在澳大利亚昆士兰州实施强制性强化计划后，叶酸缺乏状况大幅下降：一项二级健康数据分析。

Folic acid deficiency declined substantially after introduction of the mandatory fortification programme in Queensland, Australia: a secondary health data analysis.

作者信息

Slagman Anna, Harriss Linton, Campbell Sandra, Muller Reinhold, McDermott Robyn

机构信息

James Cook University, Medical and Veterinary Sciences, Australian Institute of Tropical Health and Medicine, College of Public Health, Centre for Chronic Disease Prevention, Cairns, Australia.

Notfallmedizinische Versorgungsforschung, Notfall- und Akutmedizin CVK, CCM, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany.

出版信息

Public Health Nutr. 2019 Dec;22(18):3426-3434. doi: 10.1017/S1368980019002258. Epub 2019 Sep 4.

DOI:10.1017/S1368980019002258

PMID:31482769

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10260513/

Abstract

OBJECTIVE

To investigate the prevalence of folic acid deficiency in Queensland-wide data of routine laboratory measurements, especially in high-risk sub-populations.

DESIGN

Secondary health data analysis.

SETTING

Analysis of routine folic acid tests conducted by Pathology Queensland (AUSLAB).

PARTICIPANTS

Female and male persons aged 0-117 years with routine folic acid testing between 1 January 2004 and 31 December 2015. If repeat tests on the same person were conducted, only the initial test was analysed (n 291 908).

RESULTS

Overall the prevalence of folic acid deficiency declined from 7·5 % before (2004-2008) to 1·1 % after mandatory folic acid fortification (2010-2015; P < 0·001) reflecting a relative reduction of 85 %. Levels of erythrocyte folate increased significantly from a median (interquartile range) of 820 (580-1180) nmol/l in 2008 before fortification to 1020 (780-1350) nmol/l in 2010 (P < 0·001) after fortification. The prevalence of folic acid deficiency in the Indigenous population (14 792 samples) declined by 93 % (17·4 v. 1·3 %; P < 0·001); and by 84 % in non-Indigenous residents (7·0 v. 1·1 %; P < 0·001). In a logistic regression model the observed decrease of folic acid deficiency between 2008 and 2010 was found independent of gender, age and ethnicity (ORcrude = 0·20; 95 % CI 0·18, 0·23; P < 0·001; ORadjusted = 0·21; 95 % CI 0·18, 0·23; P < 0·001).

CONCLUSIONS

While voluntary folic acid fortification, introduced in 1995, failed especially in high-risk subgroups, the 2009 mandatory folic acid fortification programme coincided with a substantial decrease of folic acid deficiency in the entire population.

摘要

目的

在昆士兰州常规实验室检测数据中调查叶酸缺乏症的患病率，尤其是在高危亚人群中。

设计

二次健康数据分析。

背景

对昆士兰病理学（澳大利亚实验室）进行的常规叶酸检测进行分析。

参与者

2004年1月1日至2015年12月31日期间接受常规叶酸检测的0至117岁的男性和女性。如果对同一人进行了重复检测，则仅分析初次检测结果（n = 291908）。

结果

总体而言，叶酸缺乏症的患病率从强制补充叶酸之前（2004 - 2008年）的7.5%下降到之后（2010 - 2015年）的1.1%（P < 0.001），相对下降了85%。红细胞叶酸水平从强化前2008年的中位数（四分位间距）820（580 - 1180）nmol/l显著增加到强化后2010年的1020（780 - 1350）nmol/l（P < 0.001）。原住民人群（14792个样本）中叶酸缺乏症的患病率下降了93%（从17.4%降至1.3%；P < 0.001）；非原住民居民中下降了84%（从7.0%降至1.1%；P < 0.001）。在逻辑回归模型中，发现2008年至2010年期间观察到的叶酸缺乏症减少与性别、年龄和种族无关（粗比值比 = 0.20；95%置信区间0.18，0.23；P < 0.001；调整后比值比 = 0.21；95%置信区间0.18，0.23；P < 0.001）。