Bloem M W, Wedel M, Egger R J, Speek A J, Schrijver J, Saowakontha S, Schreurs W H
Helen Keller International, Dhaka, Bangladesh.
Am J Epidemiol. 1990 Feb;131(2):332-9. doi: 10.1093/oxfordjournals.aje.a115502.
A cross-sectional study, a follow-up study, and an intervention trial were carried out to investigate the association between mild vitamin A deficiency and the occurrence of diarrhea and respiratory diseases. Cross-sectional analysis was performed among 1,772 children, aged 1-8 years, in the Sakon Nakhon province of northeastern Thailand. Children with a history of diarrhea or respiratory disease had lower levels of serum retinol and retinol-binding protein. Adjusted for age, sex, nutritional status, and level of urbanization, logistic regression using data for 877 children showed a negative association between serum retinol and both diarrhea and respiratory diseases. A follow-up three months later (n = 146 children) showed that children with deficient serum retinol (less than 0.35 mumol/liter) had a fourfold greater risk of respiratory disease (p less than 0.01). No relation was found for diarrhea. An intervention trial (n = 166 children aged 1-5 years) showed that, during 2 months of follow-up after administration of oral vitamin A (200,000 IU), the control group (aged 3-5 years) had a higher incidence of respiratory disease (2.9 times) as well as diarrhea (3.1 times). Between 2 and 4 months, a significantly (p less than 0.025) higher incidence of respiratory diseases (2.5 times) could be observed in children aged 1-2 years. This study supports earlier reports on a greater risk of respiratory diseases and of diarrhea in mild vitamin A deficiency. Supplementation reduced the incidence of both diarrhea and respiratory disease for a period of at least 2 months.
开展了一项横断面研究、一项随访研究和一项干预试验，以调查轻度维生素A缺乏与腹泻和呼吸道疾病发生之间的关联。对泰国东北部呵叻府1772名1至8岁儿童进行了横断面分析。有腹泻或呼吸道疾病史的儿童血清视黄醇和视黄醇结合蛋白水平较低。在对年龄、性别、营养状况和城市化水平进行校正后，对877名儿童的数据进行逻辑回归分析，结果显示血清视黄醇与腹泻和呼吸道疾病均呈负相关。三个月后的随访（n = 146名儿童）显示，血清视黄醇缺乏（低于0.35μmol/升）的儿童患呼吸道疾病的风险高出四倍（p < 0.01）。未发现与腹泻有关联。一项干预试验（n = 166名1至5岁儿童）显示，在口服维生素A（200,000国际单位）后2个月的随访期间，对照组（3至5岁）呼吸道疾病（2.9倍）和腹泻（3.1倍）的发病率较高。在2至4个月期间，1至2岁儿童呼吸道疾病的发病率显著较高（2.5倍）（p < 0.025）。本研究支持了早期关于轻度维生素A缺乏会增加呼吸道疾病和腹泻风险的报道。补充维生素A至少在2个月内降低了腹泻和呼吸道疾病的发病率。
