重庆市中小学生维生素A营养状况及影响因素分析

Vitamin A nutritional status and associated factors among primary and middle school students in Chongqing

目的了解重庆市6~17岁中小学生维生素A营养状况,并分析维生素A缺乏的影响因素,为后续研究和制定营养改善措施提供科学依据。方法于2016—2017年,通过多阶段分层与人口成比例整群随机抽样方法在重庆市选择3个农村点和3个城市点,抽取1 508名6~17岁儿童青少年,开展问卷调查和实验室检测,采用SPSS 25.0进行统计分析。结果学生维生素A浓度均值为(1.45±0.42)μmol/L,维生素A缺乏率和亚临床缺乏率分别为0.46%,13.46%。二元Logistic回归分析结果表明,超重及肥胖(OR=0.51)、母亲文化程度为高中及以上(OR=0.35)、大城市、白蛋白四分位数为Q3和Q4的学生与维生素A缺乏呈负相关,每天不吃肉(OR=2.05)、C反应蛋白四分位数为Q3(OR=2.12)和Q4(OR=4.54)的学生与维生素A缺乏呈正相关(P值均<0.05)。结论重庆市6~8岁中小学生维生素A亚临床缺乏率较高。建议通过加强营养教育、保障合理膳食、必要时使用营养强化食品或营养强化剂等手段进行改善。

Objective To examine the vitamin A status of children and adolescents aged between 6-17 years old in Chongqing, and to analyze the influencing factors of vitamin A deficiency, providing a scientific basis for nutritional improvement measures. Methods From 2016 to 2017, a multi-stage random sampling method was used to select approximately 1 508 children and adolescents aged between 6-17 years old from three rural and three urban locations in Chongqing. This study carried out a questionnaire survey and laboratory testing, and the statistical analysis was performed using SPSS version 25.0. Results The mean vitamin A level was(1.45±0.42)μmol/L, while the prevalence of vitamin A deficiency and the subclinical deficiency rate were 0.46% and 13.46%, respectively. The binary Logistic regression analysis revealed that the following factors were associated with a lower risk of vitamin A deficiency: overweight and obese students(OR=0.51);students whose mothers had a high school education or above(OR=0.35, P=0.01);students from big cities;and higher quartile albumin levels(Q3 and Q4). Students who did not eat meat each day(OR=2.05), students aged 6-8 years old, and students with C-reactive protein in the third(OR=2.12) and fourth(OR=4.54) higher quartiles were at a higher risk of vitamin A deficiency. Conclusion The subclinical vitamin A deficiency rate was relatively high among children aged 6-17 years old in Chongqing. Measures including nutritional education, reasonable diets, and nutritionally fortified food or fortifiers should be used when necessary.