西藏自治区六岁以下儿童维生素A缺乏情况调查

目的 了解西藏自治区6岁以下儿童维生素A缺乏(VAD)情况。方法 采用分层整群随机抽样方法,将西藏分为城市、牧业县、农业县、半农半牧县4层,每层抽2个市或县进行调查。调查内容包括家庭一般状况、儿童喂养和疾病情况,收集儿童血清。血清维生素A(VA)含量检测采用微量荧光法。结果 共调查6岁以下儿童1257人,男635人,女622人,藏族占98．8％。2岁以上儿童836人,发现儿童夜盲症6例,结膜干燥症2例,儿童临床VAD患病率为0．96％。在1071名接受调查的母亲中,夜盲症18例(1．7％)。4类地区均发现有临床VAD病例。西藏儿童VA平均水平为1．09μmol／L,城市儿童(1．15μmol／L)和牧业县儿童(1．12μmol／L)显著高于农业县儿童(1．04μmol／L)和半农半牧县儿童(1．05μmol／L)。儿童亚临床VAD(血清VA≤0．70μmol／L)患病率：城市、牧业县、农业县和半农半牧县儿童分别为5．4％、4．7％、11．0％和12．3％,差异有显著性;0．5岁以下和0．5岁以上婴儿组亚临床VAD患病率分别为22．2％和13．3％,显著高于1岁以上各年龄组儿童(1岁为8．5％,2～3岁为5．4％,4～5岁为7．9％);男女儿童血清VA水平和亚临床VAD患病率的差异无显著性。结论 西藏儿童VAD情况较全国为轻,但农业县和半农半牧县属于中度亚临床VAD地区,需要对这些地区的儿童,特别是1岁以下的婴儿补充VA。     

北京和贵州地区儿童维生素A缺乏的影响因素分析

【目的】　了解北京和贵州地区儿童维生素A缺乏 (vitaminAdeficiency ,VAD)的现状和影响因素。　【方法】　从两地区各选择一市二县共 12 3 6名儿童 ,其中北京随机选择城区儿童 2 0 2名、农村儿童 42 6名 ;贵州随机选择城区儿童 2 0 7名、农村儿童 40 1名。各地调查儿童年龄范围均为 0～ 71个月。采用自行设计的膳食频率问卷表对每位被调查儿童询问调查前 1周儿童的饮食摄入情况 ,并采集儿童指血 2 0 0 μl,用微量荧光法检测血清VA值。 　【结果】　城区儿童血清VA水平 (平均 1.2 7μmol/L)明显高于农村 (平均 1.0 2 μmol/L) ;北京地区儿童血清VA水平(平均 1.17μmol/L)明显高于贵州地区 (平均 1.0 3 μmol/L)。各地区被调查儿童家庭收入也呈现贵州低于北京、农村低于城区的状况 ,儿童血清VA水平和家庭收入呈正相关 (r =0 .2 3 9,P <0 .0 1)。在所有调查地区中 ,贵州农村地区儿童血清VA水平最低 (平均 0 .92 μmol/L) ,家庭收入也最低 (年收入平均 180 0元 )。在调查的所有年龄组儿童中 ,婴儿组血清VA水平最低 ( 2 8.8μmol/L) ,可疑亚临床VAD发生率最高 ( 5 0 .0 %) ,血清VA水平与年龄呈正相关 (r =0 .13 2 ,P <0 .0 1)。儿童饮食摄入呈现明显的地区差异 ,动物性食品高摄入频率的比例北京地区高于贵州     

