Michalski Ellen S, Nguyen Phuong H, Gonzalez-Casanova Ines, Nguyen Son V, Martorell Reynaldo, Tangpricha Vin, Ramakrishnan Usha
Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA 30322, USA.
Thai Nguyen University of Pharmacy and Medicine, Thai Nguyen, Viet Nam.
J Clin Transl Endocrinol. 2017 May 4;8:41-48. doi: 10.1016/j.jcte.2017.05.001. eCollection 2017 Jun.
Hypovitaminosis D and anemia are both prevalent in Vietnam, and low vitamin D status may be a risk factor for anemia. This study aimed to 1) describe vitamin D intake and its determinants, and 2) examine the associations of vitamin D intake and serum 25(OH)D concentrations with hemoglobin and anemia.
We used data from the baseline survey of a pre-conceptual micronutrient supplementation trial in women of reproductive age (WRA) in Thai Nguyen, Vietnam (N = 4961). Vitamin D intake was estimated using a semi-quantitative food frequency questionnaire (FFQ). Multivariable regression models were used for the analyses.
Median vitamin D intake was 0.2 µg/d (8.0 IU) [IQR: 0.4]. Age, being a farmer, food insecurity, and body mass index (BMI) were inversely associated with vitamin D intake, while socioeconomic status (SES), total energy intake, and education were positively associated with vitamin D intake. Vitamin D intake was not associated with hemoglobin concentration or anemia after adjusting for age, BMI, total energy intake, transferrin receptor, C-reactive protein, α-acid glycoprotein, SES, occupation, education, ethnicity, and food insecurity ( = 0.56 and = 0.65 for hemoglobin and anemia, respectively). Controlling for the same covariates, 25(OH)D <50 nmol/L (vs. ≥50 nmol/L) was associated with decreased hemoglobin concentrations ( = -0.91 (SE:0.42), = 0.03), but not with anemia ( = 0.11).
Low vitamin D status may be linked to reduced hemoglobin concentrations, but the role of diet in this association was not evident in this population of WRA in Vietnam where dietary vitamin D intake was very low.
维生素D缺乏症和贫血症在越南都很普遍,低维生素D水平可能是贫血的一个风险因素。本研究旨在:1)描述维生素D摄入量及其决定因素;2)研究维生素D摄入量和血清25(OH)D浓度与血红蛋白及贫血症之间的关联。
我们使用了越南太原省育龄妇女孕前微量营养素补充试验基线调查的数据(N = 4961)。维生素D摄入量通过半定量食物频率问卷(FFQ)进行估算。采用多变量回归模型进行分析。
维生素D摄入量中位数为0.2μg/天(8.0IU)[四分位间距:0.4]。年龄、务农、粮食不安全和体重指数(BMI)与维生素D摄入量呈负相关,而社会经济地位(SES)、总能量摄入量和教育程度与维生素D摄入量呈正相关。在调整年龄、BMI、总能量摄入量、转铁蛋白受体、C反应蛋白、α-酸性糖蛋白、SES、职业、教育程度、种族和粮食不安全因素后,维生素D摄入量与血红蛋白浓度或贫血症无关(血红蛋白和贫血症的P值分别为0.56和0.65)。在控制相同协变量的情况下,25(OH)D<50nmol/L(与≥50nmol/L相比)与血红蛋白浓度降低相关(β=-0.91(标准误:0.42),P=0.03),但与贫血症无关(β=0.11)。
低维生素D水平可能与血红蛋白浓度降低有关,但在越南这群膳食维生素D摄入量极低的育龄妇女中,饮食在这种关联中的作用并不明显。