足月正常婴儿补锌的效果：一项基于社区的双盲、随机、对照、临床试验。

Effectiveness of zinc supplementation to full term normal infants: a community based double blind, randomized, controlled, clinical trial.

机构信息

National Institute of Nutrition (ICMR), Hyderabad, Andhra Pradesh, India.

出版信息

PLoS One. 2013 May 30;8(5):e61486. doi: 10.1371/journal.pone.0061486. Print 2013.

UNLABELLED

The study was aimed to test whether zinc supplementation, if initiated early, can prevent stunting and promote optimum body composition in full term infants. For this, full term pregnant women from low income urban community were enrolled and were followed-up for 24 months postpartum. Body mass index (BMI) was calculated from maternal weight and height that were collected one month after delivery. Infants' weight, and length, head, chest and mid upper arm circumferences and skin fold thicknesses at triceps, biceps and subscapular area were collected at baseline (before randomization) and once in three months up till 24 months. Three hundred and twenty four infants were randomized and allocated to zinc (163) or placebo (161) groups respectively. Supplementation of zinc was initiated from 4 months of age and continued till children attained 18 months. The control (placebo) group of children received riboflavin 0.5 mg/day, whereas the intervention (zinc) group received 5 mg zinc plus riboflavin 0.5 mg/day. When infants were 18 months old, dietary intakes (in 78 children) were calculated by 24 hour diet recall method and hemoglobin, zinc, copper and vitamin A were quantified in blood samples collected from 70 children. The results showed prevalence of undernutrition (body mass index <18.5) in 37% of the mothers. Mean±SD calorie consumption and zinc intakes from diets in infants were 590±282.8 Kcal/day and 0.97±0.608 mg/day respectively. Multiple linear regression models demonstrated maternal weight as a strong predictor of infants' weight and length at 18 months of age. As expected, diarrhea duration impacted infants' linear growth and weight gain adversely. Zinc supplementation for a mean period of 190 days, starting from 4 months up to 18 months of age, in full term normal infants, consuming an average energy of 590 Kcal/day, had significant effect on the skin fold thicknesses, but not on their linear growth.

TRIAL REGISTRATION

Clinical Trail Registration India (CTRI) CTRI/2012/08/002884.

目的

本研究旨在检验早期补锌是否能预防足月婴儿发育迟缓并促进其最佳体成分。为此，我们招募了来自低收入城市社区的足月孕妇，并对其进行了 24 个月的产后随访。产后 1 个月收集母亲体重和身高，计算体重指数（BMI）。基线（随机分组前）时收集婴儿体重、身长、头围、胸围和上臂中段周径，此后每 3 个月测量 1 次，直至 24 个月。324 名婴儿随机分为锌组（163 名）和安慰剂组（161 名）。锌补充从 4 月龄开始，持续至儿童 18 月龄。对照组（安慰剂组）儿童每天补充核黄素 0.5mg，而干预组（锌组）儿童每天补充 5mg 锌加核黄素 0.5mg。当婴儿 18 月龄时，通过 24 小时膳食回顾法计算膳食摄入量（78 名儿童），并从 70 名儿童中采集血样，检测血红蛋白、锌、铜和维生素 A。结果：母亲中存在营养不足（BMI＜18.5）的比例为 37%。婴儿的平均膳食热量和锌摄入量分别为 590±282.8Kcal/d 和 0.97±0.608mg/d。多元线性回归模型显示，母亲体重是婴儿 18 月龄时体重和身长的重要预测因素。正如预期的那样，腹泻持续时间会对婴儿的线性生长和体重增加产生不利影响。锌补充（4 月龄开始至 18 月龄结束，平均 190 天）对摄入平均 590Kcal/d 热量的足月正常婴儿的皮肤褶皱厚度有显著影响，但对其线性生长无影响。