肺炎和腹泻患儿维生素A状况的分析

【目的】　探讨肺炎、腹泻患儿的维生素A(VA)状况并对其进行分析。　【方法】　用血清VA值评价 60例肺炎、85例腹泻患儿和 10 0名健康儿童的血清VA状况。用相对剂量反应 (RDR)深入研究患儿体内VA状况并对其进行多元回归分析。以血清VA <0 .7μmol/L ,RDR≥ 2 0 %为亚临床VA缺乏 (SVAD)诊断标准。 　【结果】　肺炎、腹泻患儿的血清VA值分别为 (1.0± 0 .4) μmol/L、(0 .7± 0 .4) μmol/L ,明显低于健康儿童 (1.9± 0 .6) μmol/L(P <0 .0 1)。肺炎、腹泻患儿的RDR均值分别为 2 3 %± 2 0 % ,2 3 %± 13 % ,SVAD检出率分别为 43 .3 %和 61.2 % (P <0 .0 5 )。肺炎患儿的RDR值和SVAD检出率以小年龄农村、发热组为高 (P <0 .0 5 )。腹泻患儿的RDR值和SVAD检出率以小年龄、脱水组为高 (P <0 .0 1)。多元回归分析提示 :家居农村发热是肺炎患儿 ,小年龄、热度高、脱水是腹泻患儿SVAD的影响因素。　【结论】　肺炎、腹泻患儿的血清VA状况劣于健康儿童。年龄小、家居农村、发热和脱水与其体内VA状况关系较密切     

学龄儿童维生素A营养状况及其与铁的相关性研究

为观察学龄儿童维生素A(VA)营养状况、亚临床VA缺乏患病率及VA与铁的相关性 ,对北京房山山区 1 0 1 2名 7～ 1 3岁学龄儿童进行膳食调查 ,随机抽取 30 5名儿童 ,静脉采血于避光下分离血清 ,用高效液相色谱法检测血清VA含量 ,同时测定其血清铁蛋白 (SF)、红细胞游离原卟啉 (FEP)和血红蛋白 (Hb) ,并依现行标准将其分为正常、铁缺乏 (ID)、红细胞生成缺铁期 (IDE)与缺铁性贫血 (IDA)四组 ,观察VA与铁的相关性。结果显示受检儿童膳食总能量、蛋白质和铁平均每日摄入量均达到膳食营养素的推荐摄入量 (RNI)及适宜摄入量 (AI) ,但平均每日VA摄入量为 (51 3 7± 2 86 1 ) μgRE ,仅占RNI的 59 7% ;血清VA平均含量为(1 0 1± 0 2 9) μmol L ,血清VA低于 1 0 5μmol L者占受检儿童的 59 0 % ,其中 1 2 8%的儿童血清VA低于0 70 μmol L ,正常及以上者仅占 41 0 %。并观察到血清VA含量与机体铁状况有相互随对方下降而减低的趋势。结果表明 ,该地区儿童存在明显的VA缺乏 ,应加强营养教育、改善不合理的膳食结构并通过适当的VA防治予以纠正     

中国裕固族7～12岁儿童维生素A水平检测分析

目的了解裕固族7～12岁儿童维生素A(vitamin A,VA)水平。方法按照整群分层抽样方法抽取甘肃省肃南裕固族自治县7～12岁儿童共184人作为研究对象,采用微量荧光测定法检测其血清中VA含量。结果该人群血清VA平均水平为1.44μmol/L,城市儿童为1.53μmol/L,明显高于农村儿童的1.30μmol/L;VA缺乏(VAD)0例;亚临床VA缺乏(SVAD)20例,占10.87%,其中城市10例,占9.09%,农村10例,占13.51%,男童8例,占8.70%,女童12例,占13.04%;可疑SVAD31例,占16.85%,其中城市19例,占17.27%,农村12例,占16.22%;男童14例,占15.22%;女童17例,占16.85%;不同地区儿童SVAD和可疑SVAD差异均无统计学意义。结论本调查未发现儿童VAD患者,但存在儿童SVAD患者;SVAD及可疑SVAD儿童患者应是今后VA缺乏防治的主要对象。     

0～6岁儿童骨密度与血清锌、铜、血铅关系的研究

【目的】　探讨 0～ 6岁儿童低骨密度与血清锌、铜、血铅的关系 ,为临床儿童低骨密度的预防提供依据。　【方法】　在本院儿保门诊 ,随机抽取己排除影响骨代谢性疾病的 0～ 6岁儿童 2 0 4名 ,用超声骨密度仪测胫骨中段骨密度 ,根据同年龄、同性别骨密度值的百分位数分成低骨密度组与正常对照组 ,同时测定血清锌、铜及全血铅。　【结果】　低骨密度组平均血清锌水平 ( 12 70 .5± 14 6.0 ) μmol/L低于对照组 ( 13 2 2 .1± 166.0 ) μmol/L ,差异有显著性(P <0 .0 5 ) ;锌缺乏患病率 ( 3 0 %)高于对照组 ( 18%) ,差异有显著性 (P <0 .0 5 ) ;低骨密度组平均血清铜值 ( 14 98.6±2 16.8) μmol/L ,稍低于对照组 ( 15 3 4.4± 2 3 0 .6) μmol/L ,但差异无显著性 (P >0 .0 5 ) ;两组铜缺乏患病率、血铅值、铅中毒患病率差异无统计学意义 (P >0 .0 5 )。　【结论】　 0～ 6岁儿童低骨密度的发生与锌缺乏有关 ,应加强儿童锌缺乏症的预防和治疗 ,以降低儿童低骨密度的发生。     

