Ramakrishnan U, Latham M C, Abel R, Frongillo E A
Program in International Nutrition, Cornell University, Ithaca, NY, USA.
Am J Clin Nutr. 1995 Jun;61(6):1295-303. doi: 10.1093/ajcn/61.6.1295.
A randomized, double-blind, placebo-controlled trial was conducted in an ongoing Growth Monitoring Research project in TamilNadu, India, to assess the impact of high-dose vitamin A supplementation on morbidity among mildly to moderately malnourished children aged < 3 y. Every 4 mo, the treatment group received 60 mg vitamin A (200,000 IU) whereas the control group received a placebo. Cases of xerophthalmia and severe malnutrition were excluded. Anthropometric measurements and serum retinol determinations were made at baseline and at the end of 1 y. Morbidity data were collected by trained village-level workers throughout the study period by using the weekly recall method. The two groups had similar nutritional status, serum retinol concentrations, age-sex composition, and other sociodemographic indicators at baseline. The mean number of episodes per child-year was 2.62 +/- 2.95 and 2.56 +/- 2.5 for respiratory illness and 1.9 +/- 2.2 and 1.77 +/- 1.77 for diarrhea for the vitamin A (n = 309) and placebo (n = 274) groups, respectively. The differences in respiratory and diarrheal morbidity between the two groups were not statistically significant and these findings remained unaltered after multivariate analysis in which the effects of age, sex, socioeconomic status, sanitation, etc, were considered. These findings are similar to other recent findings and indicate that vitamin A supplementation does not reduce common morbidity in children with mild-to-moderate vitamin A deficiency in areas where access to health care and immunization are good.
在印度泰米尔纳德邦正在进行的一项生长监测研究项目中，开展了一项随机、双盲、安慰剂对照试验，以评估大剂量补充维生素A对3岁以下轻度至中度营养不良儿童发病率的影响。每4个月，治疗组接受60毫克维生素A（200,000国际单位），而对照组接受安慰剂。患有干眼病和严重营养不良的儿童被排除在外。在基线和1年末进行人体测量和血清视黄醇测定。在整个研究期间，由经过培训的村级工作人员采用每周回忆法收集发病率数据。两组在基线时的营养状况、血清视黄醇浓度、年龄性别构成以及其他社会人口统计学指标相似。维生素A组（n = 309）和安慰剂组（n = 274）儿童每年呼吸道疾病发作的平均次数分别为2.62±2.95次和2.56±2.5次，腹泻发作的平均次数分别为1.9±2.2次和1.77±1.77次。两组之间呼吸道和腹泻发病率的差异无统计学意义，在考虑年龄、性别、社会经济地位、卫生设施等因素的多变量分析后，这些结果保持不变。这些发现与最近的其他发现相似，表明在获得医疗保健和免疫接种情况良好的地区，补充维生素A并不能降低轻度至中度维生素A缺乏儿童的常见发病率。
