Taneja Sunita, Chowdhury Ranadip, Kvestad Ingrid, Bhandari Nita, Strand Tor A
Centre for Health Research and Development, Society for Applied Studies, New Delhi, India.
Regional Centre for Child and Youth Mental Health and Child Welfare, West, NORCE Norwegian Research Centre, Bergen, Norway.
Br J Nutr. 2023 Apr 14;129(7):1172-1179. doi: 10.1017/S0007114522002343. Epub 2022 Jul 25.
Folate and vitamin B are essential for growth. Our objective was to estimate their long-term effects on linear growth in North Indian children. This is a follow-up study of a factorial designed, double-blind, randomised, placebo-controlled trial in 1000 young children. Starting at 6-30 months of age, we gave folic acid (approximately 2 RDA), vitamin B (approximately 2 RDA), both vitamins or a placebo daily for 6 months. Six years after the end of supplementation, we measured height in 791 children. We used the plasma concentrations of cobalamin, folate and total homocysteine to estimate vitamin status. The effect of the interventions, the association between height-for-age z-scores (HAZ) and baseline vitamin status, and the interactions between supplementation and baseline status were estimated in multiple regression models. Mean (sd) age at follow-up was 7·4 (0·7) years (range 6 to 9 years). There was a small, non-significant effect of vitamin B on linear growth and no effect of folic acid. We observed a subgroup effect of vitamin B supplementation in those with plasma cobalamin concentration < 200 pmol/l ( = 0·01). The effect of vitamin B supplementation in this group was 0·34 HAZ (95 % CI 0·11, 0·58). We found an association between cobalamin status and HAZ in children not given vitamin B ( = 0·001). In this group, each doubling of the cobalamin concentration was associated with 0·26 (95 % CI 0·15, 0·38) higher HAZ. Suboptimal vitamin B status in early childhood seemingly limits linear growth in North Indian children.
叶酸和维生素B对生长至关重要。我们的目标是评估它们对印度北部儿童线性生长的长期影响。这是一项对1000名幼儿进行的析因设计、双盲、随机、安慰剂对照试验的随访研究。从6至30个月大开始，我们每天给儿童服用叶酸（约2倍推荐膳食摄入量）、维生素B（约2倍推荐膳食摄入量）、两种维生素或安慰剂，持续6个月。补充结束6年后，我们测量了791名儿童的身高。我们使用钴胺素、叶酸和总同型半胱氨酸的血浆浓度来评估维生素状态。在多元回归模型中估计了干预措施的效果、年龄别身高z评分（HAZ）与基线维生素状态之间的关联，以及补充剂与基线状态之间的相互作用。随访时的平均（标准差）年龄为7.4（0.7）岁（范围6至9岁）。维生素B对线性生长有微小但不显著的影响，叶酸则无影响。我们观察到血浆钴胺素浓度<200 pmol/l的儿童补充维生素B有亚组效应（P = 0.01）。该组补充维生素B的效果为0.34 HAZ（95%CI 0.11，0.58）。我们发现未补充维生素B的儿童中钴胺素状态与HAZ之间存在关联（P = 0.001）。在该组中，钴胺素浓度每翻倍与HAZ升高0.26（95%CI 0.15，0.38）相关。幼儿期维生素B状态欠佳似乎会限制印度北部儿童的线性生长。
