Brunser O, Espinoza J, Araya M, Pacheco I, Cruchet S
Gastroenterology Unit, University of Chile, Santiago.
Eur J Clin Nutr. 1993 May;47(5):317-26.
The effect of chronic iron intake on diarrhoeal disease was evaluated in children in a community of low socio-economic stratum in Santiago, Chile. Children were incorporated into each of two consecutive cohorts; each cohort was divided into two groups, one receiving iron-enriched milk (12 mg/l) (monthly average = 70 children) and the other a control milk (1 mg/l) (monthly average = 83 children), and each cohort was followed up for 6 months. The incidence of diarrhoea was higher among the iron-supplemented children (30.4 vs 25.5 episodes/100 children/month, P < 0.025). This was mainly due to results obtained in infants 3-8 months of age during the summer months. Supplemented infants had more bowel movements on day 1 (P < 0.03) and liquid or semi-liquid stools were passed for more than 15 days more frequently (P < 0.05). While no differences were detected in aetiology, Shigella-associated episodes were less common among iron-supplemented infants (P < 0.008). Asymptomatic shedding of enteropathogens significantly increased in infants 12-18 months of age receiving iron-supplemented milk. In areas with inadequate environmental sanitation, chronic iron supplementation may have negative effects on diarrhoeal morbidity, despite improving iron nutritional status.
在智利圣地亚哥一个社会经济地位较低的社区中，对儿童慢性铁摄入对腹泻病的影响进行了评估。儿童被纳入连续的两个队列；每个队列分为两组，一组接受富铁牛奶（12毫克/升）（每月平均70名儿童），另一组接受对照牛奶（1毫克/升）（每月平均83名儿童），每个队列随访6个月。补充铁剂的儿童腹泻发病率较高（30.4对25.5次发作/100名儿童/月，P<0.025）。这主要是由于夏季3至8个月大婴儿的结果。补充铁剂的婴儿在第1天排便次数更多（P<0.03），并且更频繁地排出液体或半液体粪便超过15天（P<0.05）。虽然在病因学上未检测到差异，但补充铁剂的婴儿中与志贺氏菌相关的发作较少见（P<0.008）。接受补充铁剂牛奶的12至18个月大婴儿肠道病原体的无症状排出显著增加。在环境卫生不足的地区，尽管改善了铁营养状况，但慢性铁补充可能对腹泻发病率产生负面影响。