我国0～6岁儿童血清维生素A水平调查

【目的】　调查我国 0～ 6岁儿童的维生素A(VA)营养状况。　【方法】　以分层抽样法将全国划分为沿海、内地和边远三层 ,抽取 1 4个省、市、自治区的 8669名儿童进行问卷和血清VA含量测定。以FoxBase建立数据库 ,以Epinfo软件统计分析 ,计量资料用F、t检验和多元回归处理。　【结果】　儿童血清VA均值为(1 .0 6± 0 .33) μmol/L ,亚临床维生素A缺乏 (SVAD)患病率为 1 1 .7%。儿童血清VA水平随着年龄的增长 ,富含VA食物摄入频率的增加 ,所在地区呼吸道、发热、腹泻发病率的降低 ,家庭年人均收入和所在地区年人均国民生产总值 (GNP)的升高 ,母亲受教育程度的升高而逐渐升高(P均 <0 .0 0 0 )。儿童血清VA水平 ,取血前 2周内曾患呼吸道感染、发热、腹泻者明显低于未曾患病者。母亲是少数民族者明显低于母亲是汉族者 (P均 <0 .0 0 0 )。多元回归结果表明 :年龄小 ,未食用乳、蛋、鱼虾、肝炎、鱼肝油 ,曾患呼吸道感染、腹泻 ,所在地区及家庭经济状况差 ,母亲文化程度低 ,母亲为少数民族是其血清VA水平低下的危险因素。　【结论】　我国儿童血清VA含量尚处于较低水平     

中国东乡族和保安族114例7～14岁农村儿童维生素A水平对比分析

目的了解东乡族和保安族7～14岁农村儿童维生素A（vitaminA,VA）水平差异。方法按照整群分层抽样方法抽取东乡族民族聚居区（甘肃省东乡县）和保安族民族聚居区（甘肃省积石山县）7～14岁农村小学生各57例作为研究对象,采用微量荧光测定法检测血清中VA含量。结果东乡族农村儿童血清VA平均水平为（1.41±0.42）μmol/L,无维生素A缺乏（VAD）者,其中亚临床维生素A缺乏（SVAD）者4人（占7.0%）,可疑SVAD者10人（占17.6%）;保安族农村儿童血清VA平均水平为（1.67±0.53）μmol/L,无VAD者,其中SVAD者1人（占1.7%）,可疑SVAD者7人（占12.3%）;两民族间儿童血清VA水平差异有统计学意义。不同年龄组儿童血清VA健康状况构成比差异有统计学意义,不同民族的男性儿童VA水平间差异有统计学意义,男女儿童SVAD和可疑SVAD上差异无统计学意义。结论两民族学龄儿童较多的还是存在SVAD及可疑SVAD现象,患SVAD及可疑SVAD的儿童应该是今后VA缺乏防治的对象。     

铅中毒儿童矿物质和微量元素的变化

【目的】　探讨儿童铅中毒对机体矿物质和微量元素的影响。　【方法】　选择来医院就诊的 10 2 0例 0～ 18岁患儿为研究对象。根据铅中毒诊断标准 ,将患儿分为铅中毒组和对照组。患儿血铅、血清钙、铁、铜、锌和镁的测定采用原子吸收方法。　【结果】　铅中毒组血清铜和锌水平 [( 17.17± 3 .61) μmol/L和 ( 14 .3 6± 2 .5 0 ) μmol/L]均显著低于对照组 [( 17.96± 2 .91) μmol/L和 ( 15 .2 7± 2 .3 6) μmol/L] (P <0 .0 0 1) ,并且铅与铜和锌均存在显著负相关关系。对各年龄组 ( <1岁、1～ 5岁、6～ 12岁、13～ 18岁 )的比较发现 ,铅中毒组 6岁以上患儿血清铜、锌水平均低于同年龄对照组 ,2～ 5岁患儿仅血清锌低于对照组 ;<1岁患儿的微量元素在两组之间无差异。　【结论】　铅中毒使儿童机体微量元素铜和锌水平降低 ,这有助于指导儿童铅中毒的防治工作     

