学龄前儿童和育龄妇女的锌与血红蛋白浓度之间的关联：来自反映炎症和贫血营养决定因素的生物标志物（BRINDA）项目的代表性调查数据的分析。
Associations between Zinc and Hemoglobin Concentrations in Preschool Children and Women of Reproductive Age: An Analysis of Representative Survey Data from the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) Project.
机构信息
Alimentation, Nutrition, Sante (E6), Qualisud, Université Montpellier, Université Avignon, CIRAD, Institut Agro, IRD, Université de la Reunion, Montpellier, France.
Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
出版信息
J Nutr. 2021 May 11;151(5):1277-1285. doi: 10.1093/jn/nxaa444.
BACKGROUND
Anemia is a worldwide concern. Nutritional deficiencies and inflammation are considered main contributors, but zinc deficiency has only recently been associated with anemia.
OBJECTIVES
In this study we assessed associations between zinc status and hemoglobin (Hb) concentrations and anemia in preschool children 6-59 mo old (PSC) and nonpregnant women of reproductive age 15-49 y old (WRA) in population-based nutrition surveys.
METHODS
Cross-sectional data from 13 (PSC) and 12 (WRA) countries within the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project were used. Multivariable linear models were constructed that included zinc status (plasma/serum zinc concentrations), Hb concentrations and anemia, iron status, age, sex, and inflammation (C-reactive protein and α-1-acid glycoprotein). Zinc was adjusted for inflammation in PSC according to the BRINDA algorithm.
RESULTS
Data were available for 18,658 PSC and 22,633 WRA. Prevalence of anemia ranged from 7.5% to 73.7% and from 11.5% to 94.7% in PSC and WRA, respectively. Prevalence of zinc deficiency ranged from 9.2% to 78.4% in PSC and from 9.8% to 84.7% in WRA, with prevalence of zinc deficiency >20% in all countries except Azerbaijan (PSC), Ecuador (PSC), and the United Kingdom (WRA). Multivariable linear regression models showed that zinc concentrations were independently and positively associated with Hb concentrations in 7 of 13 countries for PSC and 5 of 12 countries for WRA. In the same models, ferritin concentration was also significantly associated with Hb among PSC and WRA in 9 and 10 countries, respectively. Zinc deficiency was significantly associated with anemia in PSC and WRA in 5 and 4 countries respectively.
CONCLUSIONS
Zinc deficiency was prevalent in most countries and associations between zinc and Hb in roughly half of the countries examined suggesting that strategies to combat zinc deficiency may help reduce anemia prevalence. More research on mechanisms by which zinc deficiency is associated with anemia and the reasons for the heterogeneity among countries is warranted.
背景
贫血是一个全球性的问题。营养缺乏和炎症被认为是主要的致病因素，但锌缺乏症最近才与贫血有关。
目的
本研究评估了锌状态与血红蛋白（Hb）浓度和 6-59 月龄学龄前儿童（PSC）和 15-49 岁育龄妇女（WRA）贫血之间的关系，这些儿童和妇女均来自基于人群的营养调查。
方法
使用了反映炎症和营养决定因素对贫血影响的生物标志物（BRINDA）项目中 13 个（PSC）和 12 个（WRA）国家的横断面数据。构建了多变量线性模型，包括锌状态（血浆/血清锌浓度）、Hb 浓度和贫血、铁状态、年龄、性别和炎症（C 反应蛋白和α-1-酸性糖蛋白）。根据 BRINDA 算法，PSC 中的锌根据炎症进行了调整。
结果
PSC 中有 18658 名儿童和 WRA 中有 22633 名妇女的数据可用。PSC 和 WRA 的贫血患病率分别为 7.5%至 73.7%和 11.5%至 94.7%。PSC 的锌缺乏症患病率为 9.2%至 78.4%，WRA 的锌缺乏症患病率为 9.8%至 84.7%，除阿塞拜疆（PSC）、厄瓜多尔（PSC）和英国（WRA）外，所有国家的锌缺乏症患病率均>20%。多变量线性回归模型显示，在 13 个 PSC 国家中有 7 个国家和 12 个 WRA 国家中有 5 个国家，锌浓度与 Hb 浓度独立且呈正相关。在相同的模型中，PSC 和 WRA 中 9 个和 10 个国家的铁蛋白浓度也与 Hb 显著相关。PSC 和 WRA 中的锌缺乏症与贫血分别在 5 个和 4 个国家显著相关。
结论
锌缺乏症在大多数国家都很普遍，在大约一半的检查国家中，锌与 Hb 之间存在关联，这表明对抗锌缺乏症的策略可能有助于降低贫血的患病率。需要进一步研究锌缺乏症与贫血相关的机制以及国家间差异的原因。
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