2010-2012年中国城市老年人维生素A营养状况

Study on vitamin A nutritional status of Chinese urban elderly residents in 2010-2012

目的通过分析2010-2012年中国城市老年人血清视黄醇水平，评价我国城市老年人维生素A的营养状况。方法2010-2012年中国居民营养与健康状况监测采用多阶段分层与人口成比例的整群随机抽样方法抽样，调查对象为中国内地31个省（直辖市、自治区）的34个大城市和41个中小城市中60岁以上老年人，共3200名。采用问卷调查收集调查对象基本情况，高效液相色谱法测定血清视黄醇水平。按照WHO推荐标准进行老年人维生素A营养状况的判定，比较不同特征老年人维生素A水平、维生素A缺乏率、边缘缺乏率差异。结果中国城市老年人群血清视黄醇P50（P25-P75）为1．83（1．37～2．39）μmol／L；大城市老年人群血清视黄醇水平低于中小城市，分别为1．70（1．25～2．25）和1．91（1．47～2．48）μmol／L（P〈0．001）；男性高于女性，分别为1．89（1．37～2．47）、1．80（1．36—2．28）μmol/L（P=0．001）；60～69、70～79、80岁及以上老年人血清视黄醇水平分别为1．87（1．42～2．43）、1．78（1．32～2．33）、1．71（1．24～2．24）μmol／L，70岁及以上老年人低于60～69岁老年（P〈0．001）。维生素A缺乏、边缘缺乏率分别为4．22％（135／3200）、8．19％（262／3200）；大城市老年人维生素A缺乏、边缘缺乏率分别为6．0％（81／1350）和10．51％（142／1350），均高于中小城市[分别为2．92％（54／1850），6．49％（120／1850）]（P〈0．05）。60～69岁老年人维生素A缺乏、边缘缺乏率分别为3．65％（72／1975）、6．99％（138／1975），70—79岁老年人分别为4．96％（50／1008）、9．82％（99／1008），980岁老年人分别为5．99％（13／217）、11．52％（25／217）；3个年龄段老年人的维生素A缺乏率差异无统计学意义（P=0．097），边缘缺乏率差异有统计学意义（P=0．005）。结论中国城市老年人存在不同程度的维生素A缺乏，其中边缘性缺乏更为普遍。大城市的老年人及高龄段老年人的维生素A缺乏尤为突出。

Objective To assess the vitamin A nutritional status of the Chinese urban elderly population by analyzing serum retinol level in 2010-2012. Methods Data were collected from the Chinese National Nutrition and Health Survey in 2010-2012. Using the multi-stage stratified cluster sampling method, serum samples from elderly residents aged ≥60 years old were obtained from 34 metropolis and 41 middle-sized and small cities. Demographic data were collected using a questionnaire survey. The serum retinol concentration was determined by high-performance liquid chromatography. Vitamin A deficiency （VAD） was determined using the World Health Organization guidelines. A total of 3 200 elderly residents were included in the study. The serum retinol levels and prevalence of VAD and marginal VAD were also compared. Results The serum retinol concentration （P50（P25-P75）） of Chinese urban elderly residents was 1.83 （1.37- 2.39） μmol/L. Compared with middle-sized and small cities （1.91 （1.47-2.48） μmol/L）, the retinal level of senior citizens in metropolis （1.70 （1.25-2.25） txmol/L） was significantly lower （P〈0.001）. The serum retinol levels of elderly male （1.89 （1.37-2.47） μmoL/L） was significantly higher than that of female （1.80 （1.36- 2.28） μmoL/L） （P=0.001）. The serum retinol concentration was 1.87 （1.42-2.43）, 1.78 （1.32-2.33）, and 1.71 （1.24- 2.24）μmol/L for 60-69, 70-79, and≥80 years olds, respectively. The retinol level in elderly people ≥70 years olds was significantly lower than that of 60-69 years olds （P〈0.001）. The overall prevalence of VAD among Chinese urban elderly residents was 4.22% （135/3 200）; 6.00% （81/1 350） for metropolis residents and 2.92% （54/1 850） for middle-sized and small city residents. The overall marginal VAD rate of Chinese urban elderly residents was 8.19% （262/3 200）; 10.51% （142/1 350） for metropolis residents and 6.49% （120/1 850） for medium-sized and small city residents. The prevalence of VAD and marginal VAD for males was 3.87% （61/1 577） and 8.24% （130/1 577）, respectively （P〈0.05）. The prevalence of VAD according to age group was 3.65% （72/1 975）, 4.96% （50/1 008）, and 5.99% （13/217）, respectively（P= 0.097）. The prevalence of marginal VAD according to age group was 6.99% （138/1 975）, 9.82% （99/1 008）, and 11.52% （25/217）, respectively（P=0.05）. Conclusion Chinese urban elderly residents showed various levels of VAD, although marginal VAD was quite common. As VAD was more common in metropolis residents and older residents, specific strategies should target these populations.