海南省贫困地区2016—2017学年汉族黎族学生贫血及营养状况

Comparative study of prevalence of anemia in Han and Li minority students from poor areas of Hainan Province

目的了解海南省贫困地区2016—2017年汉族黎族学生的贫血现况及其与营养状况的关联,为进一步制定中小学生贫血防治措施提供理论依据。方法分层抽取2016年海南省实施"学生营养改善计划"贫困地区的初中和小学各4所,汉族黎族学生1 324人,收集基本信息,并采集空腹静脉血5 mL,分别采用氰化高铁法、高效液相色谱法、液相色谱-串联质谱法检测血清血红蛋白含量、维生素A(视黄醇)水平和血清25-(OH)D水平。结果贫血检出率为6.6%(87人),黎族(9.6%)高于汉族(3.1%)(χ~2=22.810,P<0.01),性别差异无统计学意义(χ~2=0.603,P=0.438)。汉族男生、汉族女生、黎族男生、黎族女生4类学生贫血检出率分别为3.7%,2.5%,8.0%,11.3%。小学生与初中生贫血检出率差异无统计学意义(χ~2=3.81,P>0.05)。Logistic回归分析显示,消瘦组和维生素A缺乏组与正常组相比均具有更高的罹患贫血的风险(OR值分别为1.847,1.701)。结论海南省贫困地区汉族黎族中小学生的贫血检出率较低,BMI营养状况与贫血的发生存在关联性,未来贫血防治重点应向黎族学生倾斜。

Objective To analyze the prevalence of anemia among Han and Li students in poor areas of Hainan Province.Methods Four primary schools and 4 middle schools were selected.One to two classes from each grade were randomly chosen from schools located in poor areas of Hainan province.Fasting venous blood samples were collected,Hi CN,HPLC and LC-MS/MS methods were used to determine hemoglobin,retinol and 25（OH） D concentration（including 25（OH） D3 and 25（OH） D2）.Results A total of 1 324 students were enrolled,including 662 boys and 662 girls.The overall prevalence of anemia was 6.6%（87/1 324）.Prevalence of anemia among Li students（9.6%） was higher than that among Han students（3.1%）（χ~2=22.810,P〈0.01）,while no gender difference was found in anemia prevalence（χ~2=0.603,P=0.438）.Specifically,prevalence of anemia among Han male,Han female,Li male,Li female students was 3.7%,2.5%,8.0%,11.3% respectively.Logistic regression analysis suggested that students with marasmus or vitamin A deficiency（VAD） had a higher risk of anemia（OR=1.847,1.701）.Conclusion The overall prevalence of is not a serious problem among Han and Li minority students in poor areas of Hainan,however,prevention and treatment of iron deficiency and anemia still needs to be implemented,especially among Li minority students.Cautions should be paid to the association between anemia and body mass index.