一家社区心理健康诊所中儿童和青少年的铁营养状况低于全国样本。
The iron status of children and youth in a community mental health clinic is lower than that of a national sample.
作者信息
Gottfried Rhoda J, Gerring Joan P, Machell Kyla, Yenokyan Gayane, Riddle Mark A
机构信息
Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
出版信息
J Child Adolesc Psychopharmacol. 2013 Mar;23(2):91-100. doi: 10.1089/cap.2012.0001. Epub 2013 Mar 12.
OBJECTIVE
Iron plays a key role in brain function, and a deficiency of iron has been implicated in various cognitive, motor, and psychiatric disorders. Because of recent evidence that iron deficiency may be related to attention-deficit/hyperactivity disorder (ADHD) and other psychiatric disorders, the goal of this study was to compare the iron status of children and youth seen in a community mental health clinic with a national sample of same-aged subjects.
METHODS
In this study, a consecutive series of 108 patients (79 males) referred to a community mental health clinic was compared with a National Health and Nutrition Examination Survey (NHANES) sample on measures of iron status. Wilcoxon sign rank and median tests were used to compare distributions of ferritin. Quantile regression was performed to compare the ferritin level in the two samples while adjusting for demographic differences. Chi squared (χ2) was used to compare rates of low hemoglobin in the two samples.
RESULTS
The iron status of the clinic sample, as measured by ferritin levels (median=23 μg/L), was significantly lower than that of the national sample (median=43 μg/L). After adjustment for age, gender, and race, the clinic sample was found to have 19.2 μg/L lower ferritin than the national sample (95% CI from 7.6 to 30.9, p value=0.001). There were also significantly more subjects in the clinic sample with low hemoglobin than in the national sample. There were no differences in ferritin levels between those patients in the clinic sample with and without an ADHD or other specific psychiatric diagnosis.
CONCLUSIONS
The ferritin levels of children and youth in a mental health clinic sample were significantly lower than those of the same-aged subjects in a national sample. Therefore, compromised iron status may be an additional biological risk factor for cognitive, behavioral, and psychiatric problems in pediatric populations served by the community mental health clinic.
目的
铁在脑功能中起关键作用，铁缺乏与多种认知、运动及精神障碍有关。鉴于近期有证据表明铁缺乏可能与注意力缺陷多动障碍（ADHD）及其他精神障碍相关，本研究旨在比较社区心理健康诊所中儿童和青少年的铁状态与全国同龄样本的铁状态。
方法
在本研究中，将转至社区心理健康诊所的连续108例患者（79例男性）与全国健康和营养检查调查（NHANES）样本的铁状态指标进行比较。采用Wilcoxon符号秩检验和中位数检验比较铁蛋白分布。进行分位数回归以在调整人口统计学差异的同时比较两个样本中的铁蛋白水平。使用卡方（χ2）检验比较两个样本中低血红蛋白的发生率。
结果
通过铁蛋白水平测量（中位数 = 23μg/L），诊所样本的铁状态显著低于全国样本（中位数 = 43μg/L）。在调整年龄、性别和种族后，发现诊所样本的铁蛋白比全国样本低19.2μg/L（95%CI为7.6至30.9，p值 = 0.001）。诊所样本中血红蛋白低的受试者也明显多于全国样本。诊所样本中有或无ADHD或其他特定精神疾病诊断的患者之间铁蛋白水平无差异。
结论
心理健康诊所样本中儿童和青少年的铁蛋白水平显著低于全国样本中同龄受试者的铁蛋白水平。因此，铁状态受损可能是社区心理健康诊所服务的儿科人群中认知、行为和精神问题的另一个生物学危险因素。
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