Folic acid deficiency declined substantially after introduction of the mandatory fortification programme in Queensland, Australia: a secondary health data analysis

Folic acid deficiency declined substantially after introduction of the mandatory fortification programme in Queensland, Australia: a secondary health data analysis
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澳大利亚昆士兰州引入强制叶酸强化计划后,叶酸缺乏症大幅下降:二次健康数据分析

DOI:
10.1017/s1368980019002258
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发表时间:
2019
影响因子:
3.2
通讯作者:
McDermott
McDermott
中科院分区:
医学3区
文献类型:
--
作者:
Slagman;Harriss;Linton;Campbell;Sandra;Muller;Reinhold;McDermott

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目的调查昆士兰州范围内常规实验室测量数据,特别是高危亚人群中叶酸缺乏的患病率。设计二次健康数据分析。设置分析昆士兰州病理学(AUSLAB)进行的常规叶酸检测。参与者为2004年1月1日至2015年12月31日期间进行常规叶酸检测的0-117岁女性和男性。如果对同一个人重复检测进行后,仅分析了初始测试(n 291 908)。结果总体而言,叶酸缺乏症的患病率从之前(2004-2008年)的7·5 %下降到强制叶酸强化后(2010-2015年;P < 0·001)的1·1 %,相对下降了85 %。红细胞叶酸水平从2008年强化前的中位数(四分位距)820(580-1180)nmol/l显着增加到2010年强化后的1020(780-1350)nmol/l(P < 0·001)。原住民(14 792 个样本)中叶酸缺乏症的患病率下降了 93 %(17·4 vs. 1·3 %;P < 0·001);非原住民居民则增加了 84 %(7·0 比 1·1 %;P < 0·001)。在逻辑回归模型中,观察到的 2008 年至 2010 年间叶酸缺乏症的减少与性别、年龄和种族无关(OR 粗略 = 0·20;95 % CI 0·18, 0·23;P < 0·001;OR 调整 = 0·21;95 % CI 0·18, 0·23;P < 0·001)。 1995年推出的自愿叶酸强化计划尤其在高风险亚群体中失败了,2009年强制叶酸强化计划恰逢整个人口叶酸缺乏症大幅减少。
ObjectiveTo investigate the prevalence of folic acid deficiency in Queensland-wide data of routine laboratory measurements, especially in high-risk sub-populations.DesignSecondary health data analysis.SettingAnalysis of routine folic acid tests conducted by Pathology Queensland (AUSLAB).ParticipantsFemale and male persons aged 0–117 years with routine folic acid testing between 1 January 2004 and 31 December 2015. If repeat tests on the same person were conducted, only the initial test was analysed (n 291 908).ResultsOverall the prevalence of folic acid deficiency declined from 7·5 % before (2004–2008) to 1·1 % after mandatory folic acid fortification (2010–2015; P < 0·001) reflecting a relative reduction of 85 %. Levels of erythrocyte folate increased significantly from a median (interquartile range) of 820 (580–1180) nmol/l in 2008 before fortification to 1020 (780–1350) nmol/l in 2010 (P < 0·001) after fortification. The prevalence of folic acid deficiency in the Indigenous population (14 792 samples) declined by 93 % (17·4 v. 1·3 %; P < 0·001); and by 84 % in non-Indigenous residents (7·0 v. 1·1 %; P < 0·001). In a logistic regression model the observed decrease of folic acid deficiency between 2008 and 2010 was found independent of gender, age and ethnicity (ORcrude = 0·20; 95 % CI 0·18, 0·23; P < 0·001; ORadjusted = 0·21; 95 % CI 0·18, 0·23; P < 0·001).ConclusionsWhile voluntary folic acid fortification, introduced in 1995, failed especially in high-risk subgroups, the 2009 mandatory folic acid fortification programme coincided with a substantial decrease of folic acid deficiency in the entire population.
DOI: 10.1371/journal.pone.0182099
发表时间: 2017
期刊: PloS one
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