维生素A、D、E与儿童反复呼吸道感染相关性的病例对照研究

目的探讨血清维生素A、D、E水平与儿童反复呼吸道感染(RRTI)的相关性,为RRTI的防治提供更多理论依据。方法选择于2016年9月-2018年8月在哈尔滨市儿童医院呼吸内科/儿童保健门诊就诊的1 200名0.5～14岁儿童为研究对象,其中RRTI组600名儿童(就诊时存在呼吸道感染症状),对照组600名儿童按病例对照原则与RRTI组进行1∶1匹配。将儿童的一般资料和血液检查结果纳入logistic回归模型检验,探讨维生素A、D、E与RRTI的相关性,以ROC曲线确定最佳截断值。结果 RRTI组儿童的血清维生素A、E和25(OH)D水平低于对照组,差异均具有统计学意义(t分别为6.85, 7.15和9.50,P均<0.001);在校正了性别、年龄、年龄别身高、年龄别体重、年龄别身体质量指数和血红蛋白后,VA不足(OR=1.669, 95%CI:1.032～2.700))、VA缺乏(OR=1.502, 95%CI:1.173～1.924)、VD缺乏(OR=2.356, 95%CI:1.798～3.088)、VD严重缺乏(OR=1.595, 95%CI:1.147～2.219)和VE...     

Flour fortification with iron: a mid-term evaluation

OBJECTIVES: Iron-deficiency anaemia is a major nutritional problem in Iran. A programme of flour fortification with iron was launched in 2001. A mid-term evaluation was conducted in 2004 to determine the effectiveness and coverage of this programme. METHODS: To determine the effectiveness of the program, a field trial was conducted in which blood hemoglobin and ferritin levels were measured in a sample population from Bushehr (intervention) and Fars (control) provinces. The target population was women aged 15-49 years. The coverage of the programme was determined using a cross-sectional study that measured iron content in samples of flour and bread from Bushehr province. RESULTS: Five hundred and sixty-seven and 296 women were studied in the intervention and control provinces, respectively. Women in the intervention province had a lower prevalence of low ferritin levels compared with women in the control province (P=0.04). Women from the two provinces did not differ in terms of haemoglobin levels and iron-deficiency anaemia. The coverage of fortified flour and bread was 100% and 99.7%, respectively. CONCLUSIONS: This mid-term evaluation found that the iron fortification programme in Iran has only had a beneficial effect on the prevalence of low ferritin levels. The final evaluation is likely to provide more useful information regarding the effect of this programme on a number of anaemia indicators.     

Giardiasis as a predictor of childhood malnutrition in Orang Asli children in Malaysia

A cross-sectional study to examine the association of giardiasis with protein-energy malnutrition, vitamin A deficiency and iron deficiency anaemia was conducted among Orang Asli children in Selangor, Malaysia. A total of 281 children aged 2-15 years were studied. The data were collected using structured questionnaires, anthropometric measurements and laboratory analysis of blood and faecal samples. The results showed that 24.9% of the children were infected with Giardia duodenalis, while 56.5, 61.3 and 15.1% had significant underweight, stunting and wasting, respectively. Giardiasis was statistically identified as a strong predictor of significant wasting in this study population.     

早发型子痫前期患者维生素A、维生素E、辅助性T细胞水平及相关危险因素分析

目的:观察早发型子痫前期(PE)患者维生素A、维生素E及辅助性T细胞的变化,分析相关危险因素。方法:收集2016年12月-2018年5月本院正常妊娠孕妇2650例,早发型子痫前期孕妇350例。取所有孕妇外周静脉血,检测维生素A、维生素E、辅助性T细胞水平,分析可能影响早发型子痫前期因素。结果:子痫前期组孕妇血清维生素A(0.24±0.15mg/L)、维生素E(4.92±2.31mg/L)低于正常组(0.47±0.18mg/L、10.75±4.57 mg/L),血液中Th(21.01±3.96%)、Th1/Th2(20.41±5.75)高于正常组(12.31±2.50%、7.93±1.46),Th2(1.04±0.17%)低于正常组(1.60±0.29%)(均P<0.05)。多胎妊娠、年龄≥35岁、有内科合并症、维生素E缺乏、产前体质指数异常是早发型子痫前期发病的独立危险因素。结论:早发型PE孕妇体内维生素A、维生素E缺乏,且机体免疫平衡出现紊乱,多胎妊娠、年龄≥35、有内科合并症、维生素E缺乏、产前体质指数异常为早发型PE的危险因素,在临床应予以重视。     

Vitamins and iron blood biomarkers are associated with blood pressure levels in European adolescents. The HELENA study

