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  • 期刊

Zinc-Iron, but not Zinc-Alone Supplementation, Increased Linear Growth of Stunted Infants with Low Haemoglobin

補充鋅-鐵,而非單獨補充鋅,可促進發育不良併有低血紅素的嬰兒線性生長

摘要


補充鋅指出有益於線性生長,然而其效應可能取決於鋅是否為最限制的營養素。本研究目的為調查單獨給予鋅或是和鐵及維生素A一起補充,對於改善嬰兒微量營養素狀況與線性生長的效應。本研究為雙盲社區介入研究,800名居住在東Lombok鄉村、西Nusa Tenggara的3-6個月嬰兒參與研究。每天給予研究對象含鋅(鋅10mg/d)、鋅+鐵(鋅跟鐵各10mg/d)、鋅+鐵+維生素A(鋅跟鐵各10mg/d加上1,000IU的維生素A),或是安慰劑的糖漿為期六個月。結果變項為身長、體重及微量營養素狀況(血紅素、血清鋅、鐵蛋白與視網醇)。補充鋅+鐵與鋅+鐵+維生素A對於研究對象的鋅及鐵狀況有益,然而單獨給予鋅時則不利於血紅素及鐵的狀況。維生素A與血紅素增加最多的為鋅+鐵+維生素A組。原本為發育不良的研究對象,在補充鋅+鐵及鋅+鐵+維生素A後比給予安慰劑組成長了1.1-1.5公分。另一方面,在單獨補充鋅組,平均年齡身高別Z分數下降程度較安慰劑組大。原本為發育不良的研究對象在經過四個月的補充之後,HAZ在組別間有顯著的差異。然而在追蹤六個月後,儘管平均年齡身高別Z分數仍維持相同的模式,即鋅+鐵+維生素A及鋅+鐵的組較安慰劑組或單獨補充鋅組高,但其間的差異不再顯著。對血紅素/鐵狀況較差的研究對象而言,在低血紅素/鐵狀況已被改善的條件下,補充鋅將對生長狀況具有正面的影響。

關鍵字

理想生長 嬰兒 微量營養素

並列摘要


Zinc supplementation has been shown to benefit linear growth. However the effect may depend on whether zinc is the most limiting nutrient. This study aims to investigate the effect of supplementation with zinc-given alone or with iron and vitamin-A in improving infants' micronutrient status and linear growth. The study was a double-blind-community-intervention study involving 800 infants aged 3-6months in rural East Lombok, West Nusa Tenggara. Syrup consisting of zinc-alone, Zn (10 mg/d), zinc+iron, Zn+Fe (10 mg/d of each), zinc+iron+vitamin-A, Zn+Fe+vit.A (10 mg/d of each zinc and iron plus 1,000 IU vitamin-A), or placebo were given daily for six months. Outcomes measured were length, weight, and micronutrient status (haemoglobin, serum zinc, ferritin and retinol). Zn+Fe and Zn+Fe+vit.A supplementations benefit zinc and iron status of the subjects, while Zn-alone supplementation disadvantaged haemoglobin and iron status. The highest increment in vitamin A and haemoglobin status was shown in Zn+Fe+vit.A group. An effect on linear growth was observed among initially-stunted subjects in Zn+Fe and Zn+Fe+vit.A groups who grew 1.1-1.5cm longer than placebo. On the other hand, in the Zn-alone group, mean height-for-age Z-score decreased to a greater extent than placebo. The between-group difference in HAZ among initially-stunted subjects was significant after four months supplementation. While the difference was not significant in follow-up after 6 months, the pattern remained the same where means height-for-age Z-score in Zn+Fe+vit.A and Zn+Fe groups were higher than placebo and Zn-alone groups. Given the low haemoglobin/iron status of the subjects, zinc supplementation would have positive effect on growth if the low haemoglobin/iron status is also addressed and corrected.

並列關鍵字

optimal growth infant iron micronutrient zinc

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