新疆维吾尔族孕妇膳食营养、体内叶酸水平、MTHFR基因多态性对出生缺陷影响的研究

The relationship between dietary nutrition，folic acid and birth defects caused by the widespread concern at home and abroad. Existing authority of the experts have studied that the incidence of birth defects in our country between the North and South were significantly different. This study is still in its infancy in Xinjiang region, and the results in the southern and northern are different. Preliminary investigation found that Kashi Uighur maternal dietary calcium,iron, vitaminA,B1,B2,B12, C and folic acid intake is a serious shortage, and in vivo low folic acid levels, homocysteine high,but not tracking to birth defects. To study this phenomenon and to further elucidate the impact of folic acid and its associated micro-nutrients to Uighur Maternal and Child Health, we set Uygur pregnant women as the research object, to identify the association and influencing factors to the Uighur pregnant women folic acid levels and of birth defects, Investigate the possible causes and mechanisms of birth defects through a series of field investigations and laboratory analysis and MTHFR gene polymorphism analysis . To provide a scientific basis of the depth of maternal and child nutrition and health care work and to improve minority health and overall quality in the region.

膳食营养、叶酸与出生缺陷的关系已经引起国内外广泛关注。专家研究得出结论，我国南方与北方之间的出生缺陷发病率明显不同。新疆地区此项研究尚处起步阶段，且南北疆有不同的的结果。我们前期调查研究中发现，喀什地区维吾尔族孕妇膳食钙、铁、维生素A、B1、B2、B12、C和叶酸摄入严重不足，而且体内叶酸水平低、同型半胱氨酸高，但未跟踪到出生缺陷发生。为研究这一现象及进一步阐明叶酸等相关微营养素对维吾尔族母子健康的影响，以维吾尔族孕妇为研究对象，通过一系列现场调查、实验室检测和MTHFR基因多态性分析，找出维吾尔族孕妇体内叶酸水平与出生缺陷的关联及影响因素，探讨该人群出生缺陷发生的可能原因及机制。为本地区深入开展妇幼营养保健工作、提高少数民族健康水平和综合素质提供科学依据。

合理的膳食营养对孕妇和婴儿的健康至关重要，不仅能够促进胎儿的生长，而且还有益于孕妇的身体健康。母体的营养状况直接关系到母婴的身心健康，更是为直接关系到胎儿脑细胞的正常发育及出生后体格与智力的全面发展。叶酸是一种B 族维生素，母亲在妊娠期胎儿器官形成的关键时期增补叶酸可有效降低胎儿发生NTDs 的危险性。本课题通过对新疆维吾尔族、汉族、哈萨克族孕妇体内叶酸等微营养素水平变化及膳食结构、贫血检出率和血浆Hcy水平等的研究，对孕妇进行了营养调查和血清叶酸、同型半胱氨酸以及部分维生素水平的测定。经研究发现，维吾尔族和哈萨克族孕妇膳食构成不合理，蔬菜类、水果类、蛋类和豆类摄入偏低，鱼虾类摄入几乎为0，盐类摄入偏高；三大产热营养素供热比适宜；孕妇钾、硒、维生素 B1 、维生素 B2 、维生素C摄入不足，钙和叶酸摄入严重缺乏；维吾尔族孕妇血清叶酸水平较低，叶酸缺乏率较高；维吾尔族孕妇体内维生素B6 、B12 、Hcy 平均水平均处于正常范围。此研究为制定适合新疆地区孕妇的增补叶酸方式与营养保健政策，提高其健康水平和综合素质提供科学依据。