ObjectivesPrevious research showed that low concentration of biomarkers in the blood during adolescence (i.e., iron status; retinol; and vitamins B₆, B₁₂, C, and D) may be involved in the early stages of development of many chronic diseases, such as hypertension. The aim was to evaluate if iron biomarkers and vitamins in the blood are associated with blood pressure in European adolescents.MethodsParticipants from the Healthy Lifestyle in Europe by Nutrition in Adolescence cross-sectional study (N = 1089; 12.5–17.5 y; 580 girls) were selected by complex sampling. Multilevel linear regression models examined the associations between iron biomarkers and vitamins in the blood and blood pressure; the analyses were stratified by sex and adjusted for contextual and individual potential confounders.ResultsA positive association was found in girls between RBC folate concentration and systolic blood pressure (SBP) (β = 3.19; 95% confidence interval [CI], 0.61–5.77), although no association between the vitamin serum biomarkers concentrations and diastolic blood pressure (DBP) was found. In boys, retinol was positively associated with DBP (β = 3.84; 95% CI, 0.51–7.17) and vitamin B₆ was positively associated with SBP (β = 3.82; 95% CI, 1.46–6.18). In contrast, holotranscobalamin was inversely associated with SBP (β = −3.74; 95% CI, −7.28 to −0.21).ConclusionsLevels of RBC folate and vitamin B₆ in blood may affect BP in adolescents. In this context, programs aimed at avoiding high BP levels should promote healthy eating behavior by focusing on the promotion of vegetable proteins and foods rich in vitamin B₁₂ (i.e., white meat and eggs), which may help to achieve BP blood control in adolescents.     

维生素E、C联用对老年正常血脂冠心病氧化修饰低密度脂蛋白及血小板活化状态的影响

目的：探讨老年正常血脂冠心病患者体内低密度脂蛋白（ＬＤＬ）氧化修饰状态,及氧化修饰低密度蛋白（Ｏｘ－ＬＤＬ）与血小板活化状态的关系。方法：选择心病组和正常组各２６全色Ｏｘ－ＬＤＬ、血小板膜α－颗粒膜蛋白（ＧＭＰ－１４０）、血栓素Ｂ２（ＴＸＢ２）为指标,在冠心病组服用维生素Ｅ、Ｃ前及一个月后比较上述各指标的变化。结果：实验发现,正常血脂老年冠心病组血浆Ｏｘ－ＬＤＬ、ＴＸＢ２浓度,ＧＭＰ－１４０水平较     

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 simultaneous supplementation of vitamin A and iron on diarrheal and respiratory tract infection in preschool children in Chengdu City,China

ObjectiveThe goal of this study was to investigate whether vitamin A combined with iron supplementation for preschool children resulted in improved changes in children's infectious morbidity.MethodIn this randomized placebo-controlled and blinded field intervention trial, totally 445 preschoolers, ages 3 to 6 y old, were randomly selected. All children were randomly divided into four groups: vitamin A supplement-only group (group I), iron supplement-only group (group II), vitamin A and iron supplement group (group III), and no vitamin A and ferrous sulfate as placebo-control (group IV) for 6 mo. The morbidity of diarrhea and respiratory infections, were collected during supplementation.ResultsThere was evidence of the lowest incidence rate of respiratory-related illnesses and fewest symptoms of runny nose, cough, and fever for children in group III compared with children in groups I, II and IV (P < 0.05). Moreover, despite the undistinguished incidence rate of vomiting, nausea, and stomach pain, the rate of diarrhea-related illness was significantly lower for children in group III than for those in the other three groups.ConclusionThe beneficial affects on infectious morbidity over 6 mo, highlight the potential of vitamin A plus an iron supplement for preschool-aged children.     

Low iron stores are related to higher blood concentrations of manganese, cobalt and cadmium in non-smoking, Norwegian women in the HUNT 2 study

