Wasantwisut Emorn, Winichagoon Pattanee, Chitchumroonchokchai Chureeporn, Yamborisut Uruwan, Boonpraderm Atitada, Pongcharoen Tippawan, Sranacharoenpong Kitti, Russameesopaphorn Wanphen
Institute of Nutrition, Mahidol University, Salaya, Nakhon Pathom 73170, Thailand.
J Nutr. 2006 Sep;136(9):2405-11. doi: 10.1093/jn/136.9.2405.
Iron deficiency is prevalent in children and infants worldwide. Zinc deficiency may be prevalent, but data are lacking. Both iron and zinc deficiency negatively affect growth and psychomotor development. Combined iron and zinc supplementation might be beneficial, but the potential interactions need to be verified. In a randomized, placebo-controlled trial using 2 x 2 factorial design, 609 Thai infants aged 4-6 mo were supplemented daily with 10 mg of iron and/or 10 mg of zinc for 6 mo to investigate effects and interactions on micronutrient status and growth. Iron supplementation alone increased hemoglobin and ferritin concentrations more than iron and zinc combined. Anemia prevalence was significantly lower in infants receiving only iron than in infants receiving iron and zinc combined. Baseline iron deficiency was very low, and iron deficiency anemia was almost nil. After supplementation, prevalence of iron deficiency and iron deficiency anemia were significantly higher in infants receiving placebo and zinc than in those receiving iron or iron and zinc. Serum zinc was higher in infants receiving zinc (16.7 +/- 5.2 micromol/L), iron and zinc (12.1 +/- 3.8 micromol/L) or iron alone (11.5 +/- 2.5 micromol/L) than in the placebo group (9.8 +/- 1.9 micromol/L). Iron and zinc interacted to affect iron and zinc status, but not hemoglobin. Iron supplementation had a small but significant effect on ponderal growth, whereas zinc supplementation did not. To conclude, in Thai infants, iron supplementation improved hemoglobin, iron status, and ponderal growth, whereas zinc supplementation improved zinc status. Overall, for infants, combined iron and zinc supplementation is preferable to iron or zinc supplementation alone.
缺铁在全球儿童和婴儿中普遍存在。锌缺乏可能也很普遍，但缺乏相关数据。铁和锌缺乏均会对生长和精神运动发育产生负面影响。联合补充铁和锌可能有益，但潜在的相互作用需要得到验证。在一项采用2×2析因设计的随机、安慰剂对照试验中，609名4至6个月大的泰国婴儿每天补充10毫克铁和/或10毫克锌，为期6个月，以研究对微量营养素状况和生长的影响及相互作用。单独补充铁比联合补充铁和锌能更有效地提高血红蛋白和铁蛋白浓度。仅接受铁补充的婴儿贫血患病率显著低于接受铁和锌联合补充的婴儿。基线时缺铁情况非常低，缺铁性贫血几乎不存在。补充后，接受安慰剂和锌的婴儿缺铁和缺铁性贫血的患病率显著高于接受铁或铁和锌的婴儿。接受锌（16.7±5.2微摩尔/升）、铁和锌（12.1±3.8微摩尔/升）或仅铁（11.5±2.5微摩尔/升）的婴儿血清锌水平高于安慰剂组（9.8±1.9微摩尔/升）。铁和锌相互作用影响铁和锌的状态，但不影响血红蛋白。补充铁对体重增长有微小但显著的影响，而补充锌则没有。总之，在泰国婴儿中，补充铁可改善血红蛋白、铁状态和体重增长，而补充锌可改善锌状态。总体而言，对于婴儿，联合补充铁和锌比单独补充铁或锌更可取。
