Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Nutrition. 2013 Mar;29(3):542-8. doi: 10.1016/j.nut.2012.09.003. Epub 2013 Jan 5.
To assess the effects of zinc and iron-folic acid supplementation on motor and language milestones in Nepali children.
Five hundred forty-four children 4 to 17 mo old residing in Ishwarpur, Nepal were randomized to receive placebo, iron-folic acid, zinc, or zinc plus iron-folic acid daily. Data were collected at baseline and at 3-mo intervals for 1 y. The main effects of zinc and iron folic-acid supplementation were estimated for motor and language milestones. Crude and adjusted mean cumulative changes in scores from visits 1 to 5 and adjusted rates of change were modeled.
Adjusted differences in motor milestone scores from visits 1 to 5 and rates of change were not significantly different for the zinc and non-zinc groups (adjusted β = -0.7, 95% confidence interval [CI] -1.4 to 0.01; adjusted β = -0.1, 95% CI -0.5 to 0.3, respectively). Motor milestones in children receiving and not receiving iron supplements were not significantly different (adjusted β = 0.1, 95% CI -0.7 to 0.8, from visits 1 to 5; adjusted β = 0.1, 95% CI -0.3 to 0.5, for rate of change). Children receiving zinc had a 0.8 lower mean crude change in language score from visits 1 to 5 compared with children not receiving zinc (95% CI -1.3 to -0.3), but the significance was lost after adjustment (adjusted β = -0.2, 95% CI -0.6 to 0.2, for visits 1 to 5; β = -0.1, 95% CI -0.3 to 0.2, for rate of change). No significant difference in motor or language milestone scores from iron supplementation was observed.
After 1 y, neither zinc nor iron-folic acid supplementation in Nepali children improved the attainment of motor or language milestones.
评估补锌和铁叶酸对尼泊尔儿童运动和语言发育里程碑的影响。
将 544 名 4 至 17 个月大的尼泊尔儿童随机分为安慰剂、铁叶酸、锌或锌加铁叶酸组，每日接受干预。在基线和每 3 个月收集一次数据，持续 1 年。主要观察补锌和铁叶酸补充对运动和语言发育里程碑的影响。对从第 1 次访视到第 5 次访视的评分进行了粗评分和调整后的累积变化，并对调整后的变化率进行了建模。
锌组和非锌组在运动发育里程碑评分从第 1 次访视到第 5 次访视的调整后差异以及变化率均无显著差异（调整后的 β值分别为-0.7，95%置信区间为-1.4 至 0.01；-0.1，95%置信区间为-0.5 至 0.3）。接受和未接受铁补充的儿童的运动发育里程碑无显著差异（从第 1 次访视到第 5 次访视的调整后 β值分别为 0.1，95%置信区间为-0.7 至 0.8；调整后的 β值为 0.1，95%置信区间为-0.3 至 0.5）。与未接受锌的儿童相比，接受锌的儿童在第 1 次至第 5 次访视时语言评分的平均粗变化低 0.8 分（95%置信区间为-1.3 至-0.3），但调整后该差异无统计学意义（第 1 次至第 5 次访视的调整后 β值为-0.2，95%置信区间为-0.6 至 0.2；调整后的 β值为-0.1，95%置信区间为-0.3 至 0.2）。未观察到铁补充对运动或语言里程碑评分的显著影响。
1 年后，尼泊尔儿童补充锌或铁叶酸均未改善运动或语言发育里程碑的实现。
