小剂量脂质营养补充剂对9至13岁儿童青春期状态的影响：iLiNS-DYAD-加纳试验的随访研究
Impact of Small-Quantity Lipid-Based Nutrient Supplements on Pubertal Status of 9-13-Year Olds: A Follow-Up Study of the iLiNS-DYAD-Ghana Trial.
作者信息
Nti Helena, Adu-Afarwuah Seth, Oaks Brietta M, Prado Elizabeth L, Arnold Charles D, Hastings Paul D, Guyer Amanda E, Dewey Kathryn G, Amponsah Benjamin, Bentil Helena J, Mensah Mavis Osipi, Adjetey Ebenezer, Tan Xiuping, Aryee Lois Maame Donkor, Labi Fatimah Bintu Ayete, Manu Adom
机构信息
Department of Nutrition and Food Science, University of Ghana, Accra, Ghana.
Department of Sports and Exercise Medical Sciences, University of Health and Allied Sciences, Ho, Ghana.
出版信息
Curr Dev Nutr. 2024 Sep 26;8(12):104458. doi: 10.1016/j.cdnut.2024.104458. eCollection 2024 Dec.
BACKGROUND
Early and delayed puberty are both associated with adverse health and psychosocial outcomes.
OBJECTIVES
We assessed the impact of provision of small-quantity lipid-based nutrient supplement (SQ-LNS) to mothers during pregnancy and 6 mo postpartum and to their children aged 6-18 mo, on pubertal status.
METHODS
This study was a follow-up to a partially double-blind randomized controlled trial. At ≤20 wk, 1320 females were randomly assigned to receive daily: iron and folic acid during pregnancy and placebo 0-6 mo postpartum; or multiple micronutrients during pregnancy and 0-6 mo postpartum; or SQ-LNS during pregnancy and 0-6 mo postpartum and to their children from 6 to 18 mo. We re-enrolled 966 and 919 children at 9-11 y and 11-13 y, respectively. We calculated a total pubertal status score based on the Petersen Pubertal Development Scale (PDS) to assess growth spurt, skin changes, body hair, facial hair, voice break, breast development, and menstruation. Pubertal status was regressed on child's age to generate age-adjusted PDS z-scores (aPDSZ); we performed interaction and mediation analyses.
RESULTS
Mean ± standard deviation aPDSZ did not differ between the SQ-LNS and non-LNS groups at 9-11 y (0.01 ± 0.95 compared with -0.01 ± 0.98; = 0.958) but was more advanced in the SQ-LNS group at 11-13 y (0.07 ± 1.04 compared with -0.04 ± 0.98; = 0.049) in the adjusted model. The effect of SQ-LNS varied by sex (-interaction = 0.003) and household asset index z-score (-interaction = 0.002): Puberty was more advanced in the SQ-LNS compared with non-LNS group among females ( = 0.007) but not males ( = 0.877), and within lower ( = 0.002) than average ( = 0.436) and higher ( = 0.332) socioeconomic households.
CONCLUSION
Provision of SQ-LNS during the first 1000 d of life advanced pubertal status among females.
TRIAL REGISTRATION NUMBER
This trial was registered at clinicaltrials.gov as NCT00970866 (https://clinicaltrials.gov/ct2/show/record/NCT00970866).
背景
性早熟和青春发育延迟均与不良健康及心理社会结局相关。
目的
我们评估了在孕期及产后6个月为母亲提供小剂量脂质营养补充剂（SQ-LNS），并为其6至18个月大的孩子提供该补充剂，对青春期发育状况的影响。
方法
本研究是一项部分双盲随机对照试验的随访研究。在妊娠≤20周时，1320名女性被随机分配，使其在孕期每日服用：铁和叶酸，产后0至6个月服用安慰剂；或孕期及产后0至6个月服用多种微量营养素；或孕期及产后0至6个月服用SQ-LNS，其孩子在6至18个月时也服用该补充剂。我们分别重新招募了966名和919名儿童，年龄分别为9至11岁和11至13岁。我们根据彼得森青春期发育量表（PDS）计算了青春期发育状况总分，以评估生长突增、皮肤变化、体毛、面部毛发、声音变粗、乳房发育和月经情况。将青春期发育状况与儿童年龄进行回归分析，以生成年龄调整后的PDS z评分（aPDSZ）；我们进行了交互作用和中介分析。
结果
在9至11岁时，SQ-LNS组和非LNS组的平均±标准差aPDSZ无差异（分别为0.01±0.95和 -0.01±0.98；P = 0.958），但在11至13岁时，调整模型中SQ-LNS组的aPDSZ更超前（分别为0.07±1.04和 -0.04±0.98；P = 0.049）。SQ-LNS的效果因性别（交互作用P = 0.003）和家庭资产指数z评分（交互作用P = 0.002）而异：与非LNS组相比（P = 0.007），SQ-LNS组中女性的青春期发育更超前，而男性则无差异（P = 0.877）；在社会经济水平较低（P = 0.002）的家庭中比在平均水平（P = 0.436）和较高水平（P = 0.332）的家庭中更明显。
结论
在生命的前1000天提供SQ-LNS可使女性青春期发育状况提前。
试验注册号
本试验在clinicaltrials.gov注册，注册号为NCT00970866（https://clinicaltrials.gov/ct2/show/record/NCT00970866）。
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