孕期血清β-胡萝卜素和视黄醇的HIV及其他预测因素：津巴布韦的一项横断面研究

HIV and other predictors of serum beta-carotene and retinol in pregnancy: a cross-sectional study in Zimbabwe.

作者信息

Friis H, Gomo E, Koestel P, Ndhlovu P, Nyazema N, Krarup H, Michaelsen K F

机构信息

Research Department of Human Nutrition, The Royal Veterinary and Agricultural University, Frederiksberg, Denmark.

出版信息

Am J Clin Nutr. 2001 Jun;73(6):1058-65. doi: 10.1093/ajcn/73.6.1058.

DOI:10.1093/ajcn/73.6.1058

PMID:11382660

Abstract

BACKGROUND

Vitamin A status during pregnancy is important to maternal and infant health.

OBJECTIVE

Our goal was to identify predictors of serum beta-carotene and retinol.

DESIGN

This was a cross-sectional study of 1669 women (22-35 wk of gestation) in Harare, Zimbabwe, who were receiving prenatal care. The statistical effects of age, season, gestational age, gravidity, HIV-1 infection, malaria parasitemia, and serum alpha1-antichymotrypsin (ACT) on serum beta-carotene (log10 transformed) and retinol were estimated by using multiple linear regression analyses.

RESULTS

HIV infection was found in 31.5% of the women; 0.4% had malaria. Serum beta-carotene concentrations (geometric x: 0.19 micromol/L) were lower in HIV-infected women than in uninfected women (10beta = 0.78; 95% CI: 0.72, 0.84) and increased with age (10beta = 1.05; 1.02, 1.07) in gravida 1 but not in gravida > or =2 (P for interaction = 0.00002). Serum retinol (x: 0.92 micromol/L) increased with age (beta = 0.004; 0.0001, 0.008) in uninfected women but not in HIV-infected women (P for interaction = 0.02) and was 0.05-micromol/L (0.02, 0.09) lower in HIV-infected women than in uninfected women at 24 y of age. Furthermore, gestational age, season, use of prenatal supplements, and malaria were predictors of serum beta-carotene. Serum retinol was lower in women carrying male (beta = -0.04; -0.08, -0.00005) and multiple (beta = -0.21; -0.35, -0.08) fetuses. Serum ACT concentrations of 0.3-0.4, 0.4-0.5, and >0.5 g/L were associated with 3%, 11%, and 44% lower serum beta-carotene and 0.04-, 0.15-, and 0.41-micromol/L lower serum retinol. Serum ACT (g/L) was higher in women with malaria than in those without (beta = 0.10; 0.03, 0.16) and in gravida 1 than in gravida > or =2 (beta = 0.012; 0.003, 0.021), but was not higher in HIV-infected women than in uninfected women (beta = 0.001; -0.008, 0.011).

CONCLUSIONS

HIV infection, malaria, gravidity, and gestational age were predictors of serum beta-carotene and retinol. Serum ACT was an important predictor of both and was associated with gravidity and gestational age.

摘要

背景

孕期维生素A状况对母婴健康至关重要。

目的

我们的目标是确定血清β-胡萝卜素和视黄醇的预测因素。

设计

这是一项对津巴布韦哈拉雷1669名接受产前护理的孕妇（妊娠22 - 35周）进行的横断面研究。通过多元线性回归分析评估年龄、季节、孕周、妊娠次数、HIV - 1感染、疟疾寄生虫血症和血清α1 - 抗糜蛋白酶（ACT）对血清β-胡萝卜素（对数10转换）和视黄醇的统计学影响。

结果

31.5%的女性感染了HIV；0.4%患有疟疾。HIV感染女性的血清β-胡萝卜素浓度（几何均值：0.19微摩尔/升）低于未感染女性（β = 0.78；95%置信区间：0.72，0.84），且在初产妇中随年龄增加（β = 1.05；1.02，1.07），而在妊娠次数≥2次的孕妇中则不然（交互作用P = 0.00002）。未感染女性的血清视黄醇（均值：0.92微摩尔/升）随年龄增加（β = 0.004；0.0001，0.008），而感染HIV的女性则不然（交互作用P = 0.02），且在24岁时，感染HIV的女性血清视黄醇比未感染女性低0.05微摩尔/升（0.02，0.09）。此外，孕周、季节、产前补充剂的使用和疟疾是血清β-胡萝卜素的预测因素。怀有男性胎儿（β = -0.04；-0.08, -0.00005）和多胞胎（β = -0.21；-0.35, -0.08）的女性血清视黄醇较低。血清ACT浓度为0.3 - 0.4、0.4 - 0.5和>0.5克/升分别与血清β-胡萝卜素降低3%、11%和44%以及血清视黄醇降低0.04、0.15和0.41微摩尔/升相关。患有疟疾的女性血清ACT（克/升）高于未患疟疾的女性（β = 0.10；0.03，0.16），初产妇高于妊娠次数≥2次的孕妇（β = 0.012；0.003，0.021），但感染HIV的女性与未感染女性相比并无升高（β = 0.001；-0.008，0.011）。