Royal College of Surgeons in Ireland, Dublin, Ireland.
Pediatr Res. 2013 Sep;74(3):327-32. doi: 10.1038/pr.2013.101. Epub 2013 Jun 14.
Whereas iron deficiency is considered the leading cause of anemia in infants, cobalamin deficiency is foremost characterized by developmental delay, and the typical macrocytic anemia is confined to severe and longstanding cobalamin deficiency in this age group. Hematological parameters were investigated in 4-mo-old infants with biochemical signs of impaired cobalamin function who participated in a randomized controlled cobalamin intervention study at 6 wk.
One hundred and seven infants were randomly assigned to receive either an intramuscular injection with 400 μg cobalamin or no intervention at 6 wk. Hematological parameters, and cobalamin and folate status were determined at inclusion and 4 mo.
Cobalamin supplementation improved all markers of impaired cobalamin function but had no effect on hematological cell counts at 4 mo (P > 0.18). Signs indicative of an iron-restricted erythropoiesis were observed at 6 wk and 4 mo. At 4 mo, the strongest predictors of low iron status were male gender and a high percentage weight increase from birth.
In infants with biochemical signs of impaired cobalamin function, supplementation does not improve hematological cell counts. Variations in erythrocyte parameters seem to be foremost associated with iron status in this age group.
缺铁被认为是婴儿贫血的主要原因，而钴胺素缺乏症的主要特征是发育迟缓，并且在该年龄组中，典型的巨幼细胞贫血仅限于严重和长期的钴胺素缺乏症。在参与了一项为期 6 周的随机对照钴胺素干预研究的 4 个月大的婴儿中，我们研究了具有生化指标提示钴胺素功能受损的婴儿的血液学参数，这些婴儿在 6 周时有生化指标提示钴胺素功能受损。
107 名婴儿被随机分配在 6 周时接受肌肉内注射 400μg 钴胺素或不接受干预。在纳入和 4 个月时，我们确定了血液学参数以及钴胺素和叶酸状况。
钴胺素补充改善了所有提示钴胺素功能受损的标志物，但在 4 个月时对血液学细胞计数没有影响（P＞0.18）。在 6 周和 4 个月时观察到提示铁限制红细胞生成的迹象。在 4 个月时，低铁状态的最强预测因素是男性和出生后体重增加百分比高。
在具有生化指标提示钴胺素功能受损的婴儿中，补充不能改善血液学细胞计数。在该年龄组中，红细胞参数的变化似乎主要与铁状态相关。
