2016年“学生营养改善计划”试点地区学生维生素A营养状况分析
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摘要
目的了解2016年"农村义务教育学生营养改善计划"(以下简称"学生营养改善计划")试点地区学生维生素A营养状况及其影响因素,为进一步实施"学生营养改善计划"提供基础数据。方法利用2016年"学生营养改善计划"试点地区50个重点监测县监测学生维生素A数据,分析他们的维生素A营养状况及其影响因素。结果 12 609名中小学生维生素A浓度均值为(0.35±0.10)μg/mL,有随年龄的增长呈上升趋势,均值差异有统计学意义(P<0.05)。调查学生维生素A缺乏率为1.57%,男生(1.88%)高于女生(1.26%)(P <0.05),小学生(2.03%)高于初中学生(0.74%)(P <0. 01)。维生素A边缘缺乏率为19.43%,不同年龄段维生素A边缘缺乏率差异有统计学意义(P <0.05),随年龄增长而下降。多因素Logistic回归分析显示,男生、低年龄段学生及2周内基本不食用禽蛋类食物是维生素A缺乏的影响因素。结论 "学生营养改善计划"试点地区学生维生素A边缘缺乏状况较突出,小学男生更易发生维生素A缺乏,2周内基本不食用禽蛋类食物是维生素A缺乏的潜在危险因素。
Objective To understand the status of vitamin A among students in the pilot area of the " Nutrition Improvement Program for Compulsory Education Students in Rural Areas"(shorten as Student Nutrition Improvement Program)in 2016. Methods Data were from the monitoring data of students' nutritional status in the pilot area of the"Student Nutrition Improvement Program" in 2016. Serum samples of primary and secondary school students in compulsory education in rural areas were analyzed. Serum vitamin A( retinol) was determined by liquid chromatography tandem mass spectrometry. Results Totally 12 609 primary and middle school students were enrolled in this study. The mean serum retinol concentration was(0. 35 ±0. 10) μg/mL, which increased with age, and the difference of mean serum retinol concentration was statistically significant(P<0. 05). The prevalence of vitamin A deficiency of the respondents was 1.57%, the male students( 1. 88%) were more likely to suffer from VAD than the female students( 1. 26%)( P < 0. 05), the pupils(2. 03%) were more likely to suffer from VAD than the junior high school students(0. 74%)(P < 0. 01). The prevalence of marginal vitamin A deficiency was 19. 43%. The prevalence of marginal vitamin A deficiency varied between different age groups and showed a declining trend with age( P < 0. 05). The results obtained by the multivariate logistic regression analysis showed that boys, low-age group and lack of intake of eggs might be more likely to cause an increased risk of vitamin A deficiency(vitamin A deficiency and marginal deficiency). Conclusion The high prevalence of marginal vitamin A deficiency was more prominent among the students in the pilot area of the Student Nutrition Improvement Program, especially boysin primary school. Lack of egg intake was a potential risk factor for vitamin A deficiency.
Objective To understand the status of vitamin A among students in the pilot area of the " Nutrition Improvement Program for Compulsory Education Students in Rural Areas"(shorten as Student Nutrition Improvement Program)in 2016. Methods Data were from the monitoring data of students' nutritional status in the pilot area of the"Student Nutrition Improvement Program" in 2016. Serum samples of primary and secondary school students in compulsory education in rural areas were analyzed. Serum vitamin A( retinol) was determined by liquid chromatography tandem mass spectrometry. Results Totally 12 609 primary and middle school students were enrolled in this study. The mean serum retinol concentration was(0. 35 ±0. 10) μg/mL, which increased with age, and the difference of mean serum retinol concentration was statistically significant(P<0. 05). The prevalence of vitamin A deficiency of the respondents was 1.57%, the male students( 1. 88%) were more likely to suffer from VAD than the female students( 1. 26%)( P < 0. 05), the pupils(2. 03%) were more likely to suffer from VAD than the junior high school students(0. 74%)(P < 0. 01). The prevalence of marginal vitamin A deficiency was 19. 43%. The prevalence of marginal vitamin A deficiency varied between different age groups and showed a declining trend with age( P < 0. 05). The results obtained by the multivariate logistic regression analysis showed that boys, low-age group and lack of intake of eggs might be more likely to cause an increased risk of vitamin A deficiency(vitamin A deficiency and marginal deficiency). Conclusion The high prevalence of marginal vitamin A deficiency was more prominent among the students in the pilot area of the Student Nutrition Improvement Program, especially boysin primary school. Lack of egg intake was a potential risk factor for vitamin A deficiency.
