海南省461例0~3岁儿童维生素A营养状况及其影响因素分析

Analysis of factors associated with vitamin A nutritional status among 461 children aged 0–3 years in Hainan Province

目的 了解海南省0~3岁儿童血清维生素A营养状况,并探讨其影响因素,为应对维生素A缺乏问题提供科学依据。方法 采用分层随机抽样的方法,抽取海南省5个市县在乡镇卫生院进行健康体检的461例0~3岁儿童为研究对象,收集其人口学特征、喂养情况等信息,采用高效液相色谱法对其进行血清维生素A含量测定,分析比较不同特征儿童血清维生素A水平和维生素A缺乏情况的差异。结果 461例儿童中男276例、女185例,血清维生素A水平为(369.12±134.81)ng/mL,边缘缺乏率为24.73%,缺乏率为9.33%。不同性别的儿童维生素A营养状况比较差异无统计学意义(P> 0.05)。各年龄段儿童血清维生素A水平差异有统计学意义(P <0.05),0~<6月龄组边缘缺乏率(45.98%)和缺乏率(22.99%)最高,随月龄增加边缘缺乏率和缺乏率均降低(r=-0.414,P <0.05)。城市儿童血清维生素A水平高于农村儿童,边缘缺乏率和缺乏率低于农村儿童,差异均有统计学意义(均P <0.05)。每天摄入水果、维生素A补充剂的儿童血清维生素A水平均高于摄入频率≤6次/周的儿童,边缘缺乏率和缺乏率均低于摄入频率≤6次/周的儿童,差异均有统计学意义(均P <0.05)。分层回归分析显示,控制人口学特征变量后,摄入水果情况能解释维生素A营养状况2.10%的变异。结论 海南省0~3岁儿童维生素A缺乏状况属于轻度公共卫生问题,应提高3岁以下儿童维生素A缺乏情况的监测力度,及时通过添加维生素A补充剂、合理膳食等手段加以干预。

Objective To investigate nutritional status of serum vitamin A among children aged 0–3 years in Hainan Province and factors associated with it,so as to provide scientific evidence to address vitamin A deficiency problem.Methods Stratified random sampling method was used to recruit 461 children aged 0–3 years who underwent health checkups at township health centers in 5 cities and counties in Hainan Province as study subjects.High-performance liquid chromatography was used to assess serum vitamin A levels,while information of the children’s demographic and feeding characteristics were collected.The serum vitamin A levels and vitamin A deficiency of children with different characteristics were analyzed and compared.Results There were 276 males and 185 females.The average serum vitamin A levels was(369.12±134.81)ng/mL,with a marginal deficiency rate of 24.73%and a deficiency rate of 9.33%.There was no difference in the serum vitamin A levels between different gender(P>0.05),while the differences between children of different age groups were statistically significant(P<0.05).The highest marginal deficiency rate(45.98%)and the deficiency rate(22.99%)were in the 0-<6 months age group,and the marginal deficiency rate and the deficiency rate decreased with months(r=-0.414,P<0.05).Urban children had higher serum vitamin A levels and lower marginal deficiency and deficiency rates than those of rural children(P<0.05).Children who had fruit and vitamin A supplements intake daily had higher serum vitamin A levels and lower marginal deficiency and deficiency rates than those whose intake frequency≤6 times/week(P<0.05).Stratified regression analysis showed that fruit intake interpreted 2.10%of the variation in vitamin A nutritional status after controlling for demographic variables.Conclusion Vitamin A deficiency among children aged 0–3 years in Hainan Province is a mild public health issue.Monitoring should be enhanced,and timely vitamin A supplements intake and balanced diet should be the main intervention strategies.