米索前列醇晚期妊娠引产对新生儿黄疸的影响

目的　探讨米索前列醇晚期妊娠引产对新生儿胆红素水平的影响。　方法　对 5 0例无药物引产者、 5 2例用缩宫素引产者和 5 3例用米索前列醇引产者之新生儿生后 2 4、 96h微量血清总胆红素水平进行对照研究。　结果　新生儿生后 2 4、 96h微量血清总胆红素无药物引产组为 (4 7 3±12 5 ) μmol/L和 (173 9± 4 1 6 ) μmol/L ,缩宫素引产组为 (5 5 8± 15 4 ) μmol/L和 (198 9±4 3 8) μmol/L ,米索前列醇引产组为 (6 4 2± 19 8) μmol/L和 (2 30 9± 4 4 5 ) μmol/L ,3组比较差异有显著性 (P <0 0 1) ;　结论　米索前列醇用于晚期妊娠引产可加重新生儿黄疸。     

A prevalence study of vitamin A deficiency and xerophthalmia in northeastern Thailand

An epidemiologic survey of the prevalence of xerophthalmia and vitamin A deficiency was conducted in May and June 1985 in a multistage random sample of 1,772 children 1-8 years of age from 16 rural villages and the capital city of the Sakon Nakhon province in northeastern Thailand. Data of clinical eye examinations were available for 92% (n = 903) of the eligible children aged 1-5 years (n = 982); history of night blindness was obtained from a reliable source from 93% (n = 1,644) of the whole sample; and biochemical data were available for 60% (1,060) of the children examined. The distribution of clinical signs of xerophthalmia and serum retinol levels differed between the rural and urban areas. In the urban area, no signs of xerophthalmia or deficient serum retinol levels were found in the preschool children examined. The prevalence of night blindness in the rural area was 1.3% in children aged 1-5 years (95% confidence interval (Cl) 0.7-1.9); Bitot's spots were seen in 0.4% (95% Cl 0.1-1.0); 12.7% (95% Cl 9.9-15.5) showed deficient serum retinol levels (less than 0.35 mumol/liter). Of the children aged 1-8 years, 9.6% (95% Cl 7.8-11.4) showed deficient serum retinol levels. In the rural area, the prevalence of night blindness, Bitot's spots, and deficient serum retinol levels indicates a problem of public health importance according to World Health Organization criteria.     

6岁以下儿童不同年龄间维生素A缺乏情况对比研究

目的:了解6岁以下儿童不同年龄间维生素A(VitA)缺乏发生率的分布特点。方法:采用随机抽样方法,对河北省的9个市县(城市3个,1类县1个,2类县3个,3类县2个)进行调查,内容包括家庭和儿童营养问卷,收集儿童血清。儿童血清VitA标本全部在首都儿科研究所用荧光分析仪检测。结果:9个市县共调查6岁以下儿童1473人(城市505人,农村968人,男773人,女700人)。血清VitA检测结果:6岁以下儿童血清维生素A含量平均水平为31.9μg/dl,血清维生素A含量<20μg/dl的肯定缺乏发生率为4.4%;6个月以内的婴儿VitA亚临床缺乏发生率为21.2%,可疑缺乏为56.1%。年龄有显著性差异。结论:河北省属于轻度维生素A缺乏地区,低年龄组儿童缺乏情况较严重,需要补充维生素A。     

2010年四川省儿童血清维生素A水平分析

目的 了解四川省儿童维生素A营养现状.方法 采用随机整群抽样方法,在四川省范围内抽取2 182名0～5岁儿童,采用高效液相色谱法检测其血清维生素A含量,评价维生素A缺乏状况.结果 四川省0～5岁儿童血清维生素A平均水平为0.39 μg/ml,城市为0.40 μg/ml,农村为0.38μg/ml,血清维生素A水平存在城乡和年龄差异.儿童血清维生素A缺乏和边缘缺乏率分别为4.95％及19.44％.结论 四川省儿童血清维生素A水平较高,维生素A缺乏率较低.边缘维生素A缺乏病是今后防治工作的重点.建议采取相应措施降低儿童维生素A缺乏.     

