Gibson Rosalind S, Abebe Yewelsew, Stabler Sally, Allen Robert H, Westcott Jamie E, Stoecker Barbara J, Krebs Nancy F, Hambidge K Michael
Department of Human Nutrition, University of Otago, Dunedin, New Zealand 9015.
J Nutr. 2008 Mar;138(3):581-6. doi: 10.1093/jn/138.3.581.
The etiology of anemia during pregnancy in rural Southern Ethiopia is uncertain. Intakes of animal-source foods are low and infections and bacterial overgrowth probably coexist. We therefore measured the dietary intakes of a convenience sample of Sidama women in late pregnancy who consumed either maize (n = 68) or fermented enset (Enset ventricosum) (n = 31) as their major energy source. Blood samples were analyzed for a complete blood count, vitamin B-12 and folate status, plasma ferritin, retinol, zinc, albumin, and C-reactive protein (CRP). The role of infection and gravida was also examined. Dietary intakes were calculated from 1-d weighed records. No cellular animal products were consumed. Of the women, 29% had anemia, 13% had iron deficiency anemia, 33% had depleted iron stores, and 74 and 27% had low plasma zinc and retinol, respectively. Only 2% had low plasma folate (< 6.8 nmol/L) and 23% had low plasma vitamin B-12 (< 150 pmol/L), even though 62% had elevated plasma methylmalonic acid (MMA) (> 271 nmol/L). None had elevated plasma cystathionine or total homocysteine (tHcys). Women with enset-based diets had higher (P = 0.052) plasma vitamin B-12 concentration and lower (P < 0.05) cell volume, plasma cystathionine, and retinol than women consuming maize-based diets, but mean hemoglobin, plasma ferritin, MMA, tHcys, and folate did not differ. Plasma zinc, followed by CRP (< or = 5 mg/L), gravida (< or = 4), and plasma ferritin (> or = 12 microg/L) status were major positive predictors of hemoglobin. Despite some early functional vitamin B-12 deficiency, there was no macrocytic anemia. Consumption of fermented enset may have increased vitamin B-12 levels in diet and plasma.
埃塞俄比亚南部农村地区孕期贫血的病因尚不明确。动物性食物摄入量较低，且感染和细菌过度生长可能并存。因此，我们对晚期妊娠的西达摩族妇女便利样本的饮食摄入量进行了测量，这些妇女以玉米（n = 68）或发酵的埃塞俄比亚香蕉（Enset ventricosum）（n = 31）作为主要能量来源。对血样进行了全血细胞计数、维生素B - 12和叶酸状态、血浆铁蛋白、视黄醇、锌、白蛋白和C反应蛋白（CRP）分析。还研究了感染和妊娠次数的作用。饮食摄入量根据1天的称重记录计算得出。未食用任何动物性细胞产品。这些妇女中，29%患有贫血，13%患有缺铁性贫血，33%铁储备不足，血浆锌和视黄醇水平低的分别占74%和27%。只有2%的人血浆叶酸水平低（< 6.8 nmol/L），23%的人血浆维生素B - 12水平低（< 150 pmol/L），尽管62%的人血浆甲基丙二酸（MMA）升高（> 271 nmol/L）。没有人血浆胱硫醚或总同型半胱氨酸（tHcys）升高。以埃塞俄比亚香蕉为基础饮食的妇女比食用玉米为基础饮食的妇女血浆维生素B - 12浓度更高（P = 0.052），细胞体积、血浆胱硫醚和视黄醇更低（P < 0.05），但平均血红蛋白、血浆铁蛋白、MMA、tHcys和叶酸没有差异。血浆锌，其次是CRP（≤5 mg/L）、妊娠次数（≤4）和血浆铁蛋白（≥12 μg/L）状态是血红蛋白的主要正向预测指标。尽管存在一些早期功能性维生素B - 12缺乏，但没有大细胞性贫血。食用发酵的埃塞俄比亚香蕉可能增加了饮食和血浆中的维生素B - 12水平。
