不同补铁方式改善铁缺乏儿童Hb的荟萃分析

王波,詹思延,夏惜惜,等.乙二胺四乙酸铁钠改善铁缺乏人群血红蛋白水平的系统综述[J].中华流行病学杂志,2008,29(1):65-70.

Higgins J P T,Green S.Cochrane handbook for systematic reviews of interventions Version 4.2.6(updated September 2006)[Z].UK:John Wiley & Sons Ltd,2006.

>>更多...     

关于关键词的标引

正我刊要求文稿需标引2～5个关键词,请使用中国医学科学院信息研究所的中文医学主题词表(CmeSH)所列的词或登录万方医学网:http//med.wanfangdata.com.cn/mesh/mesh.aspx查找。如果查找不到相应的关键词,处理方法有:     

关于“关键词”的标引

正我刊要求文稿需标引2～5个关键词,请使用中国医学科学院信息研究所的中文医学主题词表(CmeSH)所列的词或登录万方医学网:http//med.wanfangdata.com.cn/mesh/mesh.aspx查找。如果找不到相应的关键词,可按如下方法处理:(1)可选用直接     

关于关键词的标引CSCD

本刊要求论著类文章需标引3~8个关键词。请使用中国医学科学院医学信息研究所的《中文医学主题词表》(CmeSH)所列的词,或登录万方医学网:http://med.wanfangdata.com.cn/Mesh/Mesh.aspx查找。如果查不到相应的关键词,处理办法有:(1)可选用直接相关的几个主题词进行组配。(2)可根据树状结构表选用最直接的上位主题词。     

关于关键词的标引

正我刊要求文稿需标引2～5个关键词,请使用中国医学科学院信息研究所的中文医学主题词表(CmeSH)所列的词或登录万方医学网:http//med.wanfangdata.com.cn/mesh/mesh.aspx查找。如果查找不到相应的关键词,处理方法有:(1)可选用直接相关的几个主题词进行组配。     

关于关键词的标引

正我刊要求文稿需标引2～5个关键词,请使用中国医学科学院信息研究所的中文医学主题词表(CmeSH)所列的词或登录万方医学网:http//med.wanfangdata.com.cn/mesh/mesh.aspx查找。如果查找不到相应的关键词,处理方法有:(1)可选用直接相关的几个主题词进行组配。(2)可根据树状结构表选用     

编辑部通知 网上投稿和审稿系统启用新网址公告

<正>因网络服务器变更,由四川省疾病预防控制中心主办的《职业卫生与病伤》杂志,其在线投稿和审稿系统,从2013年9月3日起启用"新网址"。"新网址"的投稿和审稿系统与原"老网址"保持不变。投稿新网址为:http://author.sccdpc.gov.cn/AuthorLogin.aspx审稿新网址为:http://editor.sccdpc.gov.cn/EditorLogin.aspx经过2个月时间的过渡期后,在线投稿和审稿系统原"老网址"即投稿老网址http://author.docoa.com.cn,和审稿老网址http://editor.docoa.com.cn。     

关于关键词的标引

<正>我刊要求文稿需标引2～5个关键词,请使用中国医学科学院信息研究所的中文医学主题词表(Cme SH)所列的词,或登录万方医学网:http//med.wanfangdata.com.cn/mesh/mesh.aspx查找。如果查找不到相应的关键词,处理办法有:(1)可选用直接相关的几个主题词进行组配。(2)可根据树状结构表选用最直接的上     

关于关键词的标引CSCD

本刊要求论著类文章需标引3~8个关键词。请使用中国医学科学院医学信息研究所的《中文医学主题词表》(CmeSH)所列的词,或登录万方医学网:http:/med.wanfangdata.com.cn/Mesh/Mesh.aspx查找。如果查不到相应的关键词,处理办法有:(1)可选用直接相关的几个主题词进行组配。     

关于“关键词”的标引

正我刊要求文稿需标引2～5个关键词,请使用中国医学科学院信息研究所的中文医学主题词表(CmeSH)所列的词或登录万方医学网:http//med.wanfangdata.com.cn/mesh/mesh.aspx查找。如果找不到相应的关键词,可按如下方法处理:(1)可选用直接相关的几个主题词进行组配。(2)可根据树状结构表选用最直接的上位主题词。(3)必要     

乙二胺四乙酸铁钠改善铁缺乏人群血红蛋白水平的系统综述

目的评价乙二胺四乙酸铁钠（NaFeEDTA）改善铁缺乏人群血红蛋白水平的效果。方法通过检索电子数据库、手工检索相关期刊书籍、收集灰色文献、查找会议摘要、联系相关领域专家，并通过查找参考文献进行全面的文献检索；使用Cochrane EPOC制定的标准对纳入研究的质量进行了评价；使用广义倒方差法对各结局的纳入研究进行Meta分析。结果在铁缺乏人群，NaFeEDTA使血红蛋白浓度增加12．14g／L（加权均差；95％CI：5．60-18．69；P〈0．001）。亚组分析提示更低的基线血红蛋白浓度、更高的干预剂量可能导致更大的血红蛋白浓度增加。结论NaFeEDTA可以有效改善铁缺乏人群的血红蛋白浓度。     