Prevalence of undernutrition and vitamin A deficiency in the Dogon Region,Mali

OBJECTIVES: A representative sample of 1510 preschool children living in the Bandiagra circle (Mopti Region, Mali) was examined between March and April 1997 to determine the level of vitamin A deficiency. METHODS: Using a randomized two level cluster sampling, 20 clusters of 75 children aged six months to six years were selected for evaluating xerophthalmia (XN night blindness and/or X1B Bitot spot). Concurrently stature and weight were determined. A semiquantitative seven-day dietary questionnaire was applied to the mothers of 484 infants to assess consumption of vitamin A rich foodstuffs. The prevalence of biochemical deficiency was attested using the Modified Relative Dose Response test (MRDR) on a sub-sample of 192. RESULTS: Of the studied children, 4.3% (95% Confidence interval [CI]: 3.2-5.3) reported night blindness and 2% (95% CI: 1.3-2.7) had Bitot spots. Prevalence of xerophthalmia attested by at least one of these signs was 5.4% (95% CI: 4.2-6.5). The prevalence reached 10.5% at three years of age. The MRDR test proved abnormal in 77.1% of the subjects (95% CI: 70.3-82.7). Serum retinol was lower than 0.35 micro mol/L in 43.8% (95.6% CI: 36.9-51.3) and less than 0.70 micro mol/L in 92.7% of the children (95% CI: 87.8-95.8). Weekly consumption of vitamin A rich food was rare: 75.8% had not eaten any animal vitamin A rich food, and 22.1% had consumed less than seven times a vitamin A rich food of either vegetable or animal origin. CONCLUSIONS: These data define vitamin A deficiency as a severe public health problem in the Bandiagara area of Mali.     

Vitamin A deficiency and xerophthalmia among school-aged children in Southeastern Asia

OBJECTIVE: To determine provisional estimates of the extent of vitamin A (VA) deficiency and xerophthalmia among school-aged children. DESIGN: Literature search of published, unpublished and website-based population survey and study reports, with country-specific imputation of prevalence rates and numbers of children affected by: (1) VA deficiency based on measured or imputed distributions of serum retinol concentration < 0.70 micromol/l (equivalent to < 20 microg/dl) and (2) xerophthalmia, by country. SETTING: Countries within the WHO South-East Asian Region. SUBJECTS: The target group for estimation was children 5-15 y of age. INTERVENTIONS: None. RESULTS: The estimated prevalence of VA deficiency is 23.4%, suggesting that there are approximately 83 million VA-deficient school-aged children in the region, of whom 10.9% (9 million, at an overall prevalence of 2.6%) have mild xerophthalmia (night blindness or Bitot's spot). Potentially blinding corneal xerophthalmia appears to be negligible at this age. CONCLUSIONS: VA deficiency, including mild xerophthalmia, appears to affect large numbers of school-aged children in South-East Asia. However, nationally representative data on the prevalence, risk factors and health consequences of VA deficiency among school-aged children are lacking within the region and globally, representing a future public health research priority.     

Plasma retinol-binding protein predicts plasma retinol concentration in both infected and uninfected Cameroonian women and children

Variation in the relationship between plasma retinol-binding protein (RBP) and retinol (ROH) has implications for vitamin A (VA) status assessment using RBP. Our objectives were to identify factors affecting the RBP:ROH relationship and to derive and evaluate population-specific RBP cutoffs for VA deficiency (VAD) in Cameroon. Plasma RBP, C-reactive protein (CRP), α1-acid-glycoprotein (AGP), and ROH concentrations were compared in a subsample of women 15-49 y (n = 121) and children 12-59 mo (n = 123) included in a national survey conducted in 2009. Plasma RBP and ROH were highly correlated (r = 0.94 for women; r = 0.96 for children; P < 0.001). Pregnancy and lactation altered the RBP:ROH relationship in women, but obesity, elevated CRP and AGP, age, and VA status did not. Among children, age altered the RBP:ROH relationship, but sex, stunting, VA status, and elevated CRP and AGP did not. Cutoffs for VAD derived using regression analysis were <1.17 μmol RBP/L for women (corresponding to <1.05 μmol ROH/L) and <0.83 μmol RBP/L for children (corresponding to <0.70 μmol ROH/L). The sensitivity and specificity of derived cutoffs were 81.8 and 93.0% for women and 94.7 and 88.9% for children, respectively. The infection-adjusted prevalence of low VA status (<1.17 μmol RBP/L) was 21.9% (95% CI = 18.7-25.0%) among women. Among children, the infection-adjusted prevalence of VAD (<0.83 μmol RBP/L) was 35.0% (95% CI = 31.1-39.0%). In conclusion, VAD remains a public health problem in Cameroon. The RBP:ROH relationship should be considered in surveys using RBP to assess VA status, and use of population-specific cutoffs may be advisable.     