引文
[1]Ezzati M, Lopez AD, Rodgers A,et al. Comparative quantification of health risks:global and regional burden of disease attributable to selected major risk factors[R].Geneva:World Health Organization,2014.
[2] Fairfield KM, Fletcher RH. Vitamins for chronic disease prevention in adults:scientific review[J]. JAMA,2002,287(23):3116-3126.
[3] Stephensen CB. Vitamin A,infection,and immune function[J]. Annu Rev Nutr,2001,21:167-192.
[4] Tanumihardjo SA,Russell RM,Stephensen CB,et al. Biomarkers of nutrition for development(BOND):vitamin A review[J]. J Nutr,2016,146(9):1816-1848.
[5]Marasinghe E, Chackrewarthy S, Abeysena C, et al. Micronutrient status and its relationship with nutritional status in preschool children in urban Sri Lanka[J]. Asia Pac J Clin Nutr,2015,24(1):144-151.
[6]杨春,杨晓光.中国人群维生素A的影响因素[J].医学综述,2016,22(7):1249-1252.
[7]张继国,张兵,杜文雯,等.中国西部6省(区)贫困农村5岁以下儿童维生素A缺乏状况分析[J].中华流行病学杂志,2011,32(12):1224-1226.
[8]张帆,胡小琪,马冠生.中国“农村义务教育学生营养改善计划”出台及实施[J].营养健康新观察,2013(1):49.
[9]卫生部,教育部.卫生部公办厅、教育部办公厅关于印发《农村义务教育学生营养改善计划营养健康状况监测评估工作方案(试行)》的通知[J].中华人民共和国卫生部公报,2012(6):15-18.
[10] World Health Organization. Global prevalence of vitamin A deficiency in populations at risk 1995-2005:WHO global database on vitamin A deficiency[DB/OL].[2018-09-10]. http://www.who. int/iris/handle/10665/44110.
[11]陶懂谊,马文领.维生素A的生物学作用及其缺乏的防治[J].中国医药导报,2013,10(1):25-29.
[12]王陇德.中国居民营养与健康状况调查报告之一[R].北京:人民卫生出版社,2002.
[13]兰子尧,陈桂华,李忻,等.贵州省部分贫困农村学生维生素A、维生素D营养状况分析[J].微量元素与健康研究,2016,33(6):60-61.
[14]赵静珺,常锋,王林江,等.陕西农村学生维生素A与维生素D水平现状[J].中国学校卫生,2016,37(12):1871-1873.
[15]周静,刘玉梅,冯棋琴,等.海南省琼中县中小学学生血清维生素A水平分析[J].中国儿童保健杂志,2015,23(4):416-418.
[16]张宇,刘小兵,陈竞,等.2010—2012年中国农村6~17岁儿童青少年维生素A营养状况[J].卫生研究,2017,46(3):345-349.
[17]甘倩,陈竞,李荔,等.学生营养改善计划地区2013年学生维生素A营养状况[J].中国学校卫生,2016,37(5):661-663.
[18] Rahman S,Rahman AS,Alam N,et al. Vitamin A deficiency and determinants of vitamin A status in Bangladeshi children and women:findings of a national survey[J]. Public Health Nutr,2017,20(6):1114-1125.
[19] Stevens GA, Bennett JE,Hennocq Q,et al. Trends and mortality effects of vitamin A deficiency in children in 138 low-income and middle income countries between 1991 and 2013:a pooled analysis of population-based surveys[J]. Lancet Glob Health,2015,3(9):e528-e536.
