Ke Chen, Lan Zhang, Hua Li, Ying Zhang, Humina Xie, Jia Shang, Weizheng Tian, Ping Yang, Lingying Chai, Meng Mao
Department of Child Health Care, Chengdu Women's and Children's Central Hospital, Chengdu, Sichuan, China.
Department of Preventive Health Care, Women and Children's Health Care Hospital of Qing Baijing, Qing Baijing District, Chengdu, Sichuan, China.
Nutrition. 2015 Feb;31(2):304-9. doi: 10.1016/j.nut.2014.07.006. Epub 2014 Aug 1.
The aim of this study was to evaluate whether an iron-fortified formula with a concentration of lactoferrin would significantly improve the hematologic indexes and iron status in term infants compared with those same values in infants fed an iron-fortified formula without lactoferrin.
In this prospective, multicenter, controlled intervention study, 260 infants ages 4 to 6 mo were selected from six maternal and children's health care hospitals in the area. All infants were divided into two groups with the sequence of outpatient: lactoferrin-fortified formula milk group (fortified group, FG, containing lactoferrin 38 mg/100 g milk and iron element 4 mg/100 g milk) and no lactoferrin fortified milk (control group, CG, containing lactoferrin 0 mg/100 g milk and iron element 4 mg/100 g milk) for 3 mo. The levels of weight, height, and head circumference and the concentration of hemoglobin (Hb), serum ferritin (SF), and serum transferring receptor (sTfR) were measured and sTfR-SF index (TFR-F index), total body iron content (TBIC) and low height for age (HAZ), low weight for age (WAZ), and low weight for height (WHZ) were computed before and after the intervention, respectively.
In all, 213 (115 in FG and 98 in CG) infants completed the intervention trial and all measurements of biochemical indicators. There were no significant differences in the average amount of daily intake of formula milk (94.3 ± 9.8 g versus 88.2 ± 8.7 g for FG and CG; P > 0.05) and iron element (3.8 ± 0.4 mg versus 3.7 ± 0.6 mg for FG and CG; P > 0.05). The average amount of daily intake of lactoferrin for infants in FG group was 35.8 ± 3.7 mg. The levels of weight, WAZ, WHZ, Hb, SF, TFR-F index, and TBIC after intervention of infants in FG were all significantly higher than those of infants in CG weight, 8723 ± 245 g versus 8558 ± 214g; WAZ, 1.02 ± 0.31 versus 0.44 ± 0.18; WHZ, 0.98 ± 0.31 versus 0.41 ± 0.12; Hb, 125.5 ± 15.4 g/L versus 116.9 ± 13.1 g/L; SF, 44.7 ± 17.2 μg/L versus 31.6 ± 18.4 μg/L; TFR-F index, 1.88 ± 0.41 versus 1.26 ± 0.39; TBIC, 6.12 ± 0.78 mg/kg versus 5.26 ± 0.55 mg/kg for FG and CG; P < 0.05), but significantly lower (P < 0.05) for the prevalence of anemia (4.1% versus 7.5%), iron deficiency (13.9% versus 24.4%), and iron-deficient anemia (1.7% versus 6.1%).
When infants who were exclusively breastfed were supplemented with lactoferrin-fortified milk, significant increases in TBIC and iron absorption in the intestine were seen.
本研究旨在评估与喂养不含乳铁蛋白的铁强化配方奶的婴儿相比,含一定浓度乳铁蛋白的铁强化配方奶是否能显著改善足月儿的血液学指标和铁状态。
在这项前瞻性、多中心、对照干预研究中,从该地区的六家妇幼保健医院选取了260名4至6个月大的婴儿。所有婴儿按门诊顺序分为两组:乳铁蛋白强化配方奶组(强化组,FG,每100g牛奶含乳铁蛋白38mg和铁元素4mg)和无乳铁蛋白强化奶组(对照组,CG,每100g牛奶含乳铁蛋白0mg和铁元素4mg),为期3个月。分别测量干预前后婴儿的体重、身高、头围以及血红蛋白(Hb)、血清铁蛋白(SF)和血清转铁蛋白受体(sTfR)的浓度,并计算sTfR - SF指数(TFR - F指数)、全身铁含量(TBIC)以及年龄别身高(HAZ)、年龄别体重(WAZ)和身高别体重(WHZ)。
共有213名婴儿(FG组115名,CG组98名)完成了干预试验及所有生化指标测量。两组婴儿配方奶日均摄入量(FG组94.3±9.8g,CG组88.2±8.7g;P>0.05)和铁元素日均摄入量(FG组3.8±0.4mg,CG组3.7±0.6mg;P>0.05)无显著差异。FG组婴儿乳铁蛋白日均摄入量为35.8±3.7mg。FG组婴儿干预后的体重、WAZ、WHZ、Hb、SF、TFR - F指数和TBIC水平均显著高于CG组(体重,FG组8723±245g,CG组8558±214g;WAZ,FG组1.02±0.31,CG组0.44±0.18;WHZ,FG组0.98±0.31,CG组0.41±0.12;Hb,FG组125.5±15.4g/L,CG组116.9±13.1g/L;SF,FG组44.7±17.2μg/L,CG组31.6±18.4μg/L;TFR - F指数,FG组1.88±0.41,CG组1.26±0.39;TBIC,FG组6.12±0.78mg/kg,CG组5.26±0.55mg/kg;P<0.05),但贫血患病率(4.1%对7.5%)、缺铁率(13.9%对24.4%)和缺铁性贫血患病率(1.7%对6.1%)显著低于CG组(P<0.05)。
纯母乳喂养的婴儿补充乳铁蛋白强化奶后,全身铁含量和肠道铁吸收显著增加。