Thoradeniya Tharanga, Wickremasinghe Rajitha, Ramanayake Ramani, Atukorala Sunethra
Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Colombo, Sri Lanka.
Br J Nutr. 2006 Mar;95(3):511-6. doi: 10.1079/bjn20051590.
Folic acid deficiency is implicated in the aetiology of nutritional anaemia and adverse pregnancy outcomes for the fetus. Data on folic acid status among adolescent girls and non-pregnant, non-lactating young women are limited. We assessed folic acid status in a random sample of 552 subjects (277 adolescent girls aged 15-18.9 years and 275 women aged 19-30 years) living in Colombo, Sri Lanka. The association of low folic acid status with anaemia was evaluated. Socio-economic, food intake and anthropometric data were obtained. Hb, serum folic acid, vitamin B12 and ferritin and plasma homocysteine concentrations were measured. Forty-three per cent of subjects studied had low serum folic acid concentrations (<3 ng/ml) and 47 % had low Fe stores (serum ferritin <20 microg/l). Overall prevalence of anaemia was 12.9 %, and 43.9 % of anaemic subjects had both low folic acid status and depleted Fe stores (serum ferritin <12 microg/l). Both low folate status and depleted Fe stores were significantly associated with anaemia (odds ratio = 2.32; 95 % CI 1.34, 4.01 and odds ratio = 5.98; 95 % CI 3.36, 10.63, respectively). Serum folic acid concentration was associated (r = 0.108, P = 0.015) with folate intake as indicated by a computed folate index. Folate index was associated inversely with household size and positively with economic status and education level. In this study population low folic acid status, besides depleted Fe stores, was associated with anaemia. The high prevalence of low folic acid status observed highlights the need for nutrition education to improve intakes of folate, Fe and other micronutrients among adolescent girls and young women.
叶酸缺乏与营养性贫血的病因及胎儿不良妊娠结局有关。关于青春期女孩以及未怀孕、未哺乳的年轻女性叶酸状况的数据有限。我们对居住在斯里兰卡科伦坡的552名受试者（277名15至18.9岁的青春期女孩和275名19至30岁的女性）进行随机抽样，评估其叶酸状况。评估了低叶酸状况与贫血之间的关联。获取了社会经济、食物摄入和人体测量数据。测量了血红蛋白、血清叶酸、维生素B12、铁蛋白以及血浆同型半胱氨酸浓度。研究的受试者中有43%血清叶酸浓度较低（<3 ng/ml），47%铁储备较低（血清铁蛋白<20 μg/l）。贫血的总体患病率为12.9%，43.9%的贫血受试者叶酸状况低且铁储备不足（血清铁蛋白<12 μg/l）。低叶酸状况和铁储备不足均与贫血显著相关（优势比分别为2.32；95%可信区间为1.34, 4.01以及优势比为5.98；95%可信区间为3.36, 10.63）。计算得出的叶酸指数表明血清叶酸浓度与叶酸摄入量相关（r = 0.108，P = 0.015）。叶酸指数与家庭规模呈负相关，与经济状况和教育水平呈正相关。在该研究人群中，除了铁储备不足外，低叶酸状况也与贫血有关。观察到的低叶酸状况的高患病率凸显了开展营养教育以提高青春期女孩和年轻女性叶酸、铁及其他微量营养素摄入量的必要性。
