2013年中国2岁以下儿童母亲维生素B12营养状况及其影响因素

Nutritional status of vitamin B and its influence factors in Chinese lactating women in 2013

目的了解中国2岁以下儿童母亲维生素B12营养状况的现状,并分析其影响因素。方法利用2013年中国居民营养与健康状况监测中2岁以下儿童母亲的调查数据,采用多阶段分层抽样方法抽取中国30个省(自治区、直辖市)的55个县(市/区)2岁以下儿童母亲。最终采集2岁以下儿童母亲血液样本10331份,问卷调查收集其基本情况,通过食物频率法收集其近1个月的膳食摄入情况,采用单纯随机抽样方法抽取20%血清样本(共1976份),用电化学发光法测定血清维生素B12水平,以血清维生素B12水平<200 pg/mL判定为维生素B12缺乏。2岁以下儿童母亲血清维生素B12水平呈对数正态分布,将其对数变换后进行广义线性回归模型分析影响血清维生素B12水平的因素。结果中国2岁以下儿童母亲血清维生素B12含量中位数(P25,P75)为469.0(349.0,633.5)pg/mL,维生素B12缺乏率为2.7%,边缘缺乏率为12.8%。不同地区、不同文化程度以及是否哺乳的2岁以下儿童母亲维生素B12缺乏率差异有统计学意义(P<0.001、P=0.037、P=0.048)。普通农村和中小城市2岁以下儿童母亲血清维生素B12水平分别是贫困农村的1.07倍和1.13倍。未哺乳的母亲血清维生素B12水平是哺乳母亲的1.08倍。初中及以下文化水平的2岁以下儿童母亲血清维生素B12水平显著低于大专/职大和大学学历2岁以下儿童母亲,分别为具有大专/职大学历和大学学历2岁以下儿童母亲的88.3%和85.0%。血清维生素B12水平与畜肉、鱼和水产品的摄入量呈正相关。结论2013年中国2岁以下儿童母亲维生素B12营养状况较好。学历、地区、是否哺乳以及膳食中畜肉、鱼和水产品摄入量可能会影响2岁以下儿童母亲维生素B12营养状况。

OBJECTIVE To examine the vitamin B12 status of lactating women in China and to analyze the factors affecting the level of serum vitamin B12 in these subjects.METHODS Participants were from the Chinese National Nutrition and Health Surveillance in 2013.By multi-stage stratified cluster randomly sampling method,10331 lactating women were selected from 55 counties of 30 provinces in China.Questionnaire was conducted to collect the basic information of lactating women and the dietary intake of them in the past one month was collected by food frequency questionnaire.A total of 20% of the total number of lactating women(a total of 1976)were randomly selected to analyze serum vitamin B12 by electro-chemiluminescence immunoassay method.Serum vitamin B12 deficiency was defined as a serum vitamin B12 level <200 pg/mL.The distribution of serum vitamin B12 was lognormal,a generalized linear model was used to analyze the factors affecting the serum vitamin B12 level after logarithm transformation of it.RESULTS The median of serum vitamin B12(P25,P75)in lactating women was 469.0(349.0,633.5)pg/mL,the prevalence of vitaminB12 deficiency was 2.7%(53/1976)and marginal deficiency rate was 12.8%.With the increase of the education level of the lactating women the rate of vitamin B12 deficiency decreased gradually.The rate of vitamin B12 deficiency of the lactating women presented regional differences and varied significantly among different regionals,education levels and the mothers who were breastfeeding or not.The value of serum vitamin B12 was analyzed by generalized linear regression model showed that the levels of serum vitamin B12 in general rural counties and medium-sized or small cities were 1.07 and 1.13 times higher than those in poor rural areas,respectively.The serum vitamin B12 level of non-lactating women was 1.08 times higher than that of lactating women.The serum vitamin B12 level of the lactating women with junior high school level or below was significantly lower than that of the lactating women with college education and university education level,88.3% and 85.0% of the lactating women with college education and university education,respectively.Serum vitamin B12 levels were positively correlated with intake of livestock meat,fish and seafood.CONCLUSION The status of vitamin B12 in lactating women in China is good.Our findings suggest that some regionals,education levels,breastfeeding or not and livestock meat,fish meat and seafood supplement may be associated with serum vitamin B12 in lactating women.