CAJ | 학술논문

目的：了解重庆市巴南区学龄前儿童膳食维生素A摄入量和血浆维生素A浓度的关系，为下一步利用膳食摄入量预测机体维生素A营养提供理论基础。方法：采用随机整群抽样方法，在重庆市巴南区鱼洞镇随机抽取3所幼儿园，对符合纳入标准的492名学龄前儿童进行膳食调查、体格测量、体检和实验室血生化检测。结果：492名学龄前儿童中，男孩229人，女孩263人，平均年龄（4．54±0．87）岁、身高（107．50±7．20） cm、体重（18．42±3．41） kg。边缘型维生素A缺乏（marginal vitamin A deficiency， MVAD）检出率为43．5％，未发现严重临床维生素A缺乏病例（血浆维生素A≤0．35μmol/L）。临床检查未发现结膜、角膜及皮肤异常和Bitot’s斑等维生素A缺乏特异临床症状，最近两周感冒发生率为27．4％（135/492），未发现腹泻等胃肠道和消化道疾病，膳食维生素A摄入不足儿童（＜600μg RE/d）的比例高达50．0％。血浆视黄醇浓度分别与膳食维生素A摄入量（r＝0．162， P＜0．001）、膳食能量摄入量（r＝0．107， P＝0．017）相关。校正其他非膳食因素后，多因素Logistic回归显示：富含维生素A的食物中猪肝未摄入（OR＝1．95，95％CI：1．05～3．61， P＝0．034）、富含维生素A的水果未摄入（OR＝1．55，95％CI：1．03～2．33， P＝0．034）、富含维生素A的蔬菜摄入＜200 g/d （OR＝3．47，95％CI：1．37～8．75， P＝0．009）是儿童维生素A缺乏的重要危险因素，而未发现肉、蛋、奶的摄入量与该地区儿童维生素A缺乏间的关系。结论：膳食维生素A摄入量和血浆视黄醇浓度呈显著相关，可以用富含维生素A的食物摄入量预测机体维生素A营养状况。
목적：료해중경시파남구학령전인동선식유생소A섭입량화혈장유생소A농도적관계，위하일보이용선식섭입량예측궤체유생소A영양제공이론기출。방법：채용수궤정군추양방법，재중경시파남구어동진수궤추취3소유인완，대부합납입표준적492명학령전인동진행선식조사、체격측량、체검화실험실혈생화검측。결과：492명학령전인동중，남해229인，녀해263인，평균년령（4．54±0．87）세、신고（107．50±7．20） cm、체중（18．42±3．41） kg。변연형유생소A결핍（marginal vitamin A deficiency， MVAD）검출솔위43．5％，미발현엄중림상유생소A결핍병례（혈장유생소A≤0．35μmol/L）。림상검사미발현결막、각막급피부이상화Bitot’s반등유생소A결핍특이림상증상，최근량주감모발생솔위27．4％（135/492），미발현복사등위장도화소화도질병，선식유생소A섭입불족인동（＜600μg RE/d）적비례고체50．0％。혈장시황순농도분별여선식유생소A섭입량（r＝0．162， P＜0．001）、선식능량섭입량（r＝0．107， P＝0．017）상관。교정기타비선식인소후，다인소Logistic회귀현시：부함유생소A적식물중저간미섭입（OR＝1．95，95％CI：1．05～3．61， P＝0．034）、부함유생소A적수과미섭입（OR＝1．55，95％CI：1．03～2．33， P＝0．034）、부함유생소A적소채섭입＜200 g/d （OR＝3．47，95％CI：1．37～8．75， P＝0．009）시인동유생소A결핍적중요위험인소，이미발현육、단、내적섭입량여해지구인동유생소A결핍간적관계。결론：선식유생소A섭입량화혈장시황순농도정현저상관，가이용부함유생소A적식물섭입량예측궤체유생소A영양상황。
Objective:To study the relationship between dietary vitamin A intake and plasma vitamin A concentration , and establish the theoretical basis for dietary intake predicting vitamin A nutritional status . Methods:By using cluster sampling , 492 children aged 2-7 years in kindergartens in Banan district of Chongqing were selected .A cross-sectional nutrition and health survey was conducted , including the clinical examination , anthropometry , laboratory test and dietary survey .Results: Among the children surveyed, 229 were boys, and 263 girls, the mean age was (4.54 ±0.87) years, height (107.50 ± 7.20) cm, and weight (18.42 ±3.41) kg, the mean value of plasma vitamin A was (1.04 ±0.30)μmol/L.The prevalence of marginal vitamin A deficiency ( MVAD) was 43.5%.No cases of severe clinical vitamin A deficiency were found (plasma vitamin A≤0.35μmol/L).Clinical examination found no conjunctiva, corneaor skin abnormalities, and no Bitot’s spots.Prevalence of the last two weeks colds were 27.4% (135/492), no diarrhea and other gastrointestinal or digestive diseases were found .The proportion of insufficient dietary vitamin A intake ( <600 μg RE/d) was as high as 50.0%.By using correlation analysis, plasma retinol concentrations were related to dietary vitamin A intake (r=0.162, P<0.001), and to dietary energy intake (r=0.107, P=0.017).After adjustment for the effects of other non-dietary factors on vitamin A deficiency , the multivariate logistic regression showed that vitamin A-rich foods of liver intake=0 g/d (OR=1.95, 95% CI:1.05-3.61, P=0.034), vitamin A-rich fruits intake=0 g/d (OR =1.55, 95% CI: 1.03 -2.33, P =0.034), vitamin A-rich vegetables intake<200 g/d (OR=3.47, 95%CI:1.37-8.75, P=0.009) were important risk factors of vitamin A deficiency .But we had not found the correlation between the intake of meat , eggs and milk and vita-min A deficiency .Conclusion:Dietary factors may be the major risk factor of vitamin A deficiency in the three kindergartens .The dietary vitamin A intakes are significantly related to plasma retinol concentra-tions, and the vitamin A-rich foods intakes can predict the body ’ s vitamin A nutritional status .