The role of vitamins in the prevention and control of anaemia
The role of vitamins in the prevention and control of anaemia
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DOI：
10.1017/s1368980000000173
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发表时间：
2000-06-01
影响因子：
3.2
通讯作者：
West, Keith P., Jr.
中科院分区：
文献类型：
--
作者：
Fishman, Steven M.;Christian, Parul;West, Keith P., Jr.
目的：虽然缺铁被认为是营养性贫血的主要原因，但维生素 A、B-12、C 和 E、叶酸和核黄素状况的变化也与其发展和控制有关。本文对与控制营养性贫血相关的维生素补充试验进行了系统综述。方法：通过MEDLINE检索查找报告贫血或铁状态变化的维生素补充试验的报告。结果：维生素A可以改善血液学指标，增强补铁效果。叶酸和维生素 B-12 都可以治疗和预防巨幼细胞贫血。核黄素可增强对铁的血液学反应，其缺乏可能是许多人群贫血的重要原因。维生素 C 可以增强膳食铁的吸收，尽管缺乏基于人群的数据显示其在减少贫血或缺铁方面的功效。给早产儿补充维生素 E 并没有减轻早产儿贫血的严重程度。维生素 B-6 可有效治疗铁粒幼细胞贫血。补充多种维生素可能会提高血红蛋白 (Hb) 浓度，但很少有研究分离出多种维生素与铁对血液学状态的影响。结论：一般来说，补充维生素在控制贫血方面对公共健康的影响尚不清楚。造血过程中涉及多种维生素的复杂相互作用也没有得到充分理解，无法解释观察到的维生素血液学反应随年龄、人口、维生素混合物和剂量的变化。需要进一步的研究来了解个体和组合维生素缺乏对贫血的作用，以设计适当的微量营养素干预措施来预防贫血。
Objective: While iron deficiency is regarded as the major cause of nutritional anaemia, changes in vitamins A, B-12, C and E, folic acid and riboflavin status have also been linked to its development and control. This paper provides a systematic review of vitamin supplementation trials relating to the control of nutritional anaemia.Methods: A MEDLINE search was used to find reports of vitamin supplementation trials that reported changes in anaemia or iron status.Results: Vitamin A can improve haematological indicators and enhance the efficacy of iron supplementation. Both folate and vitamin B-12 can cure and prevent megaloblastic anaemia. Riboflavin enhances the haematological response to iron, and its deficiency may account for a significant proportion of anaemia in many populations. Vitamin C enhances the absorption of dietary iron, although population-based data showing its efficacy in reducing anaemia or iron deficiency are lacking. Vitamin E supplementation given to preterm infants has not reduced the severity of the anaemia of prematurity. Vitamin B-6 effectively treats sideroblastic anaemia. Multivitamin supplementation may raise haemoglobin (Hb) concentration, but few studies have isolated the effect of multivitamins from iron on haematological status.Conclusions: In general, the public health impact of vitamin supplementation in controlling anaemia is not clear. Neither are the complex interactions involving multiple vitamins in haematopoiesis sufficiently understood to explain the observed variability in haematological responses to vitamins by age, population, vitamin mixture and dosages. Further research is needed to understand the roles of individual and combined vitamin deficiencies on anaemia to design appropriate micronutrient interventions to prevent anaemia.