孕期甲基供体营养质量指数的建立与评价

Development and assessment of methyl-donor nutritional quality index in pregnant women

目的 建立甲基供体营养质量指数,评价孕期甲基供体膳食质量。方法 依托北京、山东妇幼保健机构,遵循自愿原则募集218例孕妇(孕24~30周)作为研究对象。构建以甲基供体相关营养素(蛋白质、叶酸、胆碱、维生素B、维生素B、维生素B和锌)摄入量评价为主的甲基供体营养质量指数(MNQI),用于综合评价甲基供体膳食质量。采用3天24小时膳食记录法进行调查,并计算调查对象平均每天摄入营养素情况。同时采集孕妇空腹静脉血,检测红细胞叶酸、血清同型半胱氨酸、血清维生素B等一碳单位代谢指标。自拟调查问卷,调查孕妇社会人口学特征等。结果 调查对象甲基供体相关营养素摄入不足比例分别为26.8%(蛋白质)、64.1%(叶酸)、50.2%(维生素B)、73.7%(维生素B)、58.9%(维生素B)和34.9%(锌);MNQI平均得分(4.89±2.18)分,中位数为5分(P~P:3~7分)。MNQI得分与红细胞叶酸水平正相关(P<0.05),与血清同型半胱氨酸水平负相关(P<0.05)。调查对象中38.3%的孕妇甲基供体膳食质量较好(MNQI≥6)。MNQI得分与家庭经济状况有关,与家庭人均月收入3 001~6 000元/月组相比,≥6 001元/月组的MNQI得分显著提高(P<0.05)。结论 本研究建立的甲基供体营养质量指数与一碳单位代谢明显相关,可用于综合评价孕妇甲基供体膳食质量,未来仍需进一步验证其有效性。

Objective To develop and assess methyl-donor nutritional quality index in Chinese pregnant women. Methods A total of 218 pregnant women at 24 to 30 weeks of gestation were recruited on a voluntary basis from Beijing and Shandong province of China with the help of local maternal and child health institutions. Methyl-donor nutrients assessment was oriented to build the methyl-donor nutritional quality index(MNQI) for comprehensive evaluation of methyl donor intake, including daily dietary intake of protein, folic acid, vitamin B, vitamin B, vitamin B, and zinc. Maternal dietary intake was assessed using the 3-day food record, and calculated to get daily mean nutrients intakes. Fasting venous blood of each subject was collected during 24-30 weeks of gestation to measure erythrocyte folate, serum homocysteine and serum vitamin B. The sociodemographic characteristics were investigated by a self-administered questionnaire. Results In this survey, the intake deficiency of protein, folate, vitamin B, vitamin Band vitamin Bwere 26.8%, 64.1%, 50.2%, 73.7%, and 58.9%, respectively. The mean and medium of their MNQI scores were 4.89±2.18 and 5(P25~P75:3~7). The MNQI score was positively correlated with erythrocyte folate level(P<0.05), and was negatively correlated with serum homocysteine level(P<0.05). Moreover, 38.7% of women had good methyl donor intake(MNQI≥6). The MNQI scores of women with higher per capita monthly income(≥6001 RMB/month) were significantly higher than those with 3001~6000 RMB/month(P<0.05). Conclusion In this study, we have a methyl donor nutritional quality index(MNQI) which could be used to comprehensively evaluate the quality of methyl donor diet, but its effectiveness still needs to be further verified.