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[2010 - 2012年中国城市孕妇贫血及维生素A和维生素D营养状况研究]

[Study on anemia and vitamin A and vitamin D nutritional status of Chinese urban pregnant women in 2010-2012].

作者信息

Hu Y C, Chen J, Li M, Wang R, Li W D, Yang Y H, Yang C, Yun C F, Yang L C, Yang X G

机构信息

National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention; Key Laboratory of Trace Element Nutrition, National Health and Family Planning Commission, Beijing 100050, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2017 Feb 6;51(2):125-131. doi: 10.3760/cma.j.issn.0253-9624.2017.02.006.

Abstract

To evaluate the prevalence of anemia and the nutritional status of vitamins A and D by analyzing hemoglobin, serum retinol, and serum 25-hydroxyvitamin D levels in Chinese urban pregnant women during 2010-2012. Data were obtained from the China Nutrition and Health Survey in 2010-2012. Using multi-stage stratified sampling and population proportional stratified random sampling, 2 250 pregnant women from 34 metropolis and 41 middle-sized and small cities were included in this study. Information was collected using a questionnaire survey. The blood hemoglobin concentration was determined using the cyanmethemoglobin method, and anemia was determined using the World Health Organization guidelines combined with the elevation correction standard. The serum retinol level was determined using high-performance liquid chromatography, and vitamin A deficiency (VAD) was judged by the related standard recommended by the World Health Organization. The vitamin D level was determined using enzyme-linked immunosorbent assay and vitamin D deficiency was judged by the recommendation standards from the Institute of Medicine of The National Academies. The hemoglobin, serum retinol, and serum 25-hydroxyvitamin D levels were compared, along with differences in the prevalence of anemia, VAD, and the vitamin D deficiency rate (including deficiency and serious deficiency). A total of 1 738 cases of hemoglobin level, 594 cases of serum retinol level, and 1 027 cases of serum 25-hydroxyvitamin D were available for analysis in this study. The overall blood hemoglobin level ((50) ((25)-(75))) was 122.70 (114.00-131.10) g/L; 123.70 (115.21-132.00) g/L for metropolis and 122.01 (113.30-130.40) g/L for middle-sized and small cities. The blood hemoglobin level of metropolis residents was significantly higher than that of middle-sized and small city residents (0.027). The overall prevalence of anemia was 17.0% (295/1 738). The overall serum retinol level ((50) ((25)-(75))) was 1.61 (1.20-2.06) μmol/L; 1.50 (1.04-2.06) μmol/L for metropolis and 1.63 (1.31-2.05) μmol/L for middle-sized and small cities. The serum retinol level of metropolis residents was significantly higher than that of middle-sized and small city residents (0.033). The overall prevalence of VAD was 7.4% (47/639); 11.5% (33/286) for metropolis and 4.0% (14/353) for middle-sized and small cities. A significant difference was observed in the prevalence of VAD between metropolis and middle-sized and small city residents (0.001). The overall serum 25-hydroxyvitamin D level ((50) ((25)-(75))) was 15.41 (11.79-20.23) ng/ml; 14.71 (11.15-19.07) ng/ml for metropolis and 16.02 (12.65-21.36) ng/ml for middle-sized and small cities. A significant difference was observed in the vitamin D level between metropolis and middle-sized and small city residents (0.001). The overall prevalence of vitamin D deficiency was 74.3% (763/1 027); A significant difference was observed in the prevalence of serious vitamin D deficiency between metropolis (30.64%(144/470)) and middle-sized and small city residents (26%(267/1 027))(0.002). There were no significant differences between blood hemoglobin level and the prevalence of anemia, VAD, and vitamin D deficiency. The prevalence of anemia in Chinese urban pregnant women improved from 2002 to 2012. The prevalence of vitamin D deficiency in pregnant women was generally more serious, while a certain percentage of women had VAD. The prevalence of VAD and serious vitamin D deficiency among pregnant women from metropolis was significantly higher than that of pregnant women from medium and small-sized cities.

摘要

通过分析2010 - 2012年中国城市孕妇的血红蛋白、血清视黄醇和血清25 - 羟基维生素D水平,评估贫血患病率以及维生素A和D的营养状况。数据来自2010 - 2012年中国营养与健康调查。采用多阶段分层抽样和人口比例分层随机抽样,本研究纳入了来自34个大城市和41个中小城市的2250名孕妇。通过问卷调查收集信息。采用氰化高铁血红蛋白法测定血血红蛋白浓度,并根据世界卫生组织指南结合海拔校正标准确定贫血情况。采用高效液相色谱法测定血清视黄醇水平,并根据世界卫生组织推荐的相关标准判断维生素A缺乏(VAD)情况。采用酶联免疫吸附测定法测定维生素D水平,并根据美国国家科学院医学研究所的推荐标准判断维生素D缺乏情况。比较血红蛋白、血清视黄醇和血清25 - 羟基维生素D水平,以及贫血、VAD患病率和维生素D缺乏率(包括缺乏和严重缺乏)的差异。本研究共纳入1738例血红蛋白水平数据、594例血清视黄醇水平数据和1027例血清25 - 羟基维生素D水平数据用于分析。总体血血红蛋白水平((50)((25) - (75)))为122.70(114.00 - 131.10)g/L;大城市为123.70(115.21 - 132.00)g/L,中小城市为122.01(113.30 - 130.40)g/L。大城市居民的血血红蛋白水平显著高于中小城市居民(P = 0.027)。贫血总体患病率为17.0%(295/1738)。总体血清视黄醇水平((50)((25) - (75)))为1.61(1.20 - 2.06)μmol/L;大城市为1.50(1.04 - 2.06)μmol/L,中小城市为1.63(1.31 - 2.05)μmol/L。大城市居民的血清视黄醇水平显著高于中小城市居民(P = 0.033)。VAD总体患病率为7.4%(47/639);大城市为11.5%(33/286),中小城市为4.0%(14/353)。大城市和中小城市居民的VAD患病率存在显著差异(P = 0.001)。总体血清25 - 羟基维生素D水平((50)((25) - (75)))为15.41(11.79 - 20.23)ng/ml;大城市为14.71(11.15 - 19.07)ng/ml,中小城市为16.02(12.65 - 21.36)ng/ml。大城市和中小城市居民的维生素D水平存在显著差异(P = 0.001)。维生素D缺乏总体患病率为74.3%(763/1027);大城市严重维生素D缺乏患病率(30.64%(144/470))与中小城市居民(26%(267/1027))之间存在显著差异(P = 0.002)。血血红蛋白水平与贫血、VAD和维生素D缺乏患病率之间无显著差异。2002年至2012年中国城市孕妇贫血患病率有所改善。孕妇维生素D缺乏情况总体较为严重,同时有一定比例的女性存在VAD。大城市孕妇的VAD和严重维生素D缺乏患病率显著高于中小城市孕妇。

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