Effect of sodium iron ethylenediaminetetra-acetate (NaFeEDTA) on haemoglobin and serum ferritin in iron-deficient populations: a systematic review and meta-analysis of randomised and quasi-randomised controlled trials

We aimed to synthesise evidence to assess the effect and safety of NaFeEDTA on Hb and serum ferritin in Fe-deficient populations. We performed a systematic review, identifying potential studies by searching the electronic databases of Medline, Cochrane Library, Embase, WHO Library and China National Knowledge Infrastructure. We also hand-searched relevant conference proceedings and reference lists. Finally, we contacted experts in the field. The selection criteria included randomised or quasi-randomised controlled trials of NaFeEDTA compared with placebo. Hb, serum ferritin and adverse effects were outcomes of interest. Inclusion decisions, quality assessment and data extraction were performed by two reviewers independently. Seven studies met the inclusion criteria. All included studies assessed the effect of NaFeEDTA on Hb concentration, four studies assessed the effect on serum ferritin concentration, and one study on serum Zn concentration. After the intervention, Hb concentration and serum ferritin concentration were both higher in the NaFeEDTA group compared with the control group. For Hb, data from six studies could be pooled and the pooled estimate (weighted mean difference) was 8.56 (95 % CI 2.21, 14.90) g/l (P = 0.008). For serum ferritin, data from four studies could be pooled and the pooled difference was 1.58 (95 % CI 1.20, 2.09) microg/l (P < 0.001). Subgroup analysis indicated that a lower baseline Hb level was associated with a greater increase in Hb concentration. No significant difference in serum Zn concentration was found. We concluded that NaFeEDTA increased both Hb concentration and serum ferritin concentration substantially in Fe-deficient populations, and could be an effective Fe preparation to combat Fe deficiency.     

NaFeEDTA强化酱油对铁缺乏的防治效果——人群干预试验

在过去研究人体铁吸收率和对贫血儿童的治疗试验的基础上 ,观察NaFeEDTA强化酱油在自然高危人群中纠正铁缺乏的效果及可接受性。在贵州省毕节市海子街镇用双盲安慰剂对照法 ,在 14 0 0 0名 3岁以上人群中进行为期 18个月的NaFeEDTA强化酱油 (Fe 2 96mg铁 L)干预试验。观察指标包括 :血红蛋白、红细胞压积、血浆铁蛋白和维生素A、膳食、体格测量、智力发育和身体耐力。干预组平均每人每天消费 16 5ml酱油 ,其中含 4 9mg来自NaFeEDTA的铁。与对照人群相比 ,干预人群中各年龄 -性别组的血红蛋白水平明显升高、贫血率明显下降、血浆铁蛋白明显升高 ;3～ 6岁儿童身高和体重明显改善。而同时 ,两组食物消费与试验前无明显差别。NaFeEDTA强化酱油对于纠正铁缺乏、降低贫血率以及改善儿童生长发育有明显效果。同时 ,试验参加者一致反映铁强化酱油的感官性状良好 ,可接受性良好。     

Effects of wheat flour fortified with different iron fortificants on iron status and anemia prevalence in iron deficient anemic students in Northern China

OBJECTIVES: To compare the effects of wheat flours fortified with NaFeEDTA, FeSO4 and elemental iron (electrolytic iron), in improving iron status in anemic students. METHODS: Four hundreds anemic students (11 to 18 years old) were divided into four groups and given wheat flour fortified with different iron fortificants at different concentrations: control group (no added iron); NaFeEDTA group (20 mg Fe/kg); FeSO4 group (30 mg Fe/kg); and elemental iron group (60 mg Fe/kg). The trial lasted for 6 months and the following parameters were examined every 2 months: whole blood hemoglobin, free erythrocyte protoporphyrin, serum ferritin, serum iron, total iron binding capacity and transferrin receptor. RESULTS: The flour consumption in the 4 groups was 300-400 g/person/day, accounted for 70% of total cereal consumption in the diets. There were no significant differences in flour consumption among the 4 groups. Blood hemoglobin level increased in all the 3 intervened groups, but the increment in the NaFeEDTA group was significantly higher and earlier than the other 2 groups; and only 1% of the subjected remained anemic at the end of the trial in the NaFeEDTA group, while 40% and 60% of the subjects in the FeSO4 and electrolytic iron group remained anemic, respectively. The order of improvements in free erythrocyte protoporphyrin, serum ferritin and transferring receptor levels were: NaFeEDTA > FeSO4 > electrolytic iron. No significant changes were found in the control group on all the tested parameters during the trial. CONCLUSIONS: The results indicated that even NaFeEDTA was added at a lower level, it has better effects than FeSO4 and elemental iron on controlling iron deficiency anemia and improving iron status in anemic children; while elemental iron was the least effective.     

