全球精选文摘 - 叶酸补充与面部唇颚裂风险：国家基于人群的病例对照研究

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叶酸补充与面部唇颚裂风险：国家基于人群的病例对照研究

Folic acid supplements and risk of facial clefts: national population based case-control study

Wilcox AJ, Lie RT, Solvoll K 2009/5/27 10:50:40

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Abstract
Objective:
To explore the role of folic acid supplements, dietary folates, and multivitamins in the prevention of facial clefts.

Design:
National population based case-control study.

Setting:
Infants born 1996-2001 in Norway.

Participants:
377 infants with cleft lip with or without cleft palate; 196 infants with cleft palate alone; 763 controls.

Main Outcome Measures:
Association of facial clefts with maternal intake of folic acid supplements, multivitamins, and folates in diet.

Results:
Folic acid supplementation during early pregnancy (≥400μg/day) was associated with a reduced risk of isolated cleft lip with or without cleft palate after adjustment for multivitamins, smoking, and other potential confounding factors (adjusted odds ratio 0.61, 95% confidence interval 0.39 to 0.96). Independent of supplements, diets rich in fruits, vegetables, and other high folate containing foods reduced the risk somewhat (adjusted odds ratio 0.75, 0.50 to 1.11). The lowest risk of cleft lip was among women with folate rich diets who also took folic acid supplements and multivitamins (0.36, 0.17 to 0.77). Folic acid provided no protection against cleft palate alone (1.07, 0.56 to 2.03).

Conclusions:
Folic acid supplements during early pregnancy seem to reduce the risk of isolated cleft lip (with or without cleft palate) by about a third. Other vitamins and dietary factors may provide additional benefit.

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疾病资源中心

高血压	慢性阻塞性肺病
脂肪性肝病	糖尿病
卒中	肺癌
冠心病	子宫内膜异位症
结直肠癌	乳腺癌
心力衰竭	心律失常

病例分析 [栏目介绍]

甲状腺功能亢进合并黄疸

王燕燕王曙

上海交通大学附属瑞金医院内分泌科

患者，女，69岁。2009年1月无明显诱因下出现乏力，当时程度较轻，未予以重视。2009年3月患者乏力症状加重，尿色逐渐加深，大便习惯改变，颜色变淡。4月18日入我院感染科治疗，诉轻度头晕、心慌，体重减轻10kg。无肝区疼痛，无发热，无腹痛、腹泻、腹胀、里急后重，无恶性、呕吐等。入院半月前于外院就诊，查肝功能：ALT 601IU/L，AST 785IU/L，TBIL 97.7umol/L，白蛋白 41g/L，甲状腺功能：游离T3 30.6pmol/L，游离T4 51.9pmol/L，心电图示快速房颤。

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