Mandlik Rubina, Mughal Zulf, Khadilkar Anuradha, Chiplonkar Shashi, Ekbote Veena, Kajale Neha, Patwardhan Vivek, Padidela Raja, Khadilkar Vaman
Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, 32, Sassoon Road, Pune - 411001, Maharashtra, India.
Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Ganeshkind Road, Pune - 411007, Maharashtra, India.
Nutr Res Pract. 2020 Apr;14(2):117-126. doi: 10.4162/nrp.2020.14.2.117. Epub 2019 Oct 4.
BACKGROUND/OBJECTIVES: Vitamin D and zinc are recognized for their roles in immune-modulation, and their deficiencies are suggested to be important risk factors for childhood infections. This study, therefore, undertook to assess the occurrence of infections in rural Indian schoolchildren, subsequent to daily supplementation with vitamin D-calcium or zinc for 6 months.
MATERIALS/METHODS: This was a randomized, double-blind, placebo-controlled trial in apparently healthy 6-12 year-old rural Indian children, recruited to 3 study arms: vitamin D arm (1,000 IU D3 - 500 mg calcium, n = 135), zinc arm (10 mg, n = 150) and placebo arm (n = 150). The infection status was assessed using a validated questionnaire, and the biochemical parameters of serum 25(OH)D and serum zinc were measured by ELISA and colorimetry, respectively. The primary outcome variable was occurrence of infections (upper respiratory and total infections).
Serum 25(OH)D concentration in the vitamin D arm improved significantly by 34%, from 59.7 ± 10.9 nmol/L to 80 ± 23.3 nmol/L ( < 0.0001), but no improvement was observed for serum zinc concentration. While there was significant increase in the percentage of children reporting no or mild upper respiratory tract infections (URTI) and total infections (TI) in all three groups, improvements in the supplemented groups were similar to the placebo group. However, the vitamin D arm reported lower URTI and TI status in the vitamin D sufficient versus insufficient children. Also, URTI and TI status were found to be significantly ( < 0.0001) lower in children with improved 25(OH)D versus unchanged 25(OH)D.
Vitamin D-calcium supplementation helped to improve the vitamin D status but exerts no effect on the occurrence of infections when compared to the placebo group. Improvement in the serum 25(OH)D concentrations and attainment of vitamin D sufficiency may exert a beneficial effect on the infection status and needs to be investigated further. To evaluate the efficacy of zinc supplementation, higher dosages need to be administered in future studies.
背景/目的：维生素D和锌因其在免疫调节中的作用而受到认可，其缺乏被认为是儿童感染的重要风险因素。因此，本研究旨在评估印度农村学童在每日补充维生素D-钙或锌6个月后的感染发生率。
材料/方法：这是一项针对明显健康的6至12岁印度农村儿童的随机、双盲、安慰剂对照试验，招募到3个研究组：维生素D组（1000 IU D3 - 500 mg钙，n = 135）、锌组（10 mg，n = 150）和安慰剂组（n = 150）。使用经过验证的问卷评估感染状况，分别通过酶联免疫吸附测定法（ELISA）和比色法测量血清25(OH)D和血清锌的生化参数。主要结局变量是感染（上呼吸道感染和总体感染）的发生率。
维生素D组的血清25(OH)D浓度显著提高了34%，从59.7±10.9 nmol/L升至80±23.3 nmol/L（<0.0001），但血清锌浓度未出现改善。虽然三组中报告无或轻度上呼吸道感染（URTI）和总体感染（TI）的儿童百分比均显著增加，但补充组的改善情况与安慰剂组相似。然而，维生素D组中维生素D充足的儿童与不足的儿童相比，URTI和TI状况较低。此外，发现25(OH)D改善的儿童与未改变的儿童相比，URTI和TI状况显著更低（<0.0001）。
与安慰剂组相比，补充维生素D-钙有助于改善维生素D状况，但对感染发生率没有影响。血清25(OH)D浓度的改善和维生素D充足状态的实现可能对感染状况产生有益影响，需要进一步研究。为评估补锌的疗效，未来研究需要给予更高剂量。
