Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.
Department of Medical Epidemiology, College of Health Sciences, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.
Gut. 2017 Nov;66(11):1956-1967. doi: 10.1136/gutjnl-2017-314418. Epub 2017 Aug 3.
Iron-containing micronutrient powders (MNPs) reduce anaemia in African infants, but the current high iron dose (12.5 mg/day) may decrease gut and , and increase enteropathogens, diarrhoea and respiratory tract infections (RTIs). We evaluated the efficacy and safety of a new MNP formula with prebiotic galacto-oligosaccharides (GOS) combined with a low dose (5 mg/day) of highly bioavailable iron.
In a 4-month, controlled, double-blind trial, we randomised Kenyan infants aged 6.5-9.5 months (n=155) to receive daily (1) a MNP without iron (control); (2) the identical MNP but with 5 mg iron (2.5 mg as sodium iron ethylenediaminetetraacetate and 2.5 mg as ferrous fumarate) (Fe group); or (3) the identical MNP as the Fe group but with 7.5 g GOS (FeGOS group).
Anaemia decreased by ≈50% in the Fe and FeGOS groups (p<0.001). Compared with the control or FeGOS group, in the Fe group there were (1) lower abundances of and and higher abundances of (p<0.01); (2) higher abundances of virulence and toxin genes (VTGs) of pathogens (p<0.01); (3) higher plasma intestinal fatty acid-binding protein (a biomarker of enterocyte damage) (p<0.05); and (4) a higher incidence of treated RTIs (p<0.05). In contrast, there were no significant differences in these variables comparing the control and FeGOS groups, with the exception that the abundance of VTGs of all pathogens was significantly lower in the FeGOS group compared with the control and Fe groups (p<0.01).
A MNP containing a low dose of highly bioavailable iron reduces anaemia, and the addition of GOS mitigates most of the adverse effects of iron on the gut microbiome and morbidity in African infants.
NCT02118402.
含铁微量营养素粉（MNPs）可降低非洲婴儿的贫血发生率，但目前较高的铁剂量（12.5mg/天）可能会降低肠道和，并增加肠道病原体、腹泻和呼吸道感染（RTIs）。我们评估了一种新的 MNP 配方的疗效和安全性，该配方含有低剂量（5mg/天）的高生物利用度铁和益生元半乳糖-低聚糖（GOS）。
在一项为期 4 个月的对照、双盲试验中，我们将 155 名年龄为 6.5-9.5 个月的肯尼亚婴儿随机分为每天接受以下治疗：（1）不含铁的 MNP（对照组）；（2）含有 5mg 铁的相同 MNP（2.5mg 为乙二胺四乙酸铁钠，2.5mg 为富马酸亚铁）（Fe 组）；或（3）含有与 Fe 组相同 MNP 但含有 7.5g GOS 的 MNP（FeGOS 组）。
Fe 组和 FeGOS 组的贫血发生率下降了约 50%（p<0.001）。与对照组或 FeGOS 组相比，Fe 组（1）和 的丰度较低，而 的丰度较高（p<0.01）；（2）病原体的毒力和毒素基因（VTGs）丰度较高（p<0.01）；（3）血浆肠脂肪酸结合蛋白（肠细胞损伤的生物标志物）水平较高（p<0.05）；以及（4）治疗性 RTIs 的发病率较高（p<0.05）。相比之下，对照组和 FeGOS 组之间这些变量没有显著差异，只有 FeGOS 组所有病原体的 VTGs 丰度明显低于对照组和 Fe 组（p<0.01）。
含有低剂量高生物利用度铁的 MNP 可降低贫血发生率，添加 GOS 可减轻铁对非洲婴儿肠道微生物组和发病率的大多数不良影响。
NCT02118402。
