Guatemalan 随机试验研究补锌对学龄儿童心理健康的影响。
Randomized trial of the effect of zinc supplementation on the mental health of school-age children in Guatemala.
机构信息
Institute for Community Health, Cambridge Health Alliance/Harvard Medical School, Cambridge, MA, USA.
出版信息
Am J Clin Nutr. 2010 Nov;92(5):1241-50. doi: 10.3945/ajcn.2010.29686. Epub 2010 Sep 29.
BACKGROUND
Rates of mental illness in children are increasing throughout the world. Observational studies of depression, anxiety, and attention-deficit hyperactivity disorder suggest that zinc is an alternative treatment.
OBJECTIVE
We examined the effect of zinc supplementation on the mental health of school-age children in Guatemala.
DESIGN
From January to October 2006, we conducted a 6-mo randomized, double-blind, controlled trial comparing zinc supplementation (10 mg ZnO/d for 5 d/wk) with a placebo (10 mg glucose) in 674 Guatemalan children in grades 1-4. Outcome measures included internalizing (ie, depression and anxiety) and externalizing (ie, hyperactivity and conduct disorder) problem behaviors, positive behaviors (ie, socialization and leadership), and serum zinc concentrations.
RESULTS
Zinc and placebo groups did not differ significantly in any behavioral measures at baseline or at follow-up. At baseline, 21.4% of children had serum zinc concentrations <65 μg/dL. At follow-up, both groups improved significantly, and zinc concentrations were higher in the zinc group. Increases in serum zinc concentrations were inversely associated with decreases in depressive symptoms (estimate: -0.01 points per μg Zn/dL; P = 0.01), anxiety (estimate: -0.012 points per μg Zn/dL; P = 0.02), internalizing symptoms (estimate: -0.021 points per μg Zn/dL; P = 0.02), and social skills (estimate: -0.019 points per μg Zn/dL; P = 0.01) in adjusted models that were controlled for child age, sex, socioeconomic status, household, and treatment group.
CONCLUSIONS
Six months of zinc supplementation did not induce differences in mental health outcomes between zinc and placebo groups. However, increases in serum zinc concentrations were associated with decreases in internalizing symptoms (ie, depression and anxiety) in a community-based sample of children at risk of zinc deficiency. This trial was registered at clinicaltrials.gov as NCT00283660.
背景
全世界儿童的精神疾病发病率正在上升。对抑郁症、焦虑症和注意缺陷多动障碍的观察性研究表明，锌是一种替代疗法。
目的
我们研究了补锌对危地马拉学龄儿童心理健康的影响。
设计
2006 年 1 月至 10 月，我们在危地马拉 1 至 4 年级的 674 名儿童中进行了一项为期 6 个月的随机、双盲、对照试验，比较了补锌（每周 5 天，每天 10mgZnO/d）与安慰剂（10mg 葡萄糖）的效果。结局指标包括内化问题行为（即抑郁和焦虑）和外化问题行为（即多动和品行障碍）、积极行为（即社交和领导力）和血清锌浓度。
结果
补锌组和安慰剂组在基线或随访时的任何行为测量指标均无显著差异。基线时，21.4%的儿童血清锌浓度<65μg/dL。随访时，两组均有显著改善，补锌组的锌浓度升高。血清锌浓度升高与抑郁症状（估计值：-0.01 分/μgZn/dL；P=0.01）、焦虑（估计值：-0.012 分/μgZn/dL；P=0.02）、内化症状（估计值：-0.021 分/μgZn/dL；P=0.02）和社交技能（估计值：-0.019 分/μgZn/dL；P=0.01）的下降呈负相关，这些模型在调整了儿童年龄、性别、社会经济地位、家庭和治疗组等因素后。
结论
6 个月的补锌治疗并未在补锌组和安慰剂组之间引起心理健康结局的差异。然而，在一个有缺锌风险的社区儿童样本中，血清锌浓度的升高与内化症状（即抑郁和焦虑）的下降相关。这项试验在 clinicaltrials.gov 注册，编号为 NCT00283660。
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