Soekarjo D D, Pee Sd S de, Kusin J A, Schreurs W H P, Schultink W, Bloem M W
Helen Keller International Indonesia, Jakarta, Indonesia.
Eur J Clin Nutr. 2004 Jun;58(6):927-37. doi: 10.1038/sj.ejcn.1601914.
High prevalences of vitamin A deficiency and anaemia among adolescents warrant interventions. This study evaluated the effectiveness of school-based supplementation to reduce anaemia and improve vitamin A status.
School-based, grade-randomized, intervention.
In all, 1757 girls and 1859 boys, aged 12-15 y, in 24 Junior High Schools.
Weekly supplementation for 14 weeks with 60 mg iron and 250 microg folate (Fe group; n=978), 10 000 IU vitamin A (VA group; n=970) or both (VAFe group; n=1042) to subjects in 15 schools, compared to subjects in nine other schools not receiving supplements (control; n=626).
The baseline anaemia prevalence (Hb <120 g/l) in girls was 20% (prepubertal) and 26% (pubertal), and in boys 24% (pre-pubertal) and 11% (pubertal). Serum retinol concentrations were low (<1.05 micromol/l) in 41% of boys and 45% of girls. The interventions did not increase haemoglobin concentrations. Serum retinol concentration of boys, but not girls, in the VA group increased (0.33 vs 0.07 micromol/l in controls; P<0.01). The risk factors for low serum retinol concentration were lower baseline serum retinol concentration (OR 0.02-0.03) with, for girls, nightblindness at baseline (OR 5.88), and for boys, not receiving vitamin A (OR control: 1.00; VA: 0.37; Fe: 0.77; VAFe: 0.34) and maternal illiteracy (OR mother never attended school 1.00, mother received any formal education 0.17-0.33).
Supplementation with vitamin A increased serum retinol concentration of boys. Iron supplementation did not change Hb. This appeared to be due to poor compliance, and partly related to side effects.
青少年中维生素A缺乏和贫血的高患病率需要进行干预。本研究评估了以学校为基础的补充剂对减少贫血和改善维生素A状况的有效性。
以学校为基础的年级随机干预研究。
24所初中的1757名女孩和1859名男孩，年龄在12 - 15岁。
对15所学校的学生每周补充14周，其中一组补充60毫克铁和250微克叶酸（铁组；n = 978），一组补充10000国际单位维生素A（维生素A组；n = 970），另一组同时补充两者（维生素A铁组；n = 1042），并与另外9所未接受补充剂的学校的学生（对照组；n = 626）进行比较。
女孩中基线贫血患病率（血红蛋白<120 g/l）在青春期前为20%，青春期为26%；男孩中青春期前为24%，青春期为11%。41%的男孩和45%的女孩血清视黄醇浓度较低（<1.05微摩尔/升）。干预措施未提高血红蛋白浓度。维生素A组男孩的血清视黄醇浓度升高（对照组为0.07微摩尔/升，维生素A组为0.33微摩尔/升；P<0.01），而女孩未升高。血清视黄醇浓度低的危险因素包括较低的基线血清视黄醇浓度（比值比0.02 - 0.03），对于女孩，还有基线时的夜盲症（比值比5.88），对于男孩，包括未接受维生素A补充（对照组比值比：1.00；维生素A组：0.37；铁组：0.77；维生素A铁组：0.34）以及母亲文盲（母亲从未上学比值比1.00，母亲接受过任何正规教育比值比0.17 - 0.33）。
补充维生素A可提高男孩的血清视黄醇浓度。补充铁未改变血红蛋白水平。这似乎是由于依从性差，部分与副作用有关。
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