Thurlow Rosanne A, Winichagoon Pattanee, Green Timothy, Wasantwisut Emorn, Pongcharoen Tippawan, Bailey Karl B, Gibson Rosalind S
Institute of Nutrition, Mahidol University, Salaya, Thailand.
Am J Clin Nutr. 2005 Aug;82(2):380-7. doi: 10.1093/ajcn.82.2.380.
Iron deficiency is assumed to be the major cause of anemia in northeast Thailand, but other factors may be involved.
We determined the prevalence of anemia among schoolchildren in northeast Thailand and the role of hemoglobinopathies, selected micronutrient deficiencies, and other factors in hemoglobin status.
Blood samples were collected from 567 children aged 6-12.9 y attending 10 primary schools for the determination of a complete blood count and hemoglobin type [Hb AA (normal hemoglobin), Hb AE (heterozygous for Hb type E), and Hb EE (homozygous for Hb type E)] and the measurement of serum ferritin, transferrin receptor, retinol, vitamin B-12, and plasma and erythrocyte folate concentrations. Children with a C-reactive protein concentration > or = 10 mg/L (n = 12), which indicated infection, were excluded.
The prevalence of anemia was 31%. Age, hemoglobin type, and serum retinol were the major predictors of hemoglobin concentration. Hb AA and Hb AE children with anemia had lower (P < 0.01) hematocrit, mean cell volume, and serum retinol values than did their nonanemic counterparts; no significant differences in serum ferritin were found by hemoglobin type. Only 16% (n = 22) of the anemic Hb AA and Hb AE children were iron deficient. Hb AA and Hb AE children with a serum retinol concentration <0.70 micromol/L (n = 14) had a significantly higher geometric mean serum ferritin concentration than did those with a retinol concentration > or = 0.70 micromol/L (P = 0.009); no significant difference in transferrin receptor concentrations was found between these 2 groups.
Hemoglobinopathies, suboptimal vitamin A status, and age were the major predictors of hemoglobin concentration. The contribution of iron deficiency to anemia was low, and its detection was complicated by coexisting suboptimal vitamin A status.
缺铁被认为是泰国东北部贫血的主要原因，但可能涉及其他因素。
我们确定了泰国东北部学童贫血的患病率以及血红蛋白病、特定微量营养素缺乏和其他因素在血红蛋白状态中的作用。
从10所小学的567名6至12.9岁儿童中采集血样，用于测定全血细胞计数和血红蛋白类型[Hb AA（正常血红蛋白）、Hb AE（E型血红蛋白杂合子）和Hb EE（E型血红蛋白纯合子）]，并测量血清铁蛋白、转铁蛋白受体、视黄醇、维生素B-12以及血浆和红细胞叶酸浓度。排除C反应蛋白浓度≥10mg/L（n = 12）表明有感染的儿童。
贫血患病率为31%。年龄、血红蛋白类型和血清视黄醇是血红蛋白浓度的主要预测因素。贫血的Hb AA和Hb AE儿童的血细胞比容、平均红细胞体积和血清视黄醇值低于（P < 0.01）非贫血儿童；按血红蛋白类型，血清铁蛋白未发现显著差异。贫血的Hb AA和Hb AE儿童中只有16%（n = 22）缺铁。血清视黄醇浓度<0.70μmol/L的Hb AA和Hb AE儿童（n = 14）的几何平均血清铁蛋白浓度显著高于视黄醇浓度≥0.70μmol/L的儿童（P = 0.009）；这两组之间转铁蛋白受体浓度未发现显著差异。
血红蛋白病、维生素A状态欠佳和年龄是血红蛋白浓度的主要预测因素。缺铁对贫血的影响较小，且由于同时存在维生素A状态欠佳而使缺铁的检测变得复杂。