Fortifying brown bread with sodium iron EDTA, ferrous fumarate, or electrolytic iron does not affect iron status in South African schoolchildren

The choice of iron fortificant usually represents a balance between bioavailability of the compound and its tendency to cause organoleptic problems. The aim of this study was to evaluate the efficacy of sodium iron EDTA (NaFeEDTA) and ferrous fumarate at levels compatible with South African brown bread (10 mg/kg flour for NaFeEDTA and 20 mg/kg flour for ferrous fumarate) in a randomized controlled trial; electrolytic iron was evaluated at the level currently used in South Africa (35 mg/kg flour). Schoolchildren (n = 361), aged 6-11 y, from a low socioeconomic community with hemoglobin (Hb) < or = 125 g/L were randomly assigned to 1 of 4 groups that received 4 slices of brown bread supplying either: 1) no fortification iron 2) 2.35 mg iron as NaFeEDTA; 3) 4.70 mg iron as ferrous fumarate; and 4) 8.30 mg iron as electrolytic iron per intervention day. These amounts simulated a bread intake of 6 slices per day over the 34-wk study period at fortification levels of 0, 10, 20, and 35 mg/kg flour, respectively. Hb concentration and iron status were assessed at baseline and after 34 wk of intervention. The iron interventions did not affect Hb concentration, transferrin saturation, or serum ferritin, iron, or transferrin receptor concentrations relative to the control group. Our results suggest that electrolytic iron at the level currently used in South Africa is not effective in improving iron or Hb status. Neither do NaFeEDTA or ferrous fumarate appear to be suitable alternatives for the fortification of wheat flour when included at levels that do not cause color changes.     

乙二胺四乙酸铁钠与硫酸亚铁改善铁缺乏的效果比较:对照试验的系统评价

[目的]比较NaFeEDTA与FeSO4改善铁缺乏的效果。[方法]通过检索电子数据库、手工检索相关期刊与书籍、查找会议摘要、联系相关领域专家,并通过查找参考文献进行了全面的文献检索;使用CochraneEPOC制定的标准对纳入研究的质量进行了评价;使用广义倒方差法进行Meta分析。[结果]2项有对照的前后比较研究符合纳入标准。Meta分析显示,与FeSO4组相比NaFeEDTA组具有更高的血红蛋白浓度(加权均差7.01g/L,95%可信区间3.57～10.45;P﹤0.0001)、更低的铁缺乏性贫血患病率(率差-26%,95%可信区间-44%～-8%;P=0.004)。[结论]NaFeEDTA改善铁缺乏的效果很可能优于FeSO4,足够强度的证据还需随机对照试验的支持。     

Iron deficiency, pregnancy and breast-feeding in the Republic of Niger

Body iron stores in 173 African women were evaluated by serum ferritin radioimmunoassay. The population studied was selected only by its accessibility in Guesheme, Dosso county, and other villages in Niamey and Dosso counties, Republic of niger. Iron fumarate (Fumafer) was systematically administered orally (400 mg/d) for one month. 95 women were revisited at the end of treatment. 22% of revisited women were iron deficient before treatment (serum ferritin less than 12 ng/ml); after one month of treatment only 8% had serum ferritin below the threshold value of 12 ng/ml, in spite of the low doses of iron fumarate administration; and the response to treatment was more significant in multiparous women. These results emphasize the very high prevalence of iron deficiency in the population studied, and demonstrate the need for systematic iron treatment of the multiparous women living in rural areas. The efficacy of low doses of iron fumarate is clear.     

探讨建立江苏地区健康人群血清铁蛋白参考区间

目的调查分析江苏地区健康人群血清铁蛋白水平,探讨江苏地区人群铁蛋白参考区间。 方法回顾性分析24 803例江苏地区2017年1月至12月间送检到我中心使用化学发光免疫分析法检测的体检人群血清铁蛋白结果。将统计人群按照性别、年龄分组,使用SPSS软件进行统计分析,比较各分组的平均铁蛋白水平。 结果江苏地区健康成人血清铁蛋白水平呈偏态分布,不同性别、不同年龄组间血清铁蛋白水平有差异,经统计得出的的男性血清铁蛋白参考区间为：18~30岁(8.30~373.02 ng/ml)、31~40岁(11.88~481.60 ng/ml)、41~50岁(19.34~497.34 ng/ml)、51~65岁(15.05~495.41 ng/ml)、大于65岁(16.01~511.48 ng/ml),其中18~30岁及30岁以上人群组铁蛋白水平有统计学差异;女性血清铁蛋白参考区间为：18~30岁(7.44~181.76 ng/ml)、31~40岁(5.51~193.91 ng/ml)、41~50岁(4.33~218.88 ng/ml)、51~65岁(7.23~404.37 ng/ml)、大于65岁(7.36~449.67 ng/ml),其中18~50岁及50岁以上人群组铁蛋白水平有统计学差异。 结论影响铁蛋白浓度的原因除了性别外,铁蛋白水平随年龄递增呈现升高趋势,各地区实验室应建立不同性别及年龄区间的铁蛋白参考区间,从而为临床诊断提供可靠的检测数据。     

