四川省阿坝州大骨节病病区居民各种元素摄入水平调查

Dietary intake level of elements with Kashin-Beck disease areas in parts of Aba Autonomous Prefecture of Sichuan Province

目的：了解四川省阿坝州部分大骨节病区和非病区居民每日膳食各种元素摄入水平以及食物来源。方法2010年，在阿坝州松潘县、九寨沟县以及若尔盖县大骨节病病区村，采用多阶段随机抽样方式，在每个县中抽取3个病区村，共抽取大骨节病患者122例；在各县选择1个非病区村，并按该县所调查的大骨节患者数按比例选取无大骨节病和其他骨关节疾病的居民43例，共165人作为调查对象。采用24 h膳食回顾调查法，记录24 h膳食摄入情况，记录每种食物（熟食）摄入的量。连续记录3 d膳食摄入情况，计算平均值。采集当地居民有代表性的熟食样品，并采用电感耦合等离子体质谱法（ICP-MS）和电感耦合等离子体原子发射光谱法（ICP-AES）测定其中20种元素含量，计算出人均日摄入量并与相关摄入标准进行比较。结果病区村居民蔬菜和肉类的人均日摄入量分别为126.72、28.25 g，砖茶水饮用量是非病区村健康居民的3倍以上（P 〈0.05）；病区村和非病区村膳食钙（Ca）、铁（Fe）、镁（Mg）、钾（K）、钠（Na）、锌（Zn）、碘（I）、铜（Cu）、钴（Co）人均日摄入量低于国家推荐标准或者适宜摄入量；病区村80%以上人群铝（Al）、铅（Pb）人均日摄入量高于人均日最大安全摄入量。结论阿坝地区居民膳食结构单一，人体多种必需营养元素摄入严重不足，病区村和非病区村人群膳食元素摄入水平存在一定差异。

Objective To investigate and determine the dietary intake level and food source of elements in Kashin-Beck disease（KBD） and non-endemic KBD areas in parts of Aba Autonomous Prefecture , Sichuan Province. Methods Three KBD villages were selected from each county including the counties of Songpan , Jiuzhaigou and Ruoergai in Aba Autonomous Prefecture with multi stage random sampling method in 2010 , and 122 KBD patients who were diagnosed at county-level or higher-level hospitals were selected from villages. One non-KBD village was selected randomly from each county and 43 controls without KBD or other bone and joint disease were selected in proportion to the number of investigated KBD patients. Dietary intake of each object was recorded 24 hours before the survey using a 24 hour dietary survey method and intake of each kind of food（cooked food） was recorded. Three day dietary intake of each surveyed object was recorded in continuous and the average value was calculated. The local resident representative food samples were collected and 20 kinds of elements in these samples were determined with inductively coupled plasma mass spectrometry （ ICP-MS ） and inductively coupled plasma atomic emission spectrometry（ICP-AES）, and daily elements intake was calculated and compared with the relevant intake standards. Results Daily intakes of vegetables and meat were 126.72, 28.25 g, respectively, in patients with KBD. More than 3 times of brick tea was drank by KBD patients than non-KBD people （P〈0.05）. Per capita daily intakes of Ca, Fe, Mg, K, Na, Zn, I, Cu and Co were less than recommended nutrient intake or allowable daily intake in both groups. More than 80% patients with KBD overtook more Al and Pb than tolerable upper intake levels. Conclusion There is a single dietary structure and a serious shortage of a variety of essential elements intake in parts of Aba Autonomous Prefecture, and the dietary intake level of elements is different between two groups.