Suchdev Parminder S, Namaste Sorrel M L, Aaron Grant J, Raiten Daniel J, Brown Kenneth H, Flores-Ayala Rafael
Nutrition Branch, Centers for Disease Control and Prevention, Atlanta, GA; Department of Pediatrics, Emory University, Atlanta, GA;
Helen Keller International, New York, NY; Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD;
Adv Nutr. 2016 Mar 15;7(2):349-56. doi: 10.3945/an.115.010215. Print 2016 Mar.
Anemia remains a widespread public health problem. Although iron deficiency is considered the leading cause of anemia globally, the cause of anemia varies considerably by country. To achieve global targets to reduce anemia, reliable estimates of the contribution of nutritional and non-nutritional causes of anemia are needed to guide interventions. Inflammation is known to affect many biomarkers used to assess micronutrient status and can thus lead to incorrect diagnosis of individuals and to overestimation or underestimation of the prevalence of deficiency in a population. Reliable assessment of iron status is particularly needed in settings with high infectious disease burden, given the call to screen for iron deficiency to mitigate potential adverse effects of iron supplementation. To address these information gaps, in 2012 the CDC, National Institute for Child Health and Human Development, and Global Alliance for Improved Nutrition formed a collaborative research group called Biomarkers Reflecting Inflammation and Nutrition Determinants of Anemia (BRINDA). Data from nationally and regionally representative nutrition surveys conducted in the past 10 y that included preschool children and/or women of childbearing age were pooled. Of 25 data sets considered for inclusion, 17 were included, representing ∼30,000 preschool children, 26,000 women of reproductive age, and 21,000 school-aged children from all 6 WHO geographic regions. This article provides an overview of the BRINDA project and describes key research questions and programmatic and research implications. Findings from this project will inform global guidelines on the assessment of anemia and micronutrient status and will guide the development of a research agenda for future longitudinal studies.
贫血仍然是一个普遍存在的公共卫生问题。尽管缺铁被认为是全球贫血的主要原因，但贫血的病因在不同国家差异很大。为实现全球减少贫血的目标，需要对贫血的营养和非营养病因的贡献进行可靠估计，以指导干预措施。已知炎症会影响许多用于评估微量营养素状况的生物标志物，从而可能导致对个体的错误诊断以及对人群中缺乏症患病率的高估或低估。鉴于呼吁筛查缺铁以减轻铁补充剂的潜在不良影响，在传染病负担高的环境中尤其需要对铁状况进行可靠评估。为了解决这些信息差距，2012年美国疾病控制与预防中心、国家儿童健康与人类发展研究所和全球改善营养联盟组建了一个名为“反映贫血的炎症和营养决定因素生物标志物”（BRINDA）的合作研究小组。汇总了过去10年中进行的全国和地区代表性营养调查的数据，这些调查涵盖了学龄前儿童和/或育龄妇女。在考虑纳入的25个数据集中，有17个被纳入，代表了来自世界卫生组织所有6个地理区域的约30000名学龄前儿童、26000名育龄妇女和21000名学龄儿童。本文概述了BRINDA项目，并描述了关键研究问题以及对规划和研究的启示。该项目的研究结果将为全球贫血和微量营养素状况评估指南提供信息，并将指导未来纵向研究的研究议程制定。
