PDF(904 KB)
Current status of vitamin A deficiency in preschool children in Dongguan, China and the effect of vitamin A on serum ferritin and red blood cell parameters
ZHANG Zhen-Hong, NI Ming, HU Yuan
Chinese Journal of Contemporary Pediatrics ›› 2018, Vol. 20 ›› Issue (3) : 195-199.
PDF(904 KB)
PDF(904 KB)
Current status of vitamin A deficiency in preschool children in Dongguan, China and the effect of vitamin A on serum ferritin and red blood cell parameters
Objective To investigate the current status of vitamin A deficiency in preschool children in Dongguan, China, as well as the effect of vitamin A on serum ferritin, red blood cell, and reticulocyte parameters. Methods Cluster sampling was performed from April 2015 to December 2016 to select 2 085 preschool children (3-6 years old) without any disease in Dongguan. Routine blood test, reticulocyte count, serum ferritin measurement, hemoglobin electrophoresis, and vitamin A measurement were performed for all children. The associations of age and sex with vitamin A and serum ferritin concentrations were analyzed. The effect of vitamin A concentration on serum ferritin, red blood cell, and reticulocyte parameters and the effect of reduced iron storage caused by vitamin A deficiency on red blood cell parameters were evaluated. Results Of the 2 085 children, 140 (6.71%) had reduced iron storage, and 678 (32.52%) had vitamin A deficiency. Among the 678 children with vitamin A deficiency, 647 (95.4%) had subclinical deficiency and 31 (4.6%) had clinical deficiency. There was no significant difference in vitamin A concentration between boys and girls, however girls had a significantly higher serum ferritin concentration than boys (P < 0.05). The clinical vitamin A deficiency group had a significantly higher serum ferritin concentration than the subclinical vitamin A deficiency group and the normal group (P < 0.05). In cases of vitamin A deficiency, the reduced iron storage group had significant reductions in mean corpuscular volume and mean corpuscular hemoglobin than the normal iron storage group (P < 0.05). Compared with the normal vitamin A group, the vitamin A deficiency group had significantly lower hemoglobin concentration, mean corpuscular hemoglobin, red blood cell count, hematocrit, absolute reticulocyte count, reticulocyte percentage, and reticulocyte hemoglobin content, as well as a significantly higher mean corpuscular volume (P < 0.05). Conclusions Vitamin A deficiency is prevalent in preschool children in Dongguan, China, and it may adversely affect serum ferritin, red blood cell, and reticulocyte parameters.
Vitamin A / Serum ferritin / Red blood cell parameter / Reticulocyte parameter / Preschool child
[1] 杨春, 杨晓光. 中国人群维生素A的影响因素[J]. 医学综述, 2016, 22(7):1249-1252.
[2] 李文迪, 魏守磊, 彭云, 等. 新生儿维生素A缺乏的研究进展[J]. 中国儿童保健杂志, 2017, 25(8):799-802.
[3] 金鹿, 闫素梅, 史彬林, 等. 维生素A抗氧化功能的机制[J]. 动物营养学报, 2015, 27(12):3671-3676.
[4] da Cunha MS, Siqueira EM, Trindade LS, et al. Vitamin A deficiency modulates iron metabolism via ineffective erythropoiesis[J]. J Nutr Biochem, 2014, 25(10):1035-1044.
[5] 周楠. 我国学龄前儿童家庭喂养状况研究进展[J]. 中国学校卫生, 2017, 38(11):1757-1760.
[6] 李廷玉, 黄鸿眉. 维生素A缺乏的诊断、治疗及预防[J]. 实用儿科临床杂志, 2010, 25(11):867-868.
[7] 江载芳, 申昆玲, 沈颖, 等. 诸福棠实用儿科学[M]. 第8版. 北京:人民卫生出版社, 2015:556, 1811-1813, 1821, 1859-1869.
[8] 金春华,王晓燕,张丽丽,等.儿童维生素A缺乏与血红蛋白水平及呼吸道感染相关性研究[J].临床儿科杂志, 2017, 35(10):755-758.
[9] 张玉英, 李凤娥, 马翠翠, 等. 儿童铁缺乏症的调查分析及家庭喂养行为教育[J]. 中国妇幼保健, 2016, 31(21):4529-4532.
[10] 廖新, 穆亚平, 李玢, 等. 沈阳市1490名0~6岁体检儿童血清维生素A水平现状分析[J]. 中国中西医结合儿科学, 2016, 8(5):522-524.
[11] 王丽敏, 张雪玲, 王文娟, 等. 佳木斯地区6岁以下儿童血清维生素A、25-羟基维生素D、维生素E水平分析[J]. 检验医学, 2017, 32(4):276-279.
[12] 王琦. 血清铁、TIBC、Tf、SF在缺铁性贫血患儿中的变化及其意义[J]. 中国儿童保健杂志, 2017, 25(10):1064-1067.
[13] Chen K, Xie HM, Tian W, et al. Effect of single-dose albendazole and vitamin A supplementation on the iron status of pre-school children in Sichuan, China[J]. Br J Nutr, 2016, 115(8):1415-1423.
[14] Chen K, Zhang L, Luo HY, et al. No enhancing effect of vitamin A administration on iron absorption or body total iron content in preschool children from Chengdu, China[J]. J Nutr Sci Vitaminol (Tokyo), 2014, 60(4):223-230.
[15] 陈科, 刘永芳, 陈立, 等. 维生素A联合其他微量营养素干预对铁代谢稳态的影响[J]. 中华儿科杂志, 2011, 49(12):926-932.
[16] Abizari AR, Azupogo F, Brouwer ID. Subclinical inflammation influences the association between vitamin A-and iron status among school children in Ghana[J]. PLoS One, 2017, 12(2):e0170747.
[17] 蓝岚, 梁克纪, 张羽飞, 等. 维生素A缺乏对缺铁性贫血的影响——体内外实验对比研究[J]. 中国食物与营养, 2016, 22(4):62-64.
[18] 薛春娥, 沈庆慧, 王艳, 等. 血清红细胞生成素水平在缺铁性贫血中的临床意义[J]. 中国实验血液学杂志, 2015, 23(5):1410-1414.
[19] 陈科, 章岚, 罗红裔, 等. 维生素A补充对学龄前儿童铁代谢稳态的影响[J]. 中华预防医学杂志, 2014, 48(1):18-22.
[20] Zimmermann MB, Biebinger R, Rohner F, et al. Vitamin A supplementation in children with poor vitamin A and iron status increases erythropoietin and hemoglobin concentrations without changing total body iron[J]. Am J Clin Nutr, 2006, 84(3):580-586.
