中国九省农村寄宿制学校初一学生铁营养状况

Iron status of first-year junior high school students in rural boarding school among nine provinces in China

目的评估北京、广东、广西、浙江、天津、宁夏、四川、上海、山东九省农村寄宿制学校初一学生铁营养状况。方法 2013年多阶段整群抽样方法抽取九省农村寄宿制学校的初中一年级学生,采用生化指标评价铁营养状况,氰化高铁法测定血红蛋白（Hb）,参照卫生行业标准WS/T 441—2013筛查贫血。采用免疫比浊法测定血清铁蛋白（SF）、血清转铁蛋白受体（sTfR）和高敏C反应蛋白（hsCRP）,计算铁储量（BI）,以SF〈25 ng/mL,sTfR〈4.4 mg/L且不贫血判定为储存铁缺乏期（SID）;以SF〈25 ng/mL,sTfR〉4.4 mg/L且不贫血判定为缺铁性红细胞生成期（IDE）;以SF〈25 ng/mL且贫血,判定为铁缺乏贫血（IDA）。以hsCRP〉5 mg/L排除有炎症或感染的个体。结果共调查1263名年龄范围为10~18岁的初中一年级学生,调查学生的Hb、SF、sTfR和BI水平分别为（144.6±13.2）g/L、52.2 ng/mL、3.34 mg/L和（6.72±2.61）mg/kg。调查对象的贫血率为4.8%,铁缺乏检出率为10.5%,其中SID、IDE和IDA率分别为6.6%、2.5%和1.4%,铁缺乏的每个阶段女生发生率均高于男生。结论寄宿制学校中男生的铁营养状况较好,女生的铁营养状况更应重视,确保膳食铁的充足摄入。

Objective To assess the iron status among boarding school students in a cross-sectional study performed in 9 provinces which were Beijing,Guangdong,Guangxi,Zhejiang,Tianjin,Ningxia,Sichuan,Shanghai and Shandong provinces.Methods A multi-stage cluster sampling survey on iron status of first-year junior high school students in rural boarding school in 9 provinces was used.Iron status was defined utilising biochemical indicators.Hemoglobin was measured by cyanmethemoglobin method.WS/T441—2013’s hemoglobin thresholds used to define anemia.Immunoturbidimetric assay was used as analytical method for serum ferritin（ SF）,Serum soluble transferrin receptor（ sTfR） and high sensitive C-reactive protein（ hsCRP）.BI was calculated by SF andsTfR.Storage iron depletion（ SID） was defined as low SF（ SF 〈 25 ng/mL） and low sTfR（ sTfR 〈 4.4 mg/L） without anemia.Iron deficient erythropoiesis（ IDE） was defined as low SF（ SF 〈 25 ng/mL） and high sTfR（ sTfR 〉 4.4 mg/L） without anemia.Iron deficiency anemia（ IDA） was defined as low SF（ SF 〈 25 ng/mL） with anemia.Subjects with indication of inflammation（ hsCRP 〉 5 mg/L） were excluded from the analyses.Results A total of 1263 adolescents aged 10-18 years（ 696 boys and 567 girls） were involved.The levels of hemoglobin,serum ferritin,sTfR and BI concentration were（ 144.6 ± 13.2） g/L,52.2 ng/mL,3.34 mg/L and（ 6.72 ± 2.61） mg/kg for students,respectively.The overall prevalence of anemia was 4.8%.The percentage of iron deficiency was 10.5%,significantly higher in girls compared with boys.The overall percentage of SID,IDE and IDA was 6.6%,2.5% and 1.4%,respectively,with significant differences between boys and girls.Conclusion To ensure adequate iron stores,specific attention should be given to girls to ensure that their dietary intake of iron is adequate.