1Department of Nutrition,School of Public Health,University of São Paulo,Avenida Dr Arnaldo 715,São Paulo,SP01246-904,Brazil.
2Department of Global Health and Population,Harvard T.H. Chan School of Public Health,Boston,MA,USA.
Public Health Nutr. 2019 May;22(7):1223-1231. doi: 10.1017/S1368980019000193. Epub 2019 Mar 1.
To assess the nutritional status of folate and vitamin B12 with anaemia in young children.
A cross-sectional study was conducted at the primary health-care centres of four Brazilian cities. Folate and vitamin B12 were assessed by fluoroimmunoassay. Multilevel Poisson regression models were used to explore the association of folate and vitamin B12 status in relation to anaemia in young children.
Brazil.ParticipantsChildren (n 460) aged 11 to 15 months.
The median (interquartile range) of serum folate was 39·7 (28·8-55·3) nmol/l and only four children presented with folate deficiency (<10 nmol/l). Surprisingly, 30·9 % of children presented with serum folate concentrations above the upper limit of detectable values by the commercial kit used for analysis. The frequency of vitamin B12 deficiency (<148 pmol/l) was 15 % and it was inversely associated with the highest tertile of serum folate concentrations (P<0·001). Having high serum folate concentration (≥50·1 nmol/l) and vitamin B12≥148 pmol/l was associated with lower frequency of anaemia in these children (prevalence ratio=0·53; 95% CI 0·30, 0·92).
High frequency of elevated serum concentration of folate was found among young Brazilian children and 15 % of them had vitamin B12 deficiency. The combination of high serum folate and normal vitamin B12 status was associated with a lower frequency of anaemia in these children. Improvements in the current strategies to promote healthy food-based complementary feeding along with prevention and control of micronutrient deficiencies are recommended to improve children's health.
评估叶酸和维生素 B12 与儿童贫血的营养状况。
在巴西四个城市的基层医疗中心进行了一项横断面研究。采用荧光免疫分析法评估叶酸和维生素 B12 水平。采用多水平泊松回归模型探讨了叶酸和维生素 B12 状况与儿童贫血的关联。
巴西。
年龄为 11 至 15 个月的儿童(n=460)。
血清叶酸中位数(四分位间距)为 39·7(28·8-55·3)nmol/L,仅有 4 名儿童存在叶酸缺乏(<10 nmol/L)。令人惊讶的是,30·9%的儿童血清叶酸浓度高于用于分析的商业试剂盒可检测到的上限。维生素 B12 缺乏(<148 pmol/L)的频率为 15%,且与血清叶酸浓度最高的三分位呈负相关(P<0·001)。血清叶酸浓度较高(≥50·1 nmol/L)且维生素 B12≥148 pmol/L与这些儿童贫血频率较低相关(患病率比=0·53;95%CI 0·30,0·92)。
巴西儿童中发现高频率的血清叶酸浓度升高,其中 15%的儿童存在维生素 B12 缺乏。这些儿童中,高血清叶酸和正常维生素 B12 状态的组合与贫血频率较低相关。建议改善当前促进健康的基于食物的补充喂养策略,并预防和控制微量营养素缺乏症,以改善儿童健康。