[维生素A补充剂对学龄前儿童铁代谢稳态的影响]

[Effect of vitamin A supplements on iron metabolic homeostasis for preschoolers].

作者信息

Chen Ke, Zhang Lan, Luo Hongyi, Wang Jin, Li Qin, Mao Meng

机构信息

Department of Child Health Care, Chengdu Women's and Children's Central Hospital of Chongqing Medical University, Chengdu 610091, China.

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出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2014 Jan;48(1):18-22.

PMID:24713285

Abstract

OBJECTIVE

To explore the effect of vitamin A (VA) combined iron supplements on iron metabolic homeostasis for preschoolers.

METHODS

About 445 preschoolers with aged 3-6 years old from eight kindergartens in Pixian county, Chengdu were recruited into this trial from March to September, 2011. All subjects met the inclusion criteria were randomly divided into four groups using random number table: sole VA supplementation group (VA group, a single oral dose of VA at about 200 000 units), sole iron supplementation group (FE group, daily oral supplementation with the element iron 1-2 mg·kg(-1)·d(-1) for five days a week, lasting for 6 months), the combined supplementation of VA and iron group (VF group) and control group (CO group, no VA and iron supplementation). The concentration of serum VA, serum ferritin (SF), serum transferring receptor (sTfR), C-reactive protein (CRP) and hemoglobin (Hb) were measured from 3 ml vein blood. The sTfR-SF index (TFR-F index) and total body iron content (TBIC) before and after intervention were calculated. The differences of these indexes between groups before and after intervention were analyzed.

RESULTS

The level of sTfR before intervention in VA group ((1.78 ± 0.17) mg/L) was significantly higher than that of after intervention ((1.18 ± 0.11)mg/L) (t = 28.88, P < 0.01). The levels of TFR-F index and TBIC in FE and VF groups before intervention ( (1.59 ± 0.37), (1.63 ± 0.40) and (9.04 ± 2.71), (9.26 ± 2.33) mg/kg, respectively) were all lower than those of after intervention (TFR-F index:(1.84 ± 0.51), (1.87 ± 0.45) and TBIC:(12.42 ± 3.49), (13.01 ± 2.98)mg/kg) (t values were 3.93, 3.78, 7.57 and 9.41, respectively, all P values were <0.01). The incidence of iron deficiency in VA, FE, and VF groups before intervention were 26% (25/95), 31% (30/98) and 31% (28/90) and were 41% (39/95), 10% (10/98) and 18% (16/90) for after intervention, respectively. The difference of this index in VA, FE and VF groups were significant (χ(2) values were 4.59, 12.50 and 4.31, respectively, all the P values were <0.05).

CONCLUSION

Combined VA and iron was as effective as VA alone or iron alone in decreasing the iron deficiency, the impact of VA intervention on iron metabolic homeostasis was mainly manifested in iron usage and mobilization, but showed no effect on total body iron content.

摘要

目的

探讨维生素A（VA）联合铁补充剂对学龄前儿童铁代谢稳态的影响。

方法

2011年3月至9月，从成都市郫县八所幼儿园招募了约445名3 - 6岁的学龄前儿童。所有符合纳入标准的受试者使用随机数字表随机分为四组：单纯VA补充组（VA组，单次口服约200 000单位VA）、单纯铁补充组（FE组，每周5天每日口服元素铁1 - 2 mg·kg⁻¹·d⁻¹，持续6个月）、VA与铁联合补充组（VF组）和对照组（CO组，不补充VA和铁）。采集3 ml静脉血检测血清VA、血清铁蛋白（SF）、血清转铁蛋白受体（sTfR）、C反应蛋白（CRP）和血红蛋白（Hb）浓度。计算干预前后的sTfR - SF指数（TFR - F指数）和全身铁含量（TBIC）。分析干预前后各组这些指标的差异。

结果

VA组干预前sTfR水平（（1.78 ± 0.17）mg/L）显著高于干预后（（1.18 ± 0.11）mg/L）（t = 28.88，P < 0.01）。FE组和VF组干预前TFR - F指数（分别为（1.59 ± 0.37）、（1.63 ± 0.40））和TBIC（分别为（9.04 ± 2.71）、（9.26 ± 2.33）mg/kg）均低于干预后（TFR - F指数：（1.84 ± 0.51）、（1.87 ± 0.45）；TBIC：（12.42 ± 3.49）、（13.01 ± 2.98）mg/kg）（t值分别为3.93、3.78、7.57和9.41，所有P值均<0.01）。VA组、FE组和VF组干预前缺铁发生率分别为26%（25/95）、31%（30/98）和31%（28/90），干预后分别为41%（39/95）、10%（10/98）和18%（16/90）。VA组、FE组和VF组该指标差异有统计学意义（χ²值分别为4.59、12.50和4.31，所有P值均<0.05）。