Salvatte Keronlainy, Farias Dayana Rodrigues, Normando Paula, Berti Talita Lelis, Castro Inês Rugani Ribeiro de, Kac Gilberto
Department of Social and Applied Nutrition, Nutritional Epidemiology Observatory, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil.
Department of Social Nutrition, Nutrition Institute, State University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil.
J Nutr. 2023 Jul;153(7):2094-2104. doi: 10.1016/j.tjnut.2023.05.020. Epub 2023 May 21.
Vitamin B12 and folate are key nutrients that help children reach their full potential in growth and development; however, little is known about the status of these vitamins in Brazilian children.
To describe the serum concentrations of vitamin B12 and folate, to investigate the association between high folate concentration (HFC) and vitamin B12 deficiency, and to evaluate the association between vitamin B12 and stunting/underweight in Brazilian children aged 6-59 mo.
Data from 7417 children aged 6-59 mo collected during the Brazilian National Survey on Child Nutrition were used. Serum concentrations of vitamin B12 of <150 pmol/L and folate of <10 nmol/L were classified as deficient, and folate concentrations of >45.3 nmol/L were classified as HFC. Children with length/height-for-age z-score of less than -2 were considered stunted, and those with weight-for-age z-score of less than -2 were underweight. Logistic regression models were performed.
In Brazil, 14.2% (95% CI: 12.2, 16.1) of children aged 6-59 mo had vitamin B12 deficiency, 1.1% (95% CI: 0.5, 1.6) had folate deficiency, and 36.9% (95% CI: 33.4, 40.3) had HFC. Vitamin B12 deficiency was higher in children from the northern region of Brazil (28.5%), between 6 and 24 mo (25.3%), whose mothers had lower formal education (0-7 y; 18.7%). Children with HFC had 62% lower odds (OR: 0.38; 95% CI: 0.27, 0.54) of vitamin B12 deficiency than those with normal/deficient folate. Children with vitamin B12 deficiency and normal/deficient folate had higher odds of stunting (OR: 1.58; 95% CI: 1.02, 2.43) than children without vitamin B12 deficiency and normal/deficient folate.
Vitamin B12 deficiency is a public health problem among Brazilian children aged <2 y with vulnerable socioeconomic status. HFC was inversely associated with vitamin B12 deficiency, and lower odds of stunting were observed in children with HFC and vitamin B12 deficiency than in those with vitamin B12 deficiency and normal/deficient folate.
维生素B12和叶酸是关键营养素，有助于儿童在生长发育中充分发挥潜能；然而，对于巴西儿童这些维生素的状况知之甚少。
描述维生素B12和叶酸的血清浓度，调查高叶酸浓度（HFC）与维生素B12缺乏之间的关联，并评估6至59月龄巴西儿童中维生素B12与发育迟缓/体重不足之间的关联。
使用了巴西全国儿童营养调查期间收集的7417名6至59月龄儿童的数据。血清维生素B12浓度<150 pmol/L和叶酸浓度<10 nmol/L被分类为缺乏，叶酸浓度>45.3 nmol/L被分类为HFC。年龄别身长/身高Z评分小于-2的儿童被视为发育迟缓，年龄别体重Z评分小于-2的儿童被视为体重不足。进行了逻辑回归模型分析。
在巴西，6至59月龄儿童中14.2%（95%置信区间：12.2，16.1）存在维生素B12缺乏，1.1%（95%置信区间：0.5，1.6）存在叶酸缺乏，36.9%（95%置信区间：33.4，40.3）存在HFC。巴西北部地区儿童（28.5%）、6至24月龄儿童（25.3%）以及母亲受正规教育程度较低（0至7年；18.7%）的儿童中维生素B12缺乏更为常见。与叶酸正常/缺乏的儿童相比，HFC儿童维生素B12缺乏的几率低62%（比值比：0.38；95%置信区间：0.27，0.54）。与无维生素B12缺乏且叶酸正常/缺乏的儿童相比，维生素B12缺乏且叶酸正常/缺乏的儿童发育迟缓的几率更高（比值比：1.58；95%置信区间：1.02，2.43）。
维生素B12缺乏是社会经济地位脆弱的2岁以下巴西儿童中的一个公共卫生问题。HFC与维生素B12缺乏呈负相关，与维生素B12缺乏且叶酸正常/缺乏的儿童相比，HFC且维生素B12缺乏的儿童发育迟缓几率更低。
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