Departments of Human Nutrition, All India Institute of Medical Sciences, New Delhi, India.
Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India.
Eur J Clin Nutr. 2021 Nov;75(11):1588-1597. doi: 10.1038/s41430-021-00878-6. Epub 2021 Apr 7.
The prevalence of anemia has remained high among Indian adolescent girls over the past decade, despite the ongoing iron and folic acid (IFA) supplementation program. This study was conducted to assess the impact of daily supplementation of a package of IFA with vitamin B on hemoglobin levels among adolescent girls.
A community-based cluster-randomized trial was conducted in the rural block of Faridabad District, Haryana, India in the year 2017. A total of 760 adolescent girls in the age group of 12-19 years with mild and moderate anemia were selected from government schools. Daily-supervised administration of iron and folic acid was conducted for 90 days: experimental group-IFA (iron (60 mg), folic acid (500) mcg), and cyanocobalamin (1000 mcg), control group-IFA and placebo. Hemoglobin, serum ferritin, and vitamin B levels were assessed at baseline and endline.
Two-hundred adolescent girls completed 90 doses of daily supplementation. The mean hemoglobin (experimental group: 1.3 ± 1.0 g/dL, control group: 1.6 ± 1.2 g/dL, P = 0.004) and ferritin levels (experimental group: 18.6 ± 31.5 ng/mL, control group: 18.8 ± 35.0 ng/mL, P = 0.188) increased in both the control and experiment groups. Serum vitamin B deficiency significantly reduced to 2.5% in the experimental group and ferritin deficiency alleviated in more than 96% of the girls post intervention.
Daily supplementation of IFA with/without vitamin B for 90 days eliminated iron, vitamin B deficiency and reduced the overall proportion of anemia by 53.5%. However, addition of vitamin B to IFA supplementation had no impact on improving the hemoglobin levels among adolescent girls. The present study does not recommend provision of vitamin B for prevention and treatment of anemia in this population group.
尽管印度正在持续开展铁和叶酸（IFA）补充计划，但过去十年间，印度青少年女孩的贫血患病率仍然居高不下。本研究旨在评估每日补充包含维生素 B 的 IFA 包对青少年女孩血红蛋白水平的影响。
2017 年，在印度哈里亚纳邦法里达巴德区的农村进行了一项基于社区的整群随机试验。从政府学校中选择了 760 名年龄在 12-19 岁、患有轻度和中度贫血的青少年女孩。每天监督服用铁和叶酸 90 天：实验组-IFA（铁（60mg），叶酸（500μg），氰钴胺素（1000μg），对照组-IFA 和安慰剂。在基线和终点评估血红蛋白、血清铁蛋白和维生素 B 水平。
有 200 名青少年女孩完成了 90 天的每日补充剂量。实验组的平均血红蛋白（1.3±1.0g/dL）和对照组（1.6±1.2g/dL）均升高（P=0.004），实验组和对照组的铁蛋白水平（18.6±31.5ng/mL，18.8±35.0ng/mL）均升高（P=0.188）。实验组血清维生素 B 缺乏显著减少至 2.5%，铁蛋白缺乏在干预后超过 96%的女孩中得到缓解。
每日补充 IFA 加/不加维生素 B90 天可消除铁、维生素 B 缺乏，并使贫血的总体比例降低 53.5%。然而，在 IFA 补充中添加维生素 B 对改善青少年女孩的血红蛋白水平没有影响。本研究不建议在该人群中提供维生素 B 用于预防和治疗贫血。
