Bahreynian Maryam, Qorbani Mostafa, Naderimagham Shohreh, Nejatinamini Sara, Ataie-Jafari Asal, Sharifi Farshad, Saqib Fahad, Khajavi Alireza, Mansourian Morteza, Ahmadishokouh Ali Asghar, Asayesh Hamid, Safari Omid, Kelishadi Roya
Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Hezarjerib Ave, Isfahan, Iran.
Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Baghestan Boulevard, Karaj, 31485/56 Iran.
J Diabetes Metab Disord. 2017 Aug 9;16:32. doi: 10.1186/s40200-017-0313-7. eCollection 2017.
Vitamin A deficiency (VAD) is considered as one of the most serious public health concerns in developing countriesand the leading cause of mortality in under-five-year-old children.A large number of young children and pregnant women especially in low-income, non-industrialized communities are more susceptible to VAD. This study aims to report the burden of disease (BOD) attributable to VAD in Iranian population aged less than 5 years by using data of the Global Burden of Disease (GBD) study 2010.
The GBD 2010 study calculated the proportion of deaths, years of life lost (YLLs), and years lived with disability (YLDs) and disability-adjusted life years (DALYs) attributable to VAD by using the comparative risk assessment (CRA). VAD defined as low serum retinol concentrations (plasma retinol concentration < 0.70 umole/L) among children aged less than five. The VAD outcomes consisted of mortality due to diarrhea, measles, malaria, neglected infectious diseases, morbidity due to malaria (children < 5 years), low birth weight and other perinatal conditions. Uncertainty in the estimates is presented as 95% uncertainty interval (UI).
In 1990, there were 371 (95% UI: 166,665) DALYs due to VAD per 100,000 under five-year-old Iranian children in both sexes. The DALYs rate had a downward trend throughout the following years and reached to 76 (95% UI: 33-139)in 2010.The DALYs in children aged under 5 years was 378 (95% UI: 153-747) years for boys and 363 (95% UI: 148-692) years for girls in 1990 which fell to 79 (95% UI: 32-149) and 73 (95% UI: 29-138) in boys and girls in 2010, respectively. The rates of YLDs attributable to VAD changed in both sexes from 87(95% UI: 34-162) in 1990 to 46 (95% UI: 17-69) in 2010. The highest rate of YLDs attributed to VAD was observed in children aged 1-4. On the other hand, the YLLs were mostly in the 0-1-year-oldchildren in all years except 2010.
It was found that DALYs attributable to VAD in 1990, followed by a considerable reduction rate after a period of two decades, in 2010. Additional studies on the burden of diseases particularly at sub-national level with more accurate data are recommended.
维生素A缺乏症（VAD）被认为是发展中国家最严重的公共卫生问题之一，也是五岁以下儿童死亡的主要原因。大量幼儿和孕妇，尤其是在低收入、非工业化社区的人群，更容易患维生素A缺乏症。本研究旨在利用2010年全球疾病负担（GBD）研究的数据，报告伊朗五岁以下人群中维生素A缺乏症所致的疾病负担（BOD）。
2010年全球疾病负担研究使用比较风险评估（CRA）计算了维生素A缺乏症所致的死亡比例、寿命损失年数（YLLs）、失能生存年数（YLDs）以及伤残调整生命年（DALYs）。维生素A缺乏症定义为五岁以下儿童血清视黄醇浓度低（血浆视黄醇浓度<0.70微摩尔/升）。维生素A缺乏症的后果包括腹泻、麻疹、疟疾、被忽视的传染病导致的死亡、疟疾所致的发病（五岁以下儿童）、低出生体重和其他围产期疾病。估计值的不确定性以95%不确定区间（UI）表示。
1990年，伊朗每十万名五岁以下儿童中，因维生素A缺乏症导致的伤残调整生命年为371（95%UI：166，665）。在接下来的几年中，伤残调整生命年率呈下降趋势，2010年降至76（95%UI：33 - 139）。1990年，五岁以下男孩因维生素A缺乏症导致的伤残调整生命年为378（95%UI：153 - 747）年，女孩为363（95%UI：148 - 692）年，2010年男孩和女孩分别降至79（95%UI：32 - 149）年和73（95%UI：29 - 138）年。维生素A缺乏症所致失能生存年率在两性中从1990年的87（95%UI：34 - 162）降至2010年的46（95%UI：17 - 69）。维生素A缺乏症所致失能生存年率最高的是1 - 4岁儿童。另一方面，除2010年外，各年份寿命损失年数大多在0 - 1岁儿童中。
研究发现，1990年维生素A缺乏症所致伤残调整生命年较高，随后在二十年期间大幅下降。建议开展更多关于疾病负担的研究，特别是在国家以下层面，采用更准确的数据。
