待产女性血清维生素B<sub>12</sub>和叶酸水平的流行病学特征

杜玉娇; 李晶; 王红丽; 杜姣洋; 屈鹏飞; 张若; 郭乐倩; 颜虹; 党少农

Abstract

杜玉娇,李晶,王红丽,杜姣洋,屈鹏飞,张若,郭乐倩,颜虹,党少农.待产女性血清维生素B₁₂和叶酸水平的流行病学特征[J].Chinese journal of Epidemiology,2020,41(8):1359-1364

待产女性血清维生素B₁₂和叶酸水平的流行病学特征

Epidemiological characteristics of serum vitamin B₁₂ and folate levels in women awaiting delivery

Received:September 27, 2019

DOI：10.3760/cma.j.cn112338-20190927-00707

KeyWord: 维生素B₁₂ 叶酸待产缺乏率

English Key Word: Vitamin B₁₂ Folate Awaiting delivery Prevalence of deficiency

FundProject:陕西省卫生和计划生育委员会出生缺陷防治课题研究（Sxwsjswzfcght2016-013）；国家自然科学基金重点项目（81230016）；国家重点研发计划（2017YFC0907200，2017YFC0907201）

Author Name	Affiliation	E-mail
Du Yujiao	Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
Li Jing	Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
Wang Hongli	Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
Du Jiaoyang	Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
Qu Pengfei	Assisted Reproduction Center, Northwest Women's and Children's Hospital, Xi'an 710003, China
Zhang Ruo	Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
Guo Leqian	Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
Yan Hong	Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
Dang Shaonong	Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China	tjdshn@mail.xjtu.edu.cn

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Abstract:

目的分析陕西省待产女性维生素B₁₂和叶酸水平及两者间关系的流行病学特征。方法资料来源于2014年1月至2016年12月在6所三甲医院待产的健康孕妇，产前采集血样以测定维生素B₁₂和叶酸水平。采用分位数回归模型分析待产女性维生素B₁₂和叶酸水平间的关系。结果共纳入1 277名待产女性，其血清维生素B₁₂的中位数为164.7 pg/ml，缺乏率为69.6%，血清叶酸的中位数为7.6 ng/ml，缺乏率为12.1%，单纯缺乏维生素B₁₂者占58.4%，单纯缺乏叶酸者占0.9%。农村待产女性维生素B₁₂和叶酸水平低于城市女性，维生素B₁₂和叶酸水平随年龄的增长而呈不同幅度增加，<25岁者维生素B₁₂和叶酸水平明显较低。叶酸缺乏者的维生素B₁₂水平比非缺乏者平均低37.62 pg/ml，分位数回归模型显示，在不同的维生素B₁₂分位点上，叶酸缺乏者的维生素B₁₂水平明显低于不缺乏者，且这种差异随着维生素B₁₂水平的升高而增大。结论陕西省待产女性维生素B₁₂和叶酸缺乏症仍普遍存在，在妇幼保健实践中，叶酸增补的同时可能需重视维生素B₁₂补充。加大健康教育力度，重点提高农村和年轻女性对营养素补充重要性的认识，从而改善其维生素B₁₂和叶酸水平。

English Abstract:

Objectives To analyze the epidemiological characteristics and levels of vitamin B₁₂ and folate as well as their relationship in women awaiting delivery, in Shaanxi province. Methods Data were collected from healthy pregnant women who gave birth at six top hospitals in Shaanxi, from January 2014 to December 2016. Blood samples were taken prenatally to determine the levels of vitamin B₁₂ and folate. Quantile regression model was used to analyze the relationship between the levels of vitamin B₁₂ and folates in women awaiting delivery. Results A total of 1 277 women awaiting delivery were included in this study. Among them, the median level of serum vitamin B₁₂ was 164.7 pg/ml, in women at late pregnancy, with the deficiency rate as 69.6%, while the median level of serum folate was 7.6 ng/ml, with the deficiency rate as 12.1%. 58.4% of these women presented simple vitamin B₁₂ deficiency and 0.9% with simple folate deficiency. Women living in rural areas showed lower levels of both vitamin B₁₂ and folate than the women from the urban areas. Both the levels of vitamin B₁₂ and folate increased with age but were significantly lower in women under the age of 25. Among those with or without folate deficiency, the average difference in the levels of vitamin B₁₂ was 37.62 pg/ml. Quantile regression models showed that the vitamin B₁₂ levels in women with folate deficiency were significantly lower than those without, despite the different levels of vitamin B₁₂. This difference appeared increasing along with the increase of the vitamin B₁₂ levels. Conclusions Our data showed that both vitamin B₁₂ and folate were deficient in women awaiting delivery, in Shaanxi. We suggest that vitamin B₁₂ should also be added into the folic acid supplementation program, together with the reinforcement on health education program to improve the awareness of nutrient supplementation in rural and young women. Hopefully, these strategies could increase the levels of both vitamin B₁₂ and folate, in the province.

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