Prevalent vitamin B-12 deficiency in twelve-month-old Guatemalan infants is predicted by maternal B-12 deficiency and infant diet
Prevalent vitamin B-12 deficiency in twelve-month-old Guatemalan infants is predicted by maternal B-12 deficiency and infant diet
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DOI：
10.1093/jn/137.5.1307
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发表时间：
2007-05-01
影响因子：
4.2
通讯作者：
Allen, Lindsay H.
中科院分区：
文献类型：
--
作者：
Jones, Katharine M.;Ramirez-Zea, Manuel;Allen, Lindsay H.
据报告，在危地马拉研究的低收入妇女和儿童中，大约有三分之一的人血浆维生素B-12浓度不足(<；148pmol/L)或极低(148-220pmol/L)。由于维生素B-12缺乏会对婴儿发育和认知功能产生不利影响，因此本研究考察了12岁时血浆维生素B-12缺乏的预测因素。对304名危地马拉婴儿(其中80%是部分母乳喂养的)及其母亲的随机临床试验的基线数据进行了分析。婴儿排除标准包括双胞胎、严重发育迟缓或中度消瘦、有重大健康问题、严重发育迟缓、血红蛋白95g/L、母亲年龄17岁、母亲怀孕3个月。收集的数据包括社会经济状况、婴儿人体测量、从辅食中摄取维生素B-12以及母亲报告的母乳喂养频率。检测全血细胞计数和血浆维生素B-12、叶酸、铁蛋白和C反应蛋白。49%的婴儿和68%的母亲血浆维生素B-12缺乏或边际浓度，母亲平均每天摄入3.1微克维生素B-12，婴儿每天从辅食中摄取2.2微克。在线性回归分析中，婴儿血浆B-12浓度与母亲从辅食(主要是奶粉)中摄取的维生素B-12和B-12呈显著正相关，与母乳喂养频率和较大家庭规模呈负相关(P<；0.0001)。对哺乳期妇女补充维生素B-12、食物强化和改善婴儿维生素B-12状况的教育是可以改善这一人群中母亲和婴儿维生素B-12状况的潜在干预措施。
Approximately one-third of low-income women and children studied in Guatemala are reported to have deficient (< 148 pmol/L) or marginal (148-220 pmol/L) plasma vitamin B-12 concentrations. Because vitamin B-12 deficiency can adversely affect infant development and cognitive function, the present study examined predictors of deficient plasma vitamin B-12 concentrations at the age of 12 me. Analyses were performed on baseline data from a randomized clinical trial in 304 Guatemalan infants, 80% of whom were partially breast-fed, and their mothers. Exclusion criteria for infants included twins, severe stunting or moderate wasting, reported major health problems, severe developmental delay, hemoglobin < 95 g/L, maternal age < 17 y, and maternal pregnancy > 3 mo. Data collected included socio-economic status, infant anthropometry, vitamin B-12 intake from complementary foods, and breast-feeding frequency reported by mothers. A complete blood count and plasma vitamin B-12, folate, ferritin, and C-reactive protein were measured. Deficient or marginal plasma vitamin B-12 concentrations were found in 49% of infants and 68% of mothers, The mean intake of maternal vitamin B-12 was 3.1 mu g/d, and infants consumed 2.2 mu g/d from complementary foods. In linear regression analysis, infant plasma B-12 concentration was strongly and positively associated with maternal plasma vitamin B-12 and B-12 intake from complementary foods (predominantly powdered cow's milk), and inversely associated with frequency of breast-feeding and larger household size (P < 0.0001). Vitamin B-12 supplementation of lactating women, food fortification, and education to improve infant's vitamin B-12 status are potential interventions that can improve the vitamin B-12 status of mothers and infants in this population.