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  • Title: [Study on anemia and vitamin A and vitamin D nutritional status of Chinese urban pregnant women in 2010-2012].
    Author: Hu YC, Chen J, Li M, Wang R, Li WD, Yang YH, Yang C, Yun CF, Yang LC, Yang XG.
    Journal: Zhonghua Yu Fang Yi Xue Za Zhi; 2017 Feb 06; 51(2):125-131. PubMed ID: 28219150.
    Abstract:
    Objective: To evaluate the prevalence of anemia and the nutritional status of vitamins A and D by analyzing hemoglobin, serum retinol, and serum 25-hydroxyvitamin D levels in Chinese urban pregnant women during 2010-2012. Methods: Data were obtained from the China Nutrition and Health Survey in 2010-2012. Using multi-stage stratified sampling and population proportional stratified random sampling, 2 250 pregnant women from 34 metropolis and 41 middle-sized and small cities were included in this study. Information was collected using a questionnaire survey. The blood hemoglobin concentration was determined using the cyanmethemoglobin method, and anemia was determined using the World Health Organization guidelines combined with the elevation correction standard. The serum retinol level was determined using high-performance liquid chromatography, and vitamin A deficiency (VAD) was judged by the related standard recommended by the World Health Organization. The vitamin D level was determined using enzyme-linked immunosorbent assay and vitamin D deficiency was judged by the recommendation standards from the Institute of Medicine of The National Academies. The hemoglobin, serum retinol, and serum 25-hydroxyvitamin D levels were compared, along with differences in the prevalence of anemia, VAD, and the vitamin D deficiency rate (including deficiency and serious deficiency). Results: A total of 1 738 cases of hemoglobin level, 594 cases of serum retinol level, and 1 027 cases of serum 25-hydroxyvitamin D were available for analysis in this study. The overall blood hemoglobin level (P(50) (P(25)-P(75))) was 122.70 (114.00-131.10) g/L; 123.70 (115.21-132.00) g/L for metropolis and 122.01 (113.30-130.40) g/L for middle-sized and small cities. The blood hemoglobin level of metropolis residents was significantly higher than that of middle-sized and small city residents (P=0.027). The overall prevalence of anemia was 17.0% (295/1 738). The overall serum retinol level (P(50) (P(25)-P(75))) was 1.61 (1.20-2.06) μmol/L; 1.50 (1.04-2.06) μmol/L for metropolis and 1.63 (1.31-2.05) μmol/L for middle-sized and small cities. The serum retinol level of metropolis residents was significantly higher than that of middle-sized and small city residents (P=0.033). The overall prevalence of VAD was 7.4% (47/639); 11.5% (33/286) for metropolis and 4.0% (14/353) for middle-sized and small cities. A significant difference was observed in the prevalence of VAD between metropolis and middle-sized and small city residents (P<0.001). The overall serum 25-hydroxyvitamin D level (P(50) (P(25)-P(75))) was 15.41 (11.79-20.23) ng/ml; 14.71 (11.15-19.07) ng/ml for metropolis and 16.02 (12.65-21.36) ng/ml for middle-sized and small cities. A significant difference was observed in the vitamin D level between metropolis and middle-sized and small city residents (P<0.001). The overall prevalence of vitamin D deficiency was 74.3% (763/1 027); A significant difference was observed in the prevalence of serious vitamin D deficiency between metropolis (30.64%(144/470)) and middle-sized and small city residents (26%(267/1 027))(P=0.002). There were no significant differences between blood hemoglobin level and the prevalence of anemia, VAD, and vitamin D deficiency. Conclusion: The prevalence of anemia in Chinese urban pregnant women improved from 2002 to 2012. The prevalence of vitamin D deficiency in pregnant women was generally more serious, while a certain percentage of women had VAD. The prevalence of VAD and serious vitamin D deficiency among pregnant women from metropolis was significantly higher than that of pregnant women from medium and small-sized cities. 目的： 分析2010—2012年中国城市孕妇血红蛋白,以及血清视黄醇、25羟基维生素D水平，评价其贫血患病率以及维生素A和维生素D的营养状况。 方法： 2010—2012年中国居民营养与健康状况监测采用多阶段分层与人口成比例的整群随机抽样方法抽样，调查对象为中国内地31个省（直辖市、自治区）的34个大城市和41个中小城市的2 250名孕妇。采用问卷调查收集调查对象基本情况；氰化高铁法检测血红蛋白含量，按WHO推荐标准结合海拔校正界值进行贫血判定；高效液相色谱法检测血清视黄醇水平，按WHO推荐标准进行维生素A缺乏判定；酶联免疫法测定血清中25羟基维生素D，按照美国国家科学院医学研究所推荐标准进行维生素D缺乏判定。比较不同特征孕妇血红蛋白、血清视黄醇、血清25羟基维生素D差异，以及贫血患病率、维生素A、维生素D缺乏率（包括缺乏和严重缺乏）差异。 结果： 最终检测了1 738名孕妇的血红蛋白、594名孕妇的血清视黄醇和1 027名孕妇的血清25羟基维生素D水平。孕妇血红蛋白P(50)（P(25)~P(75)）为122.70(114.00~131.10)g/L；大城市高于中小城市，分别为123.70(115.21~132.00)、122.00(113.30~130.40)g/L（P=0.027）。孕妇贫血率为17.0%（295/1 738）。孕妇血清视黄醇P(50)（P(25)~P(75)）为1.61(1.20~2.06)μmol/L；大城市低于中小城市，分别为1.50(1.04~2.06)、1.63(1.31~2.05)μmol/L（P=0.033）。孕妇维生素A缺乏率为7.4%（47/639）；大城市高于中小城市，分别为11.5%（33/286）、4.0%（14/353）（P<0.001）。孕妇血清25羟基维生素D P(50)（P(25)~P(75)）为15.41(11.79~20.23)ng/ml；大城市低于中小城市，分别为14.71(11.15~19.07)、16.02(12.65~21.36)ng/ml（P<0.001）。孕妇维生素D缺乏率（包括缺乏与严重缺乏）高达74.3%（763/1 027）；大城市孕妇维生素D严重缺乏率为30.64%（144/470），高于中小城市[26%(267/1 027)] (P=0.002)。不同年龄城市孕妇血红蛋白水平、贫血率、维生素A缺乏率、维生素D缺乏率差异均无统计学意义（P>0.05）。 结论： 中国城市孕妇贫血状况有所改善，孕妇普遍存在较为严重的维生素D不足，同时存在一定比例的维生素A缺乏，大城市孕妇维生素A缺乏率高于中小城市，大城市孕妇维生素D严重缺乏率高于中小城市。.
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