智利19至72个月大儿童的铁状态生物标志物与C反应蛋白

Iron status biomarkers and C-reactive protein in children aged 19 to 72 months in Chile.

作者信息

Brito Alex, Hertrampf Eva, Olivares Manuel

机构信息

Micronutrients Laboratory, Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile.

出版信息

Food Nutr Bull. 2013 Mar;34(1):14-20. doi: 10.1177/156482651303400103.

DOI:10.1177/156482651303400103

PMID:23767277

Abstract

BACKGROUND

The Chilean Ministry of Health has combated iron deficiency through the delivery of fortified milk by the National Complementary Feeding Program (NCFP).

OBJECTIVE

To assess iron status and associations between biomarkers of iron status and serum C-reactive protein (CRP) in 218 beneficiaries of the NCFP aged 19 to 72 months in Santiago and Valparaiso, Chile.

METHODS

Blood was collected from a cross-sectional representative sample. Iron status (measured by hemoglobin, zinc protoporphyrin, and serum ferritin levels) and inflammation (according to CRP level) were determined.

RESULTS

Serum CRP level was positively associated with serum ferritin and zinc protoporphyrin levels (r = 0.16 and r = 0.15; p = .0168 and p = .0290, respectively). Serum ferritin was higher among children with high CRP (> 10 mg/dL) than among those with low CRP (< or = 10 mg/dL) (p = .003). After adjustment for 10, 6, and 5 mg/L CRP, the prevalence of low serum ferritin changed from 56.4% without adjustment to 60.6%, 61.5%, and 42.7%, respectively, and the prevalence of high zinc protoporphyrin changed from 22.9% to 21.6%, 17.4%, and 17.9%, respectively. There were no differences between regions in biomarkers of iron status. There was no association between consumption of fortified milk and the prevalence of abnormal serum ferritin (< 15 microg/L) after adjustment for sex, age, and breastfeeding (OR, 1.00; 95% CI, 0.99 to 1.01; p = .288). After adjustment for 10 mg/L CRP, 5.5% were classified as having iron-deficiency anemia, 42.7% as having iron-deficiency erythropoiesis, 17.9% as having depleted iron stores, and 35.8% as having normal iron status. CONCLUSIONS. CRP level was positively associated with: serum ferritin and zinc protoporphyrin levels. Chilean children aged 19 to 72 months from Santiago and Valparaiso who were beneficiaries of the NCFP had a low prevalence of iron-deficiency anemia, a high prevalence of iron-deficiency erythropoiesis, and a moderate prevalence of depleted iron stores.

摘要

背景

智利卫生部通过国家补充喂养计划（NCFP）提供强化牛奶来防治缺铁。

目的

评估智利圣地亚哥和瓦尔帕莱索218名年龄在19至72个月的NCFP受益者的铁状态以及铁状态生物标志物与血清C反应蛋白（CRP）之间的关联。

方法

从横断面代表性样本中采集血液。测定铁状态（通过血红蛋白、锌原卟啉和血清铁蛋白水平衡量）和炎症（根据CRP水平）。

结果

血清CRP水平与血清铁蛋白和锌原卟啉水平呈正相关（r = 0.16和r = 0.15；p分别为0.0168和0.0290）。CRP水平高（> 10 mg/dL）的儿童血清铁蛋白高于CRP水平低（≤ 10 mg/dL）的儿童（p = 0.003）。在对CRP水平进行10、6和5 mg/L的校正后，血清铁蛋白水平低的患病率分别从未校正时的56.4%变为60.6%、61.5%和42.7%，高锌原卟啉的患病率分别从22.9%变为21.6%、17.4%和17.9%。铁状态生物标志物在不同地区之间没有差异。在对性别、年龄和母乳喂养进行校正后，强化牛奶的摄入量与血清铁蛋白异常（< 15 μg/L）的患病率之间没有关联（比值比，1.00；95%置信区间，0.99至1.01；p = 0.288）。在对10 mg/L的CRP进行校正后，5.5%被归类为患有缺铁性贫血，42.7%为缺铁性红细胞生成，17.9%为铁储备耗竭，35.8%为铁状态正常。结论：CRP水平与血清铁蛋白和锌原卟啉水平呈正相关。来自圣地亚哥和瓦尔帕莱索的19至72个月的智利NCFP受益者缺铁性贫血患病率低，缺铁性红细胞生成患病率高，铁储备耗竭患病率中等。