Low iron (Fe) stores may influence absorption or transport of divalent metals in blood. To obtain more knowledge about such associations, the divalent metal ions cadmium (Cd), manganese (Mn), cobalt (Co), copper (Cu), zinc (Zn) and lead (Pb) and parameters of Fe metabolism (serum ferritin, haemoglobin (Hb) and transferrin) were investigated in 448 healthy, menstruating non-smoking women, age 20-55 years (mean 38 years), participating in the Norwegian HUNT 2 study.The study population was stratified for serum ferritin: 257 were iron-depleted (serum ferritin <12 μg/L) and 84 had iron deficiency anaemia (serum ferritin <12 μg/L and Hb<120 g/L). The low ferritin group had increased blood concentrations of Mn, Co and Cd but normal concentrations of Cu, Zn and Pb. In multiple regression models, ferritin emerged as the main determinant of Mn, Co and Cd (p<0.001), while no significant associations with Cu, Zn and Pb were found. Adjusted r² for the models were 0.28, 0.48 and 0.34, respectively. Strong positive associations between blood concentrations of Mn, Co and Cd were observed, also when controlled for their common association with ferritin. Apart from these associations, the models showed no significant interactions between the six divalent metals studied. Very mild anaemia (110≤Hb<120 g/L) did not seem to have any effect independent of low ferritin. Approximately 26% of the women with iron deficiency anaemia had high concentrations of all of Mn, Co and Cd as opposed to 2.3% of iron-replete subjects.The results confirm that low serum ferritin may have an impact on body kinetics of certain divalent metal ions, but not all. Only a fraction of women with low iron status exhibited an increased blood concentration of divalent metals, providing indication of complexities in the body's handling of these metals.     

Associations of iron metabolism genes with blood manganese levels: a population-based study with validation data from animal models

Background

Given mounting evidence for adverse effects from excess manganese exposure, it is critical to understand host factors, such as genetics, that affect manganese metabolism.

Methods

Archived blood samples, collected from 332 Mexican women at delivery, were analyzed for manganese. We evaluated associations of manganese with functional variants in three candidate iron metabolism genes: HFE [hemochromatosis], TF [transferrin], and ALAD [δ-aminolevulinic acid dehydratase]. We used a knockout mouse model to parallel our significant results as a novel method of validating the observed associations between genotype and blood manganese in our epidemiologic data.

Results

Percentage of participants carrying at least one copy of HFE C282Y, HFE H63D, TF P570S, and ALAD K59N variant alleles was 2.4%, 17.7%, 20.1%, and 6.4%, respectively. Percentage carrying at least one copy of either C282Y or H63D allele in HFE gene was 19.6%. Geometric mean (geometric standard deviation) manganese concentrations were 17.0 (1.5) μg/l. Women with any HFE variant allele had 12% lower blood manganese concentrations than women with no variant alleles (β = -0.12 [95% CI = -0.23 to -0.01]). TF and ALAD variants were not significant predictors of blood manganese. In animal models, Hfe^-/- mice displayed a significant reduction in blood manganese compared with Hfe^+/+ mice, replicating the altered manganese metabolism found in our human research.

Conclusions

Our study suggests that genetic variants in iron metabolism genes may contribute to variability in manganese exposure by affecting manganese absorption, distribution, or excretion. Genetic background may be critical to consider in studies that rely on environmental manganese measurements.

     

Serum concentrations of retinol, alpha-tocopherol and the carotenoids are influenced by diet, race and obesity in a sample of healthy adolescents

An important part of understanding the functions of vitamin A, vitamin E and the carotenoids in nutritional status assessment, health promotion and disease prevention is knowledge of factors that influence their distribution in human tissues. Our objective was to examine serum concentrations of these nutrients and compounds in a sample of 285 healthy participants, 12-17 y old, from three U. S. cities. Pearson correlations between diet measured with a food frequency questionnaire and serum nutrient concentrations among these adolescents (adjusted for total serum cholesterol, age, sex, race and body mass index) were as follows: retinol, 0.23; alpha-tocopherol, 0.16; alpha-carotene, 0.31; beta-carotene, 0.15; beta-cryptoxanthin, 0.38; lycopene, 0.08; and lutein + zeaxanthin, 0.25. Multivariate linear regression modeled associations of demographic, dietary and physiologic variables with serum concentrations of these nutrients. African-American participants had significantly lower concentrations of serum retinol (P < 0.001), alpha-tocopherol (P < 0.01) and alpha-carotene (P < 0.02), but higher concentrations of lutein + zeaxanthin (P = 0.001) compared with Caucasians. Obese participants had serum nutrient concentrations that were 2-10% (P < 0.05) lower than normal weight participants. Dietary intake was a significant predictor of all serum analytes (P < 0.01) except lycopene. These models explained 20% of the variability in serum retinol, 28% of the variability in serum alpha-tocopherol, and 14-24% of the variability in serum carotenoids.     

