The impact of mandatory fortification of flour with folic acid on the blood folate levels of an Australian population
The impact of mandatory fortification of flour with folic acid on the blood folate levels of an Australian population
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DOI：
10.5694/j.1326-5377.2011.tb04169.x
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发表时间：
2011-01-17
影响因子：
11.4
通讯作者：
Joshua, Douglas E.
中科院分区：
文献类型：
--
作者：
Brown, Ross D.;Langshaw, Mark R.;Joshua, Douglas E.
目的：为了确定自2009年9月引入以来，面包制作中使用的小麦粉强制性叶酸强化对澳大利亚人群血液叶酸水平的影响。设计，设置和患者：血清和红细胞（RBC）的回顾性分析2007年4月至2010年4月期间，从各种住院患者和门诊患者中收集了20592份血液样本，并在一家大型公立医院诊断病理学实验室进行了分析。血清和红细胞叶酸水平低的患病率以及强制性强化前后的月平均水平。2009年4月至2010年4月期间，低血清叶酸水平的患病率降低了77（从9.3%到2.1%），低RBC叶酸水平的患病率降低了85%（从3.4%到0.5%）。2010年4月，所有样本中育龄女性红细胞叶酸水平低的患病率为0.16%。平均血清叶酸水平增加31%（从17.7 nmol/L增加到23.1 nmol/L; t = 9.3，P < 0.01），平均红细胞叶酸水平增加22%（从881 nmol/L增加到1071 nmol/L）。平均血清叶酸水平的最大增量发生在2009年9月，一个月，强制性强化推出，虽然有证据表明，在前几个月的逐步变化。结论：推出强制性强化叶酸显着降低了叶酸缺乏症的患病率在澳大利亚，包括育龄妇女。
Objective: To determine the impact that mandatory fortification with folic acid of wheat flour used in breadmaking has had on the blood folate levels of an Australian population since it was introduced in September 2009.Design, setting and patients: A retrospective analysis of serum and red blood cell (RBC) folate levels of 20 592 blood samples collected between April 2007 and April 2010 from a wide variety of inpatients and outpatients and analysed in a large public hospital diagnostic pathology laboratory.Main outcome measures: Prevalences of low levels of serum and RBC folate and monthly mean levels before and after introduction of mandatory fortification.Results: Between April 2009 and April 2010, there was a 77% reduction in the prevalence of low serum folate levels (from 9.3% to 2.1%) in all samples tested and an 85% reduction in the prevalence of low RBC folate levels (from 3.4% to 0.5%). In April 2010, the prevalence of low RBC folate levels for females of childbearing age was 0.16% for all samples. There was a 31% increase in mean serum folate level (from 17.7 nmol/L to 23.1 nmol/L; t = 9.3, P < 0.01), and a 22% increase in mean RBC folate level (from 881 nmol/L to 1071 nmol/L). The greatest increment in mean serum folate levels occurred in September 2009, the month that mandatory fortification was introduced, although there was evidence of a gradual change during the preceding months.Conclusion: The introduction of mandatory fortification with folic acid has significantly reduced the prevalence of folate deficiency in Australia, including in women of childbearing age.