Vitamin A deficiency is prevalent in children less than 5 y of age in Nigeria

Vitamin A deficiency (VAD) is a serious and widespread public health problem in developing countries. We conducted a nationwide food consumption and nutrition survey in Nigeria to help fomulate strategies to address VAD, among other deficiencies. One objectives was to assess the vitamin A status of children <5 y old. A total of 6480 households with a mother and child <5 y old were randomly sampled. Blood samples were collected by venipuncture and processed to obtain serum for measurement of retinol concentration by HPLC. Nationwide, 29.5% of children <5 y old were vitamin A deficient (serum retinol <0.70 micromol/L). The proportions of children with VAD differed among the agroecological zones; incidences were 31.3% in the dry savanna, 24.0% in the moist savanna, and 29.9% in the humid forest (P < 0.001). More children (P < 0.05) with severe deficiency (serum retinol < 0.35 micromol/L) lived in the humid forest (7.1%) than in the dry (3.1%) or moist savanna (2.4%). The distribution of VA in children <5 y old was 25.6% in the rural sector, 32.6% in the medium, and 25.9% in the urban sector (P < 0.05). In conclusion, VAD is a severe public health problem in Nigeria. Although the proportion of children with low serum vitamin A levels varies agroecologically and across sectors, it is an important public health problem in all zones and sectors.     

Prevalence of Undernutrition and Vitamin A Deficiency in the Dogon Region,Mali

Objectives: A representative sample of 1510 preschool children living in the Bandiagra circle (Mopti Region, Mali) was examined between March and April 1997 to determine the level of vitamin A deficiency.

Methods: Using a randomized two level cluster sampling, 20 clusters of 75 children aged six months to six years were selected for evaluating xerophthalmia (XN night blindness and/or X1B Bitot spot). Concurrently stature and weight were determined. A semiquantitative seven-day dietary questionnaire was applied to the mothers of 484 infants to assess consumption of vitamin A rich foodstuffs. The prevalence of biochemical deficiency was attested using the Modified Relative Dose Response test (MRDR) on a sub-sample of 192.

Results: Of the studied children, 4.3% (95% Confidence interval [CI]: 3.2–5.3) reported night blindness and 2% (95% CI: 1.3–2.7) had Bitot spots. Prevalence of xerophthalmia attested by at least one of these signs was 5.4% (95% CI: 4.2–6.5). The prevalence reached 10.5% at three years of age. The MRDR test proved abnormal in 77.1% of the subjects (95% CI: 70.3–82.7). Serum retinol was lower than 0.35 μmol/L in 43.8% (95.6% CI: 36.9–51.3) and less than 0.70 μmol/L in 92.7% of the children (95% CI: 87.8–95.8). Weekly consumption of vitamin A rich food was rare: 75.8% had not eaten any animal vitamin A rich food, and 22.1% had consumed less than seven times a vitamin A rich food of either vegetable or animal origin.

Conclusions: These data define vitamin A deficiency as a severe public health problem in the Bandiagara area of Mali.     

Mild vitamin A deficiency and childhood morbidity--an Indian experience

Over 1500 preschool urban Indian children were followed weekly for morbidity from 12 to 18 mo. Examination for mild xerophthalmia (Bitot's spots and night blindness) was done initially and at 6 and 12 mo. Children with mild xerophthalmia at the start of a 6-mo interval developed respiratory disease in the interval twice as often as children with normal eyes at the start of the interval. No association was found between mild xerophthalmia and incidence of diarrhea.