Serum levels of zinc,calcium, and iron are associated with the risk of preeclampsia in pregnant women

Evidence indicates that various elements, including antioxidant minerals, might play an important role in preeclampsia (PE). This study was carried out to investigate the relationship between serum mineral levelsof zinc, calcium, iron, and selenium and the risk of preeclampsia in Korean women. Twenty-nine normal controls and 30 women with preeclampsia were recruited for the study. Preeclampsia was defined as having high blood pressure (≥140/90 mm Hg after 20 weeks gestation) and proteinuria (≥300 mg/24 hours). Serum mineral content was determined by instrumental neutron activation analysis. Serum zinc (P < .0001) and calcium (P = .0188) levels were lower in women with preeclampsia than those of normal women, while serum iron was significantly higher in women with preeclampsia (P = .0045). The odds ratio for preeclampsia was lower in women with higher serum zinc levels than those with lower levels after adjustment for age, height, and weight before delivery (P < .0001). The adjusted odds ratio for preeclampsia also decreased across tertiles of serum calcium concentration (P = .0452). However, there was an increased adjusted odds ratio for preeclampsia across tertiles of serum iron level (P = .0104). These results suggest that levels of serum minerals such as zinc, calcium, and iron may be associated with the risk of preeclampsia in Korean pregnant women.     

慢性病防控要高度重视导致慢性病的社会决定因素

  目的  了解中国 ≥ 18岁人群膳食知识和态度现状及膳食知识素养影响因素,为开展膳食营养健康教育提供参考依据。  方法  收集中国国家调查数据库中2015年中国健康与营养调查的全国15个省/市/自治区12 836名 ≥ 18岁人群膳食知识调查数据,应用SPSS 22.0统计软件分析中国 ≥ 18岁人群膳食知识和态度现状及膳食知识素养的影响因素。  结果  中国 ≥ 18岁人群膳食知识全部知晓率为4.70 %,总体知晓率为65.94 %,膳食宝塔或指南的知晓率为27.04 %,主动了解膳食知识的态度持有率为27.64 %,具备膳食知识素养比例为36.01 %;中国 ≥ 18岁人群获取膳食知识最常用的3个途径依次为电视或电台（50.48 %）、网络和书籍（22.27 %）、报纸或杂志（14.74 %）;多因素非条件logistic回归分析结果显示,文化程度初中及以上、有工作、知晓膳食宝塔或指南和愿意主动了解膳食知识的 ≥ 18岁人群更易具备膳食知识素养,年龄35～44岁和农村户口的 ≥ 18岁人群更不易具备膳食知识素养。  结论  中国 ≥ 18岁人群膳食知识和态度水平均较低,应重点加强农村户口、文化程度较低、无工作的35～44岁人群膳食知识的宣传工作。     

The impact of vitamin a deficiency and repletion with retinol and β-carotene on concanavalin a-induced lymphocyte proliferation

Concanavalin A (Con A)-induced splenic lymphocyte proliferation was studied in young rats during vitamin A deficiency and after oral repletion with 1500 retinol equivalents (R.E.) of either retinyl palmitate (RP) or βC-carotene (βC). Initial studies, designed to optimize the proliferation assay, showed that the response of vitamin A-deficient rats was consistently delayed in comparison to control rats fed a vitamin A-adequate diet. The overall magnitude of the proliferative response in vitamin A-deficient rats was also somewhat reduced (≈34% less than that of the control group). After vitamin A-deficient rats were repleted with RP, the Con A-induced proliferative response of splenic lymphocytes resembled that of the control group in both magnitude and kinetics. However, in vitamin A-deficient rats repleted with βC, the delayed response to Con A persisted in some animals and the overall response was intermediate between that of vitamin A-deficient rats and either control rats or rats repleted with RP.     

孕28周血清维生素A、E水平对子痫前期孕妇妊娠结局预测价值

目的:分析血清维生素(V)A、VE水平预测子痫前期孕妇妊娠结局的价值。方法:以2017年6月-2018年11月本院常规孕前检查的427例女性(孕前组)及573例妊娠20周内产前检查孕妇(孕期组)为研究对象,孕期组定期产检后明确发生子痫前期53例。均检测血清VA、VE,孕期组同时行肝肾功能检测并统计妊娠结局。结果:与孕前组比较,孕期组妊娠20周时血清VA、VE水平及VE异常率未见差异(P>0.05),但VA缺乏率及异常率较高(P<0.05)。孕28周时,轻度、重度子痫前期孕妇血清VA、VE、血尿素氮(BUN)、血肌酐(SCR)水平均高于无子痫前期孕妇,且重度者高于轻度孕妇(P<0.05);血清VA、VE水平与BUN、SCR呈负相关(P<0.05);预测子痫前期孕妇不良妊娠结局的ROC曲线下面积分别为0.829、0.915,临界值分别为0.19mg/L、3.26mg/L,敏感度与特异度分别为61.9%、65.5%和92.3%、86.9%。结论:孕妇易出现VA缺乏,VA、VE对于预测子痫前期孕妇不良妊娠结局有一定价值。