Randomized Trial of Probiotics and Calcium on Diarrhea and Respiratory Tract Infections in Indonesian Children
Randomized Trial of Probiotics and Calcium on Diarrhea and Respiratory Tract Infections in Indonesian Children
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DOI：
10.1542/peds.2011-1379
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发表时间：
2012-05-01
期刊：
影响因子：
8
通讯作者：
Bovee-Oudenhoven, Ingeborg M. J.
中科院分区：
文献类型：
--
作者：
Agustina, Rina;Kok, Frans J.;Bovee-Oudenhoven, Ingeborg M. J.
目的：研究钙和益生菌对印度尼西亚雅加达低社会经济水平社区急性腹泻和急性呼吸道感染（ARTIs）的发病率和持续时间的影响。方法：我们对494名1至6岁的健康儿童进行了为期6个月的双盲安慰剂对照研究，这些儿童接受了低钙低乳糖牛奶（LC;类似于50 mg/天; n = 124），常规钙含量（RC;类似于440 mg/天; n = 126），RC每天使用5.10（8）菌落形成单位的干酪乳杆菌CRL 431（干酪; n = 120），或每天含有5.10（8）菌落形成单位的罗伊氏乳杆菌DSM 17938（罗伊氏乳杆菌; n = 124）的RC。腹泻和ART发作的次数和持续时间分别是主要和次要结局。（24小时内>= 3次稀便/液体便）在RC和LC之间无显著差异（相对危险度[RR]：0.99 [95%置信区间（CI）：0.62-1.58]），在干酪和RC之间（RR：1.21 [95% CI：0.76-1.92]），或在reuteri和RC组之间（RR：0.76 [95% CI：0.46-1.25]）。所有报告的腹泻（24小时内>= 2次稀便/液体便）的发生率在reuteri组显著低于RC组（RR：0.68 [95% CI：0.46-0.99]）。无论使用何种定义，reuteri显著降低了营养状况较低（低于年龄组身高体重z评分中位数）儿童的腹泻发病率。没有干预措施影响ARTIS.CONCLUSIONS：RC牛奶，单独或与L干酪，并没有减少腹泻或ARTIS在印尼儿童。罗伊氏乳杆菌可以预防腹泻，特别是在营养状况较低的儿童中。
OBJECTIVE: To investigate the effects of calcium and probiotics on the incidence and duration of acute diarrhea and acute respiratory tract infections (ARTIs) in low-socioeconomic communities of Jakarta, Indonesia.METHODS: We conducted a 6-month, double-blind, placebo-controlled study in 494 healthy children aged 1 to 6 years who received low-lactose milk with low calcium content (LC; similar to 50 mg/day; n = 124), regular calcium content (RC; similar to 440 mg/day; n = 126), RC with 5.10(8) colony-forming units per day of Lactobacillus casei CRL431 (casei; n = 120), or RC with 5.10(8) colony-forming units per day of Lactobacillus reuteri DSM17938 (reuteri; n = 124). Number and duration of diarrhea and ARTIs episodes were primary and secondary outcomes, respectively.RESULTS: Incidence of World Health Organization-defined diarrhea (>= 3 loose/liquid stools in 24 hours) was not significantly different between RC and LC (relative risk [RR]: 0.99 [95% confidence interval (CI): 0.62-1.58]), between casei and RC (RR: 1.21 [95% CI: 0.76-1.92]), or between reuteri and RC (RR: 0.76 [95% CI: 0.46-1.25]) groups. Incidence of all reported diarrhea (>= 2 loose/liquid stools in 24 hours) was significantly lower in the reuteri versus RC group (RR: 0.68 [95% CI: 0.46-0.99]). Irrespective of the definition used, reuteri significantly reduced diarrhea incidence in children with lower nutritional status (below-median height-and-weight-for-age z score). None of the interventions affected ARTIs.CONCLUSIONS: RC milk, alone or with L casei, did not reduce diarrhea or ARTIs in Indonesian children. L reuteri may prevent diarrhea, especially in children with lower nutritional status.