Sazawal S, Black R E, Bhan M K, Jalla S, Bhandari N, Sinha A, Majumdar S
ICMR Advanced Center for Diarrheal Disease Research, All India Institute of Medical Sciences, New Delhi, India.
J Nutr. 1996 Feb;126(2):443-50. doi: 10.1093/jn/126.2.443.
Persistent diarrhea (PD) and dysentery (DD) account for most diarrhea-associated deaths among children in developing countries. Zinc deficiency can cause stunting and impaired immune function, both of which are risk factors for these diarrheal illnesses. We investigated the effect of zinc supplementation on the incidence of PD and DD in a community-based, double-blind randomized trial in children 6-35 mo of age. Increase over baseline in plasma zinc concentrations in the supplemented group compared with a control group (3.61 vs. 0.009 mumol.L-1), indicated successful supplementation. The overall reductions in the zinc supplemented group of 21% in the incidence of PD (95% CI -6 to 42%) and 14% in the incidence of dysentery (95% CI -15 to 36%) were not significant. There was a significant interaction of treatment effect with baseline plasma zinc concentration and age for PD and with gender for DD. In the zinc-supplemented group compared with the control group, the incidence of PD was reduced by 73% (P < 0.05; 95% CI 34 to 91%) in children with a baseline zinc < 7.65 mumol.L-1 and by 49% (P < 0.05; 95%CI 24 to 66%) in children > 11 mo of age. Zinc supplementation resulted in a 38% (P < 0.05 95%CI 8 to 59%) reduction in the incidence of DD in boys. There was no effect on PD among children 6-11 mo old or on DD in girls. In conclusion, zinc supplementation had a significant impact on the incidence of persistent diarrhea in children > 1 y old and in children with low plasma zinc, as well as on dysentery in boys. These findings may have important implications for reducing diarrhea-related morbidity and mortality.
持续性腹泻（PD）和痢疾（DD）是发展中国家儿童腹泻相关死亡的主要原因。锌缺乏会导致发育迟缓以及免疫功能受损，而这两者都是这些腹泻疾病的危险因素。我们在一项针对6至35个月大儿童的社区双盲随机试验中，研究了补锌对PD和DD发病率的影响。与对照组相比，补充组血浆锌浓度较基线水平升高（3.61 vs. 0.009 μmol·L-1），表明补锌成功。补充锌组中，PD发病率总体降低21%（95%CI -6至42%），痢疾发病率总体降低14%（95%CI -15至36%），但差异均无统计学意义。对于PD，治疗效果与基线血浆锌浓度和年龄存在显著交互作用；对于DD，治疗效果与性别存在显著交互作用。与对照组相比，在基线锌浓度<7.65 μmol·L-1的儿童中，补充锌组的PD发病率降低了73%（P<0.05；95%CI 34至91%）；在年龄>11个月的儿童中，PD发病率降低了49%（P<0.05；95%CI 24至66%）。补锌使男孩的DD发病率降低了38%（P<0.05，95%CI 8至59%）。对6至11个月大的儿童的PD发病率以及女孩的DD发病率没有影响。总之，补锌对1岁以上血浆锌水平低的儿童的持续性腹泻发病率以及男孩的痢疾发病率有显著影响。这些发现可能对降低腹泻相关的发病率和死亡率具有重要意义。
