Benn Christine Stabell
Research Center for Vitamins and Vaccines, Bandim Health Project, Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark.
Odense Patient data Explorative Network, Odense University Hospital/Institute of Clinical Research, University of Southern Denmark, 5000 Odense C, Denmark.
Nutrients. 2017 Mar 15;9(3):280. doi: 10.3390/nu9030280.
It is usually acknowledged that high-dose vitamin A supplementation (VAS) provides no sustained improvement in vitamin A status, and that the effect of VAS on mortality is more likely linked to its immunomodulating effects. Nonetheless, it is widely assumed that we can deduce something about the need for continuing or stopping VAS programs based on studies of the biochemical prevalence of vitamin A deficiency (VAD). This is no longer a tenable assumption. The justification for using VAS is to reduce child mortality, but there is now doubt that VAS has any effect on overall child mortality. What we need now are not surveys of VAD, but proper randomized trials to evaluate whether VAS has beneficial effects on overall child survival.
人们通常认为,大剂量补充维生素A并不能持续改善维生素A状况,而且补充维生素A对死亡率的影响更可能与其免疫调节作用有关。尽管如此,人们普遍认为,我们可以根据维生素A缺乏症(VAD)的生化流行率研究推断出是否需要继续或停止维生素A补充计划。但这一假设已不再成立。使用维生素A补充剂的理由是降低儿童死亡率,但现在人们怀疑维生素A补充剂对儿童总体死亡率是否有任何影响。我们现在需要的不是维生素A缺乏症的调查,而是适当的随机试验,以评估维生素A补充剂对儿童总体生存是否有有益影响。