背景:传统上与营养不良有关,越来越多的证据表明,微量营养素缺乏可以与营养过剩共存。因此,这项工作旨在系统地回顾铁,儿童和年轻人的锌和维生素A(VA)状态和体重状态(体重不足和超重)。
方法:OvidMedline,OvidEmbase,系统地搜索Scopus和Cochrane数据库,以进行评估微量营养素状态的观察性研究(血液,血清或血浆铁水平,锌或VA生物标志物)和体重状态(体重指数或其他人体测量)在任何种族和性别的25岁以下的人。使用美国饮食协会质量标准清单进行偏倚风险评估。在可能的情况下,我们进行了随机效应限制的最大似然荟萃分析.
结果:筛选后,83项观察性研究涉及来自44个国家的190443名参与者,许多研究报告了一种以上的微量营养素和/或体重状态指标。铁是研究最多的微量营养素,有46、28和27项研究报告了铁的数据,锌和VA状态,分别。从7项符合条件的研究中综合16项OR记录,营养过剩(超重和肥胖)增加缺铁(ID)的几率(OR(95%CI):1.51(1.20至1.82),p<0.0001,I2=40.7%)。肥胖儿童的赔率似乎更高(1.88(1.33至2.43),p<0.0001,I2=20.6%)与超重者(1.31(0.98至1.64)相比,p<0.0001,I2=40.5%),虽然组间差异不显著(p=0.08).
结论:营养过剩与ID风险增加有关,但不是锌或VA缺乏,铁状态与体重呈倒U型关系。我们的结果强调了微量营养素生物标志物报告中的显着异质性以及如何定义缺乏。炎症状态很少得到充分考虑,身份证的负担很可能被低估了,特别是在营养过剩的儿童和年轻人中。
■CRD42020221523。
BACKGROUND: Traditionally associated with undernutrition, increasing evidence suggests micronutrient deficiencies can coexist with overnutrition. Therefore, this work aimed to systematically
review the associations between iron, zinc and vitamin A (VA) status and weight status (both underweight and overweight) in children and young people.
METHODS: Ovid Medline, Ovid Embase, Scopus and Cochrane databases were systematically searched for observational studies assessing micronutrient status (blood, serum or plasma levels of iron, zinc or VA biomarkers) and weight status (body mass index or other anthropometric measurement) in humans under 25 years of any ethnicity and gender. Risk of bias assessment was conducted using the American Dietetic Association Quality Criteria Checklist. Where possible, random effects restricted maximum likelihood meta-analyses were performed.
RESULTS: After screening, 83 observational studies involving 190 443 participants from 44 countries were identified, with many studies having reported on more than one micronutrient and/or weight status indicator. Iron was the most investigated micronutrient, with 46, 28 and 27 studies reporting data for iron, zinc and VA status, respectively. Synthesising 16 records of OR from seven eligible studies, overnutrition (overweight and obesity) increased odds of iron deficiency (ID) (OR (95% CI): 1.51 (1.20 to 1.82), p<0.0001, I2=40.7%). Odds appeared to be higher for children living with obesity (1.88 (1.33 to 2.43), p<0.0001, I2=20.6%) in comparison to those with overweight (1.31 (0.98 to 1.64), p<0.0001, I2=40.5%), although between group differences were not significant (p=0.08).
CONCLUSIONS: Overnutrition is associated with increased risk of ID, but not zinc or VA deficiencies, with an inverted U-shaped relationship observed between iron status and bodyweight. Our results highlight significant heterogeneity in the reporting of micronutrient biomarkers and how deficiencies were defined. Inflammation status was rarely adequately accounted for, and the burden of ID may well be under-recognised, particularly in children and young people living with overnutrition.
UNASSIGNED: CRD42020221523.