叶酸水平和神经管缺陷. 对预防的影响
L E Daly1, P N Kirke, A Molloy
1Department of Public Health Medicine and Epidemiology, University College Dublin, Ireland.
JAMA
|December 6, 1995
概括
降低神经管缺陷 (NTDs) 的风险包括优化红细胞叶酸水平. 策略包括针对高风险妇女或一般人口,以补充和食品强化为关键方法.
科学领域:
- 产科和妇科 产科和妇科
- 公共卫生 公共卫生
- 营养科学 营养科学
背景情况:
- 神经管缺陷 (NTD) 是一种严重的出生缺陷.
- 怀孕早期的叶酸水平对于预防NTD至关重要.
- 红细胞叶酸和NTD风险之间存在剂量反应关系.
研究的目的:
- 评估不同叶酸提升策略对NTD预防的影响.
- 为了比较针对高风险个体与普通人口的有效性.
- 评估补充剂与食品强化对减少NTD的效率.
主要方法:
- 对NTD风险的病例控制研究数据的分析.
- 根据两个干预策略计算预期的NTD病例减少.
- 评估个体风险变化与人口患病率的影响.
主要成果:
- 针对高风险个体显著降低个人风险,但对人口的影响很小.
- 全人口的方法产生了小的个体风险降低,但大人口的患病率下降.
- 目前的指导方针是每天0.4毫克叶酸,可以实现近乎最佳的NTD减少 (48%).
结论:
- 高风险和全民策略都对预防NTD有价值.
- 补充是高风险向的有效;食品强化适合人口方法.
- 这两种策略应该被视为全面的NTD预防的补充.
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