5岁以下儿童补充锌与发育迟缓的系统评价和荟萃分析

Gihan Ahmad, Hanaa Ahmed, Enas S. Abbas
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摘要

缺锌的患病率为发育迟缓的埃及儿童的28%。因此,本研究旨在确定补锌策略在国家层面上是否可行和有效地减少生长迟缓。我们对国际标准随机对照试验号登记的电子数据库进行了文献检索,这些数据库报道了锌补充剂对婴儿或5岁以下儿童的影响。研究结果采用随机效应荟萃分析进行汇总;在这些荟萃分析的实施、分析和报告的所有阶段,我们都遵循了系统评价和荟萃分析的首选报告项目(PRISMA)指南。meta分析中包含的最后54个随机对照试验显示,与婴儿相比,锌补充剂对儿童身高和身高年龄z分数的影响更大(p相互作用分别= 0.002和0.06)。在≥2岁的儿童中,锌增加身高(N = 7项试验;WMD = 1.37 cm, 95%CI: 0.50-2.25),身高为年龄z-score (N = 6试验;WMD = 0.12, 95%ci: 0.05-0.19)。补锌显著提高身高(N = 40试验,WMD = 0.23 cm, 95%CI: 0.09-0.38;I2 = 66.9%)表明,在40项随机对照试验中,28项(70%)研究中,5岁以下儿童补充锌对身高有积极影响,其中10项研究具有统计学意义。建议2-5岁儿童口服锌补充剂。然而,还需要进一步的研究。
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Systematic Review and Meta-analysis of Zinc Supplementation and Stunting in Children under 5 years of age
he prevalence of zinc deficiency is 28 % of stunted Egyptian children. Therefore, this study was done to determine whether zinc supplementation strategy is feasible and effective for reducing growth retardation at national level. We conducted literature searches of electronic databases of the international standard randomized control trial number register that reported on the effect of zinc supplementation in infants or children below 5 years old. The findings were pooled using random effects meta-analysis; we followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines during all stages of implementation, analysis, and reporting of these meta-analyses after testing of homogeneity. The final fifty four randomized controlled trials included in the meta-analysis showed the zinc supplementation had a greater effect on height and Height for age z-score in children compared with infants (P-interaction = 0.002 and 0.06, respectively). Among children aged ≥2 years, zinc increased height (N = 7 trials; WMD = 1.37 cm, 95%CI: 0.50–2.25) and, height for age z-score (N = 6 trials; WMD = 0.12, 95%CI: 0.05–0.19). Zinc supplementation significantly increased height (N = 40 trials, WMD = 0.23 cm, 95%CI: 0.09–0.38; I2 = 66.9%) showed 28 of 40 studies (70%) had a positive effect of zinc supplementation among children aged < 5 years old on height in randomized controlled trials and, ten of them were statistically significant. Oral zinc supplementation among children aged from 2-5 years is recommended. However, further studies are needed.
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