海南少数民族地区中小学生维生素A和维生素D营养状况

VITAMIN A AND VITAMIN D STATUS OF STUDENTS FROM HAINAN NATIONAL MINORITY AREAS

目的了解海南省少数民族地区中小学生维生素A(VA)和维生素D(VD)营养状况,为进一步制定营养干预措施提供参考依据。方法采用多阶段整群随机抽样方法,抽取海南省琼中县和白沙县1~9年级中小学生(6~18岁)1055名,采集清晨空腹静脉血,采用高效液相色谱法(HPLC)和液相色谱-串联质谱法(LC-MS/MS)检测血清VA和VD水平。结果中小学生血清视黄醇浓度为(1.17±0.29)μmol/L,初中生高于小学生,差异有统计学意义(P<0.001);VA缺乏率3.8%,边缘缺乏率35.6%,小学生VA缺乏率和边缘缺乏率均高于初中生,差异有统计学意义(VA缺乏:P=0.001;VA边缘缺乏:P<0.001)。学生血清VD平均浓度为(0.066±0.014)μmol/L,小学生血清VD浓度高于初中生,男生高于女生,差异均具有统计学意义(均P<0.001);VD缺乏率为0.0%,不足率12.1%,初中生VD不足率高于小学生,女生高于男生,差异均有统计学意义(均P<0.001)。多因素分析显示,影响学生血清视黄醇浓度的因素主要包括年龄、市县来源、供餐模式和民族,年龄越大血清视黄醇浓度越高,琼中县学生浓度高于白沙县,学校食堂供餐学生浓度高于企业供餐,汉族学生浓度高于少数民族;影响VD水平的因素主要包括性别、年龄、供餐模式和民族。男生血清VD水平高于女生,年龄越高VD水平越低,学校食堂供餐的学生VD水平高于企业供餐,少数民族学生VD水平高于汉族学生。结论海南省少数民族地区学生中VA缺乏较少,但边缘缺乏较普遍;VD营养状况总体较好,但仍有部分学生VD不足,需采取针对性的措施进行营养干预。

Objective To assess the vitamin A（VA） and vitamin D（VD） status of students from Hainan minority areas, to provide reference for further nutrition intervention. Methods 1055 students（6-18 years old） from grade 1 to grade 9 were randomly selected from 4 primary schools and 4 middle schools of Qiongzhong Country and Baisha Country by multi-stage sampling. Fasting venous blood samples were collected, and HPLC or LC-MS/MS method was used to determine the serum VA and VD concentration. Results The serum retinol concentration was（1.17±0.29）μmol/L by average. The difference between the primary and middle school students was statistically significant（P〈0.001）. It was higher in the middle school students than that in primary school students. The overall prevalence rate of VA deficiency（VAD） and VA insufficiency（VAI） was 3.8% and 35.6% respectively, and they both were higher in primary school students than that in middle school students. The difference between them were statistically significant（VAD：P=0.001;VIA：P〈0.001）.The vitamin D concentration was（0.066±0.014） μmol/L by average, It was higher in primary school students than that in the middle school students, and higher in boys than that in girls. The difference between them were statistically significant（P〈0.001）. The overall prevalence rate of VD deficiency（VDD） and VD insufficiency（VDI） was 0.0% and 12.1% respectively. The prevalence rate of VDI was higher in the middle school students than that in primary school students（P〈0.001）, and higher in girls than that in boys（P〈0.001）. Multiple-factor analysis results showed that the influencing factors of serum retinol concentration included the age, area, feeding mode and nationality, and the influencing factors of VD concentration included the sex, age, feeding mode and nationality. Conclusion The VA deficiency rate was not high among students from Hainan minority areas, but VA insufficiency was quite common. The VD status was better, but VD insufficiency was still high. Targeted measures should be taken in nutritional interventions.