1997-2015 年，全美国军队人群中的临床诊断维生素缺乏症和紊乱。
Clinically-diagnosed vitamin deficiencies and disorders in the entire United States military population, 1997-2015.
机构信息
Military Nutrition Division, US Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA.
Nutrition Impact, LLC, 9725 D Drive North, Battle Creek, MI, 49014, USA.
出版信息
Nutr J. 2021 Jun 15;20(1):55. doi: 10.1186/s12937-021-00708-2.
BACKGROUND
This study examined incidence rates, temporal trends, and demographic factors associated with vitamin deficiencies/disorders in all United States military personnel from 1997 to 2015 (mean N = 1,382,266/year).
METHODS
Employing an ecological study design, the Defense Medical Epidemiological Database and specific International Classification of Diseases codes were used to determine incidence rates for clinically-diagnosed vitamin deficiencies/disorders. Associations with demographic factors were examined.
RESULTS
The overall incidence rate of vitamin deficiencies/disorders was 92.7 cases/100,000 person-years (p-yr). Highest rates were for vitamin D (53.7 cases/100,000 p-yr), other B-complex vitamins (20.2 cases, 100,000 p-yr), vitamin B anemia (7.6 cases/100,000 p-yr), deficiencies of "other vitamins" (5.9 cases/100,000 p-yr), and vitamin A (2.5 cases/100,000 p-yr). Thiamin, riboflavin, niacin, pyridoxine, folate, vitamin C, and vitamin K deficiencies and hypervitaminoses A and D had < 1 case/100,000 p-yr. Rates for vitamin D, other B-complex, "other vitamin", and thiamin deficiencies increased over time, while vitamin A and C deficiencies decreased. Women had higher incidence rates for all examined deficiencies/ disorders except niacin and vitamin C. Incidence rates rose with age in 8 of 15 deficiency/disorder categories and blacks had higher incidence rates in 9 of 15 deficiency/disorder categories.
CONCLUSIONS
The overall rate of clinically-diagnosed vitamin deficiencies and disorders was low but higher in women and minority subgroups. As for most illnesses, the diagnosed incidence of such disorders may be an underestimate of the actual incidence. These findings can guide clinical decision making with regard to testing for nutritional deficiencies and delivering public health information to at risk populations.
CLINICAL TRIAL REGISTRATION
(No. ISRCTN58987177 ). Registration date 9 October 2019.
背景
本研究旨在调查 1997 年至 2015 年间（平均每年 N=1,382,266 人）美国全体军人的维生素缺乏/障碍的发生率、时间趋势和与人口统计学因素相关的情况。
方法
采用生态研究设计，利用国防医疗流行病学数据库和特定的国际疾病分类代码来确定临床诊断的维生素缺乏/障碍的发生率。并对人口统计学因素的相关性进行了分析。
结果
维生素缺乏/障碍的总发生率为 92.7 例/10 万人年（p-yr）。发病率最高的是维生素 D（53.7 例/10 万人年）、其他 B 族维生素（20.2 例，100,000 p-yr）、维生素 B 贫血（7.6 例/10 万人年）、“其他维生素”缺乏症（5.9 例/10 万人年）和维生素 A（2.5 例/10 万人年）。硫胺素、核黄素、烟酸、吡哆醇、叶酸、维生素 C 和维生素 K 缺乏症和超维生素 A 和 D 的发生率<1 例/10 万人年。维生素 D、其他 B 族维生素、“其他维生素”和硫胺素缺乏症的发生率随着时间的推移而增加，而维生素 A 和 C 缺乏症的发生率则下降。除烟酸和维生素 C 外，女性所有检查的缺乏症/疾病的发生率均较高。在 15 种缺乏/障碍类型中，有 8 种的发生率随年龄增长而升高，在 15 种缺乏/障碍类型中，黑人有 9 种的发生率较高。
结论
总的来说，临床上诊断的维生素缺乏和紊乱的发生率较低，但在女性和少数族裔亚组中较高。与大多数疾病一样，此类疾病的诊断发病率可能低估了实际发病率。这些发现可以为测试营养缺乏症和向高危人群提供公共卫生信息的临床决策提供指导。
临床试验注册
（注册号 ISRCTN58987177）。注册日期为 2019 年 10 月 9 日。
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