Background: 

Reports of nutritional deficiencies in patients with thalassemia (Thal) are common. Despite its importance, however, nutritionally focused research in Thal has been limited by inadequate sample size, inconsistent methodology, a lack of control comparisons, and few interventional trials. Due to these limitations, clinicians lack evidence-based nutrition recommendations to support clinical decision-making. This systematic review summarizes observed relationships between nutrition and morbidity in Thal published in the last 3 decades.

Methods: 

PubMed, Web of Science, and Embase were screened for articles pertaining to nutrition in Thal using comprehensive search terms. Studies performed in humans, written in English, and published between 1990 and 2020 were included. Over 2100 manuscripts were identified, from which 97 were included.

Results: 

Patients with Thal were most often deficient in vitamins A, C, D, selenium, and zinc. Prevalence of nutritional deficiency was positively correlated with age and iron overload. Evidence to support the role of vitamin D and zinc for bone health was observed; zinc was also found to improve glucose metabolism.

Conclusions: 

Due to the risk for multinutrient deficiency, nutritional status should be assessed annually in patients with Thal with prompt nutrient replacement when deficiency is detected. Routine supplementation with vitamin D and zinc is recommended.

中文翻译：

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地中海贫血的营养：对缺乏症、与发病率的关系和补充建议的系统回顾

背景： 

关于地中海贫血（Thal）患者营养缺乏的报道很常见。然而，尽管它很重要，但以营养为重点的塔尔研究却受到样本量不足、方法不一致、缺乏对照比较和很少干预试验的限制。由于这些限制，临​​床医生缺乏基于证据的营养建议来支持临床决策。这篇系统综述总结了过去 30 年发表的 Thal 中观察到的营养与发病率之间的关系。

方法： 

使用综合搜索术语在 PubMed、Web of Science 和 Embase 中筛选了 Thal 中与营养相关的文章。其中包括 1990 年至 2020 年间以英文撰写并发表的人类研究。已鉴定出 2100 多份手稿，其中 97 份被收录。

结果： 

Thal 患者最常缺乏维生素 A、C、D、硒和锌。营养缺乏的发生率与年龄和铁超载呈正相关。观察到支持维生素 D 和锌对骨骼健康作用的证据；锌还被发现可以改善葡萄糖代谢。

结论： 

由于存在多种营养素缺乏的风险，应每年评估 Thal 患者的营养状况，并在发现缺乏时立即补充营养。建议定期补充维生素 D 和锌。