed data collected in the Catalan Health Interview Survey conducted in 1994. This is a cross-sectional study based on a representative sample of the non-institutionalized population of Catalonia. We included for analysis a total of 5,424 subjects (3,649 males and 1,775 females) who declared to be current smokers (2,335 males and 1,331 females) or past smokers (1,314 males and 444 females). We computed the crude and age-standardized quit ratios (QR) or prevalence of cessation, as well as the odds ratio (OR) of quitting smoking, according to gender and the variables studied. RESULTS: The age-standardized QR was 31. 8% for males and 30.9% for females and increased with age. The QR was, both in males and females, greater among married subjects, with higher socioeconomic status, and with healthy life-styles (moderate and heavy leisure physical activity and moderate alcohol consumption). The OR of quitting smoking was higher in heavy smokers (OR = 2.9; 95% CI: 2.2-3.8; smokers of > 30 cigarettes/day vs. 1-10 cigarettes/day) in males, while it was < 1 for females of medium intensity, conforming a shaped curve rather than a linear trend (OR = 1.7; 95% CI: 1.0-2.9, in heavy smokers). CONCLUSIONS: This study confirms a positive association in males and females between quitting smoking and increasing age, a higher socioeconomic level, heavy smoking, and healthy life-styles. The identification of these groups should facilitate the planning of successful interventions. Further effort is also necessary to target groups with low cessation rates, such as individuals in disadvantaged social classes and light smokers.     

Right bundle branch block is not a predictor of coronary artery disease

Right bundle branch block (RBBB) is considered as an important predictor of poor outcome in patients with acute myocardial infarction, but the prognostic implication of RBBB in patients with suspected coronary artery disease (CAD) is unclear. Furthermore, the association between RBBB and incidence of CAD also its influence on the severity of stenosis in coronary arteries has not been established. This study was designed to assess the relationship between RBBB and the presence and the severity of CAD in patients with suspected CAD. The study population consisted of 172 patients with RBBB and 174 patients with normal resting electrocardiography (ECG). Severity of CAD was defined as estimated Gensini score according to the degree, quantity and distribution of lesions in angiographic study. According to our study based on angiographic investigations, in patients with RBBB the prevalence of CAD was 77.3 percent versus 70.1 percent in patients with normal resting ECG (P=0.13). Also, there was no significant association between the presence of RBBB and magnitude of Gensini score (OR=0.87, P=0.62). However, male gender and history of diabetes mellitus were associated with higher Gensini score (OR=3.41; 95% CI: 1.96-5.93, P<0.0001 and OR=3.22; 95% CI: 1.77-5.87, P<0.0001 respectively). This study suggests that although RBBB was associated with more severity of stenosis in left coronary system (LAD&LCX), but as a whole there was no association between RBBB and the presence and severity of CAD.     

Prevalence of chronic pain in adult workers

Chronic pain is a public health problem which causes personal and social losses. There are few epidemiological studies of chronic pain in Brazil and elsewhere in the world, especially those dealing with non-specific pain, in general population. The objectives of this study were: to identify the prevalence of chronic pain in adult workers; to analyze the prevalence of chronic pain according to gender, and local of pain. The sample was 505 workers at Londrina State University (Paraná, Brazil) (estimated prevalence = 50%, 4% error, and confidence interval = 95%). Data were collected by interviews. The prevalence of chronic pain was 61.4%; and it was significantly higher among women (p = 0.0001). The most prevalent locals of pain were: head (26.7%), lower back (19.4%) and limbs (13.3%).     

贵池区农村人群乙型肝炎的血清流行病学调查

目的了解池州市贵池区农村社区人群实施乙肝疫苗接种后HBV感染状况和抗体水平以及人群HBV感染的血清流行病学变动趋势。方法采用分层整群随机抽样方法,对贵池区3个乡镇的450名农村居民进行问卷调查,并用ELISA法开展HBV感染标志的血清学检测。结果贵池区农村人群HBV流行率为38.68%,标化后人群HBV流行率为37.34%,HBsAg、抗-HBs、抗-HBc阳性率分别是9.67%、42.22%、14.15%;20岁以上人群HBV流行率为46.08%,HBsAg、抗-HBs、抗-HBc阳性率分别是10.84%、35.84%、15.66%;而20岁以下人群分别为11.96%、5.43%、65.22%、8.70%,各项指标在两年龄组中分布差异有统计学意义。HBV的各血清学指标在男女性别中分布差异无统计学意义。HBV流行率、抗-HBs阳性率和HBsAg阳性率在有、无HepB接种史的人群中分布差异有统计学意义,接种乙肝疫苗后HBsAg阳性率、抗-HBc及HBV流行率均降低。结论接种乙肝疫苗是控制农村地区人群HBV感染的有效措施。     

Seroprevalence of hepatitis B and hepatitis C markers in adolescents in Southern Brazil

This study was carried out to determine the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) markers among adolescents aged between 10 and 16 years old, who are elementary school students in the city of Chapecó, Santa Catarina State, Brazil. The study involved a cross-sectional survey that included 418 volunteers, from March to July, 2008. Serology comprised HBsAg, anti-HBc, anti-HBs and anti-HCV. Tests were performed using automated Microparticle Enzyme Immunosorbant Assay (Abbott, AxSYM System, Wiesbaden, Germany). The prevalence of HBsAg was found to be 0.2% (95%CI: 0.0-1.3), and the prevalence of anti-HBc was found to be 1.4% (95%CI: 0.5-3.1). Regarding anti-HBs, 48.6% had titers greater than 10UI/L. None of the volunteers presented reactive results for anti-HCV. This study showed a low prevalence of HBV and HCV markers of infection and a great number of volunteers immunized against HBV. Finally this study shows the importance of proper health campaigns and policies in reducing those prevalences.     

Serum concentrations of micronutrient antioxidants in an adult Arab population

Serum concentrations of retinol, alpha-tocopherol, beta-carotene and lycopene were measured by reversed-phase high-performance liquid chromatography (r-P HPLC) in 260 randomly selected healthy adult Kuwaitis (159 men and 101 women) aged 18-63 years (mean 33.3 years) to established reference ranges of the micronutrient antioxidants. Total cholesterol concentrations were assayed by an enzymatic method to determine alpha-tocopherol: cholesterol ratios. The mean +/- SEM (micromol/L) for retinol, alpha-tocopherol, beta-carotene and lycopene were 1.76+/-0.02, 20.0+/-0.5, 0.52+/-0.03, 0.95+/-0.05, respectively. Compared to other populations, these data showed, on the whole, ordinary concentrations of beta-carotene, comparatively low concentrations of retinol and alpha-tocopherol and high concentrations of lycopene. Retinol concentrations were similar for both sexes, whereas alpha-tocopherol concentration was significantly (P < 0.0001) lower and the carotenoid levels (beta-carotene and lycopene) significantly higher (P < 0.0001) in women. Of the micronutrient antioxidants, alpha-tocopherol was most correlated with cholesterol (r = 0.492, P < 0.0001). beta-Carotene and lycopene were highly correlated with each other (r =0.744, P< 0.0001). Age was positively associated with beta-carotene (r = 0.214, P = 0.001) and lycopene (r = 239, P< 0.0001). Our data enabled us to establish a gender non-specific reference range for retinol and gender-specific reference ranges for alpha-tocopherol, beta-carotene and lycopene.