Randomized controlled trial assessing the efficacy of a reusable fish-shaped iron ingot to increase hemoglobin concentration in anemic, rural Cambodian women
Randomized controlled trial assessing the efficacy of a reusable fish-shaped iron ingot to increase hemoglobin concentration in anemic, rural Cambodian women
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DOI：
10.3945/ajcn.117.152785
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发表时间：
2017-08-01
影响因子：
7.1
通讯作者：
Green, Timothy J.
中科院分区：
文献类型：
--
作者：
Rappaport, Aviva I.;Whitfield, Kyly C.;Green, Timothy J.
背景：贫血症影响着柬埔寨 45% 的育龄妇女。建议贫血患病率较高的人群补充铁剂。然而，存在成本、分配和遵守方面的问题。一种潜在的替代方案是可重复使用的鱼形铁锭，当将其添加到烹饪锅中时，铁会浸入准备其的液体中。 目的：我们试图确定使用铁锭烹饪或每日服用铁补充剂的柬埔寨农村贫血妇女（18-49 岁）与对照组相比，1 年后血红蛋白浓度是否存在差异。 设计：在柏威夏，随机抽取 340 名患有轻度或中度贫血的妇女分配至 1) 铁锭组，2) 铁补充剂（18 毫克/天）组，或 3) 非安慰剂对照组。在基线以及 6 个月和 12 个月时采集静脉血样。分析血液中的血红蛋白、血清铁蛋白和血清转铁蛋白受体。血红蛋白电泳用于检测血红蛋白结构变异。结果：在筛查过程中使用便携式血红蛋白计时，贫血患病率为 44%。基线时，由于血清铁蛋白浓度较低，铁缺乏症的患病率为 9%。铁锭组（115 g/L；95% CI：113、118 g/L；P = 0.850）和补铁组（115 g/L；95% CI：113、117 g/L；P = 0.998）与对照组（115 g/L；95% CI：P = 0.998）相比，平均血红蛋白浓度无显着差异。 113, 117 g/L) 在 12 个月。 6个月时，补铁组血清铁蛋白显着高于对照组（73μg/L；95% CI：64、82μg/L；P = 0.002）；然而，这种显着性在 12 个月时并未维持（73 μg/L；95% CI：58, 91 μg/L；P = 0.176）。结论：铁锭和铁补充剂均未增加该人群在 6 或 12 个月时的血红蛋白浓度。我们不建议在柬埔寨或缺铁率较低且遗传性血红蛋白疾病较高的国家使用鱼形铁锭。
Background: Anemia affects 45% of women of childbearing age in Cambodia. Iron supplementation is recommended in populations in which anemia prevalence is high. However, there are issues of cost, distribution, and adherence. A potential alternative is a reusable fish-shaped iron ingot, which, when added to the cooking pot, leaches iron into the fluid in which it is prepared.Objective: We sought to determine whether there was a difference in hemoglobin concentrations in rural Cambodian anemic women (aged 18-49 y) who cooked with the iron ingot or consumed a daily iron supplement compared with a control after 1 y.Design: In Preah Vihear, 340 women with mild or moderate anemia were randomly assigned to 1) an iron-ingot group, 2) an iron-supplement (18 mg/d) group, or 3) a nonplacebo control group. A venous blood sample was taken at baseline and at 6 and 12 mo. Blood was analyzed for hemoglobin, serum ferritin, and serum transferrin receptor. Hemoglobin electrophoresis was used to detect structural hemoglobin variants.Results: Anemia prevalence was 44% with the use of a portable hemoglobinometer during screening. At baseline, prevalence of iron deficiency was 9% on the basis of a low serum ferritin concentration. There was no significant difference in mean hemoglobin concentrations between the iron-ingot group (115 g/L; 95% CI: 113, 118 g/L; P = 0.850) or iron-supplement group (115 g/L; 95% CI: 113, 117 g/L; P = 0.998) compared with the control group (115 g/L; 95% CI: 113, 117 g/L) at 12 mo. Serum ferritin was significantly higher in the iron-supplement group (73 mu g/L; 95% CI: 64, 82 mu g/L; P = 0.002) than in the control group at 6 mo; however, this significance was not maintained at 12 mo (73 mu g/L; 95% CI: 58, 91 mu g/L; P = 0.176).Conclusions: Neither the iron ingot nor iron supplements increased hemoglobin concentrations in this population at 6 or 12 mo. We do not recommend the use of the fish-shaped iron ingot in Cambodia or in countries where the prevalence of iron deficiency is low and genetic hemoglobin disorders are high.