Sodium iron NaFeEDTA as an iron fortification compound in Central America. Absorption studies.

Studies were performed in seven children and 98 adults to compare the proportion of iron absorbed when administered as ferric sulfate (Fe2(SO4)3), NaFeEDTA, hemoglobin (Hb), and ferrous ascorbate. Studies in children (mostly iron deficient) showed that when the compounds were given with a milk-rice-sugar formula totalling 5 mg Fe, iron from hemoglobin was absorbed best, followed by NaFeEDTA and by Fe2(SO4)3 (mean percent absorption +/-SD = 34.5 +/- 1.5, 8.6 +/- 1.9 and 3.3 +/- 1.5, respectively). Studies in normal or iron deficient adults also demonstrated a better absorption of iron from NaFeEDTA than from Fe2(SO4)3 whether these compounds were given in an aqueous solution (5 mg Fe) or with a standard meal consisting of beans, tortillas, bread, and coffee providing also a total of 5 mg Fe. Hb iron under the same conditions was absorbed in the same proportion to the reference iron ascorbate, always being higher than iron absorbed from the other compounds. Fe2(SO4)3 and NaFeEDTA mixed in the same meal were absorbed in the same proportion as when NaFeEDTA alone was added to the meal and 2 to 3 times better than when Fe2(SO4)3 alone was added to the meal. Addition of desferrioxamine depressed iron absorption from Fe2(SO4)3 and NaFeEDTA, the latter being less affected. Addition of ascorbic acid increased absorption from both. When the compounds were added to the meal to provide 50 mg of iron, percent absorption was depressed in relation to the smaller iron dose in the case of Fe2(SO4)3 and Hb but remained unaltered in the case of NaFeEDTA. Addition of 45 mg Fe as Fe2(SO4)3 or NaFeEDTA to 0.4 mg Fe from the Hb in the meal did not change Hb iron absorption. Addition of 45 mg Fe as Hb or NaFeEDTA to 0.4 mg Fe from Fe2(SO4)3 in the meal enhanced iron absorption from the latter in the same proportions. Addition of 45 mg Fe as Fe2(SO4)3 and Hb to 0.4 mg Fe as NaFeEDTA in the meal respectively depressed and enhanced iron absorption from NaFeEDTA. These studies indicate that NaFeEDTA, Fe2(SO4)3 and nonheme food iron from a common pool different from the heme pool but which is changed in its characteristics by the presence of NaFeEDTA, resulting in a better absorption of iron.     

Fortification iron as ferrous sulfate plus ascorbic acid is more rapidly absorbed than as sodium iron EDTA but neither increases serum nontransferrin-bound iron in women

The absorption profile of iron fortificants may be a determinant of their ability to generate nontransferrin-bound iron (NTBI) and, thus, their potential safety. Ferrous iron may be absorbed more rapidly than chelated ferric iron, but differences at the fortification level cannot be distinguished with nonisotopically labeled serum iron curves. Using stable isotope appearance curves (SIAC) in serum, we measured iron absorption profiles from FeSO(4) with ascorbic acid (AA) and from NaFeEDTA, as well as the serum hepcidin and NTBI response following the meals. Healthy women (n = 16) were given 6 mg oral iron as labeled FeSO(4) and NaFeEDTA with a maize porridge using a crossover design. SIAC, NTBI, and serum hepcidin were measured over 8 h after the meal. Iron from FeSO(4) plus AA was more rapidly absorbed, resulting in a 35% greater relative AUC during the first 2 h than for NaFeEDTA (P < 0.001). Median (95% CI) fractional iron absorption from the FeSO(4)- and NaFeEDTA-fortified meals was 15.2% (11.0-19.5) and 6.0% (5.0-9.2), respectively (P < 0.001). In response to the FeSO(4)-fortified meal, there was an ~60% increase in median serum hepcidin (P < 0.05) but no significant change in NTBI. There was no significant change in serum hepcidin or NTBI after the NaFeEDTA-fortified meal. SIAC are a useful new tool to compare iron absorption profiles from different iron compounds in fortified foods. Even with the use of a very well absorbed ferrous iron compound, iron fortification in this population does not increase NTBI, suggesting a low risk for adverse health consequences.