补充红棕榈油作为维生素A缺乏的小学生干眼症潜在预防解决方案：一项整群随机对照试验
Red palm olein supplementation as a potential preventive solution for xerophthalmia among vitamin A-deficient primary schoolchildren: a cluster randomized controlled trial.
作者信息
Tan Pei Yee, Lim Chuan Chun, Seng Katherine Boon Hwei, Loganathan Radhika, Lim Yvonne Ai-Lian, Teng Kim-Tiu, Mohd Johari Syahirah Nadiah, Selvaduray Kanga Rani, Ramli Norlina
机构信息
Product Development and Advisory Services Division, Malaysian Palm Oil Board, No. 6, Persiaran Institusi, Bandar Baru Bangi, 43000, Kajang, Selangor, Malaysia.
Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia.
出版信息
Eur J Clin Nutr. 2025 Apr 17. doi: 10.1038/s41430-025-01620-2.
OBJECTIVE
This study aimed to investigate the effectiveness of carotenoid-rich red palm olein (RPO) in treating or preventing xerophthalmia among Malaysian rural primary schoolchildren with confirmed vitamin A deficiency (VAD) (plasma retinol <0.70 µmol/L) and marginal vitamin A status (plasma retinol 0.70 to <1.05 µmol/L).
METHODS
A double-blinded, cluster randomized controlled trial was conducted on 504 schoolchildren aged 8-12 years from ten rural primary schools in Malaysia. The selected schools were randomly assigned into two groups: the experimental group (n = 249) received RPO-enriched biscuits (326.3 µg retinol equivalents/day), while the control group (n = 255) received palm olein (PO)-enriched biscuits for 6 months (4 days/week). Chi-square test and mixed effects logistic regression model were applied to examine the effects of supplementation on the resolution or prevention of xerophthalmia.
RESULTS
After 6-month supplementation, a higher resolution rate of xerophthalmia (31.2%) was observed in the experimental group compared to the control group (24.1%), but this difference lacked statistical significance (p = 0.11). Nevertheless, the experimental group showed a significantly higher prevention rate of xerophthalmia (81.8%) or conjunctival xerosis (82.5%) than the control group (56.5% or 57.6%, respectively) after 6-month supplementation (p < 0.001). Moreover, schoolchildren in the experimental group were 4.8 times less likely to develop xerophthalmia compared to the control group.
CONCLUSION
A 6-month supplementation of RPO-enriched biscuits demonstrated potential benefits in preventing xerophthalmia or conjunctival xerosis among vitamin A-deficient primary schoolchildren in rural areas of Malaysia. Therefore, RPO may offer a promising preventive solution to xerophthalmia for populations at a high risk of developing VAD.
CLINICAL TRIAL REGISTRATION
ClinicalTrials.gov (NCT03256123).
目的
本研究旨在调查富含类胡萝卜素的红棕榈油（RPO）对马来西亚农村地区确诊维生素A缺乏（VAD）（血浆视黄醇<0.70μmol/L）和边缘维生素A状态（血浆视黄醇0.70至<1.05μmol/L）的小学生干眼症治疗或预防的有效性。
方法
对来自马来西亚十所农村小学的504名8至12岁学童进行了一项双盲、整群随机对照试验。所选学校被随机分为两组：实验组（n = 249）接受富含RPO的饼干（326.3μg视黄醇当量/天），而对照组（n = 255）接受富含棕榈油（PO）的饼干，为期6个月（每周4天）。应用卡方检验和混合效应逻辑回归模型来检验补充剂对干眼症缓解或预防的效果。
结果
补充6个月后，实验组干眼症的缓解率（31.2%）高于对照组（24.1%），但差异无统计学意义（p = 0.11）。然而，补充6个月后，实验组干眼症（81.8%）或结膜干燥症（82.5%）的预防率显著高于对照组（分别为56.5%或57.6%）（p < 0.001）。此外，与对照组相比，实验组学童患干眼症的可能性降低了4.8倍。
结论
为期6个月补充富含RPO的饼干对马来西亚农村地区维生素A缺乏的小学生预防干眼症或结膜干燥症显示出潜在益处。因此，RPO可能为有发展成VAD高风险的人群提供一种有前景的干眼症预防解决方案。
临床试验注册
ClinicalTrials.gov（NCT03256123）。
Zotero 插件