Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; Population Health and Immunity Division, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia; Department of Infectious Diseases at the Peter Doherty Institute, The University of Melbourne, Melbourne, VIC, Australia.
Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia.
Am J Clin Nutr. 2023 Jan;117(1):73-82. doi: 10.1016/j.ajcnut.2022.11.023. Epub 2022 Dec 23.
Iron deficiency and anemia have been associated with poor cognition in children, yet the effects of iron supplementation on neurocognition remain unclear.
We aimed to examine the effects of supplementation with iron on neural indices of habituation using auditory event-related brain potentials (ERPs).
This substudy was nested within a 3-arm, double-blind, double-dummy, individual randomized trial in Bangladesh, in which 3300 8-mo-old children were randomly selected to receive 3 mo of daily iron syrup (12.5 mg iron), multiple micronutrient powders (MNPs) (including 12.5 mg iron), or placebo. Children were assessed after 3 mo of intervention (mo 3) and 9 mo thereafter (mo 12). The neurocognitive substudy comprised a randomly selected subset of children from the main trial. Brain activity elicited during an auditory roving oddball task was recorded using electroencephalography to provide an index of habituation. The differential response to a novel (deviant) compared with a repeated (standard) sound was examined. The primary outcome was the amplitude of the mismatch response (deviant minusstandard tone waveforms) at mo 3. Secondary outcomes included the deviant and standard tone-evoked amplitudes, N2 amplitude differences, and differences in mean amplitudes evoked by deviant tones presented in the second compared with first half of the oddball sequence at mo 3 and 12.
Data were analyzed from 329 children at month 3 and 363 at mo 12. Analyses indicated no treatment effects of iron interventions compared with placebo on the amplitude of the mismatch response (iron syrup compared with placebo: mean difference (MD) = 0.07μV [95% CI: -1.22, 1.37]; MNPs compared with placebo: MD = 0.58μV [95% CI: -0.74, 1.90]) nor any secondary ERP outcomes at mo 3 or 12, despite improvements in hemoglobin and ferritin concentrations from iron syrup and MNPs in this nested substudy.
In Bangladeshi children with >40% anemia prevalence, iron or MNP interventions alone are insufficient to improve neural indices of habituation. This trial was registered at the Australian New Zealand Clinical Trials Registry as ACTRN12617000660381.
铁缺乏和贫血与儿童认知能力下降有关，但铁补充对神经认知的影响仍不清楚。
我们旨在使用听觉事件相关脑电位（ERP）检查铁补充对习惯形成的神经指数的影响。
这项亚研究嵌套在孟加拉国的一项 3 臂、双盲、双模拟、个体随机试验中，其中 3300 名 8 个月大的儿童被随机选择接受 3 个月的每日铁糖浆（12.5mg 铁）、多种微量营养素粉末（MNPs）（包括 12.5mg 铁）或安慰剂。在干预 3 个月后（mo 3）和之后 9 个月（mo 12）对儿童进行评估。神经认知子研究由主要试验中的随机儿童子集组成。使用脑电图记录听觉漫游Oddball 任务期间产生的脑活动，以提供习惯形成的指数。检查了对新（偏差）与重复（标准）声音的差异反应。主要结局是 mo 3 时的不匹配反应（偏差减去标准音波）的振幅。次要结局包括偏差和标准音波诱发的振幅、N2 振幅差异以及在 mo 3 和 12 时，Oddball 序列的第二半与第一半之间呈现的偏差音波的平均振幅差异。
在 mo 3 时分析了 329 名儿童的数据，在 mo 12 时分析了 363 名儿童的数据。分析表明，与安慰剂相比，铁干预措施对不匹配反应的振幅没有治疗作用（铁糖浆与安慰剂相比：平均差异（MD）=0.07μV[95%CI：-1.22，1.37]；MNPs 与安慰剂相比：MD=0.58μV[95%CI：-0.74，1.90]），也没有在 mo 3 或 12 时的任何次要 ERP 结果，尽管在这项嵌套子研究中，铁糖浆和 MNPs 都提高了血红蛋白和铁蛋白浓度。
在孟加拉国贫血患病率超过 40%的儿童中，单独使用铁或 MNP 干预不足以改善习惯形成的神经指数。这项试验在澳大利亚新西兰临床试验注册处注册为 ACTRN12617000660381。