[20]张帆,张倩,胡小琪,等.实施“农村义务教育学生营养素改善计划的学校食堂生均营养素供应情况”[J].中国食物与营养,2016,22(5):75-78.
[21]陈京蓉,熊鹰,王红,等.重庆市贫困农村中小学食物及营养素供应情况[J].中国学校卫生,2018,39(6):910-912.
[2] Fairfield KM, Fletcher RH. Vitamins for chronic disease prevention in adults:scientific review[J]. JAMA,2002,287(23):3116-3126.
[3] Stephensen CB. Vitamin A,infection,and immune function[J]. Annu Rev Nutr,2001,21:167-192.
[4] Tanumihardjo SA,Russell RM,Stephensen CB,et al. Biomarkers of nutrition for development(BOND):vitamin A review[J]. J Nutr,2016,146(9):1816-1848.
[5]Marasinghe E, Chackrewarthy S, Abeysena C, et al. Micronutrient status and its relationship with nutritional status in preschool children in urban Sri Lanka[J]. Asia Pac J Clin Nutr,2015,24(1):144-151.
[6]杨春,杨晓光.中国人群维生素A的影响因素[J].医学综述,2016,22(7):1249-1252.
[7]张继国,张兵,杜文雯,等.中国西部6省(区)贫困农村5岁以下儿童维生素A缺乏状况分析[J].中华流行病学杂志,2011,32(12):1224-1226.
[8]张帆,胡小琪,马冠生.中国“农村义务教育学生营养改善计划”出台及实施[J].营养健康新观察,2013(1):49.
[9]卫生部,教育部.卫生部公办厅、教育部办公厅关于印发《农村义务教育学生营养改善计划营养健康状况监测评估工作方案(试行)》的通知[J].中华人民共和国卫生部公报,2012(6):15-18.
[10] World Health Organization. Global prevalence of vitamin A deficiency in populations at risk 1995-2005:WHO global database on vitamin A deficiency[DB/OL].[2018-09-10]. http://www.who. int/iris/handle/10665/44110.
[11]陶懂谊,马文领.维生素A的生物学作用及其缺乏的防治[J].中国医药导报,2013,10(1):25-29.
[12]王陇德.中国居民营养与健康状况调查报告之一[R].北京:人民卫生出版社,2002.
[13]兰子尧,陈桂华,李忻,等.贵州省部分贫困农村学生维生素A、维生素D营养状况分析[J].微量元素与健康研究,2016,33(6):60-61.
[14]赵静珺,常锋,王林江,等.陕西农村学生维生素A与维生素D水平现状[J].中国学校卫生,2016,37(12):1871-1873.
[15]周静,刘玉梅,冯棋琴,等.海南省琼中县中小学学生血清维生素A水平分析[J].中国儿童保健杂志,2015,23(4):416-418.
[16]张宇,刘小兵,陈竞,等.2010—2012年中国农村6~17岁儿童青少年维生素A营养状况[J].卫生研究,2017,46(3):345-349.
[17]甘倩,陈竞,李荔,等.学生营养改善计划地区2013年学生维生素A营养状况[J].中国学校卫生,2016,37(5):661-663.
[18] Rahman S,Rahman AS,Alam N,et al. Vitamin A deficiency and determinants of vitamin A status in Bangladeshi children and women:findings of a national survey[J]. Public Health Nutr,2017,20(6):1114-1125.
[19] Stevens GA, Bennett JE,Hennocq Q,et al. Trends and mortality effects of vitamin A deficiency in children in 138 low-income and middle income countries between 1991 and 2013:a pooled analysis of population-based surveys[J]. Lancet Glob Health,2015,3(9):e528-e536.
[20]张帆,张倩,胡小琪,等.实施“农村义务教育学生营养素改善计划的学校食堂生均营养素供应情况”[J].中国食物与营养,2016,22(5):75-78.
[21]陈京蓉,熊鹰,王红,等.重庆市贫困农村中小学食物及营养素供应情况[J].中国学校卫生,2018,39(6):910-912.