学龄儿童维生素D营养状况与身体肌肉量关系的研究

目的探讨学龄儿童维生素D营养状况与身体肌肉量的关系。方法研究对象来自“儿童青少年心血管与骨健康促进项目”,于2017年采用分层整群抽样的方法在北京市对15391名6~16岁儿童开展基线调查,2019年对其进行随访调查。进行问卷调查和检测血清25(OH)D,使用生物电阻抗法测定机体肌肉量,并计算全身肌肉质量指数(MMI)。采用多因素线性回归分析维生素D营养状况与基线和随访期MMI的关系。结果纳入分析的10890名儿童的年龄为(11.5±3.3)岁,男童占49.6%,基线25(OH)D水平为(35.4±12.0)nmol/L,充足率为11.1%。多因素线性回归校正年龄、性别、体脂肪量、吸烟、饮酒、奶制品摄入、维生素D补充、钙剂补充、体力活动、青春期发育状态后,未观察到维生素D营养状况与基线MMI水平关联有统计学意义(P>0.05)。而对于随访时点MMI,25(OH)D每增加10 nmol/L,其Z值增加0.008(P=0.058);相比于维生素D缺乏,维生素D不足和充足的儿童分别增高0.002(P=0.815)和0.037(P=0.031),趋势P=0.089。亚组分析显示,在BMI正常组中,25(OH)D每增加10 nmol/L,维生素D充足的儿童基线MMI和随访时点MMI Z值分别增高0.019和0.014,均P<0.05。结论儿童维生素D营养状况与身体肌肉量有关,维生素D充足的儿童倾向于在未来获得更高的肌肉量。倡导儿童青少年维持充足的维生素D水平,加强营养与运动,提升身体素质。     

北京城区老年绝经妇女维生素D与骨矿密度的关系

目的 分析北京城区老年绝经妇女维生素D水平与其身体各部位骨密度(BMD)的关系.方法 在2008年5月至7月,采用整群随机抽样方法 抽取北京3个城区所辖17个礼区的60岁以上老年绝经妇女400名(年龄的中位数为67.8岁),采用美国DioSorin放射免疫试剂盒测定血清25-羟基维生素D[25(OH)D]浓度,根据血清25(OH)D浓度将对象分为维生素D缺乏组[A组,25(OH)D≤25 nmol/L]、不足组[B组,25 nmol/L<25(OH)D≤50 nmol/L]、适宜组[C组,50 nmol/L<25(OH)D≤75 nmol/L]和维生素D充足组[D组,25(OH)D>75 nmol/L].采用双能X线吸收法(DEXA)测定全身、腰椎(L_(2～4))和股骨近端的BMD.结果 血清25(OH)D浓度为(36.0±14.6)nmol/L,全身和股骨颈BMD分别为(0.829±0.090)、(0.679±0.106)g/cm~2.A、B、C+D组全身BMD分别为(0.811±0.077)、(0.825±0.088)、(0.864±0.112)g/cm~2(F=16.93,P<0.01),股骨颈BMD分别为(0.666±0.107)、(0.673±0.099)、(0.725±0.117)g/cm~2(F=18.36,P<0.01),血清25(OH)D浓度与全身、股骨颈BMD呈正相关(r值分别为0.17、0.18,P值均<0.05).结论我国老年妇女维生素D营养状况与腰椎、股骨近端、髋部以及四肢BMD密切相关.     

0～7岁儿童维生素D营养状况与骨密度的关系

目的探讨0～7岁儿童维生素D营养状况与骨密度的关系。方法选取浙江大学附属第一医院2018年1月-2018年10月体检的390例0～7岁儿童为研究对象,采用电化学发光法测定儿童血清25-羟维生素D [25-(OH) D]水平以评估维生素D营养状况,根据评估结果分为25-(OH) D充足组和25-(OH) D不足/缺乏组,采用定量超声仪测定儿童骨密度,分析维生素D营养状况与骨密度的关系。结果研究中所有儿童的血清25-(OH) D平均浓度为(28. 93±3. 40) ng/ml,25-(OH) D不足/缺乏发生率为43. 3%(169/390),25-(OH) D充足组和25-(OH) D不足/缺乏组不同年龄段儿童的血清25-(OH) D水平差异均有统计学意义(均P<0. 05),并且两组不同年龄段儿童的骨密度Z值差异均有统计学意义(均P<0. 05)、骨密度不足检出率也存在显著性差异(P<0. 05),相关分析显示儿童血清25-(OH) D不足/缺乏时血清25-(OH) D水平与骨密度呈正相关,差异无统计学意义(P<0. 05),而血清25-(OH) D充足时血清25-(OH) D水平与骨密度无明显相关(P>0. 05)。结论 0～7岁儿童维生素D营养状况不佳,25-(OH) D不足/缺乏时儿童的血清25-(OH) D水平与骨密度呈正相关,临床工作中可以通过合理补充维生素D改善儿童骨骼健康状况。     

北京市郊区儿童维生素D营养状况与骨量的关系

目的了解北京市怀柔区儿童维生素D营养状况与骨量的关系,为改善我国儿童骨骼健康提供基础资料。方法采用横断面研究的方法 ,随机选取北京市怀柔区（北纬40.3°）381名7-11岁儿童,采集静脉血,用酶联免疫吸附法测定血清25-羟维生素D[25（OH）D]浓度,双能X线吸收仪测定前臂及全身骨矿物含量（BMC）、骨矿物密度（BMD）和骨面积（BA）。结果研究对象血清25（OH）D浓度平均为（44.4±12.5）nmol/L。血清25（OH）D浓度与身高、体重及全身和前臂的BMC、BMD和BA呈显著正相关（r=0.10~0.17;P〈0.05）;调整年龄、性别、身高和体重后,仅全身分部位中的左上肢BMC和左上肢及右上肢BA与血清25（OH）D浓度呈正相关（r=0.11-0.14;P〈0.05）,其余部位显著性消失。维生素D营养状况适宜儿童[25（OH）D〉50 nmol/L]的全身BMC比维生素D不足儿童[25（OH）D≤50 nmol/L]平均高4.2%（P〈0.05）,但调整混杂因素后差异消失。结论维生素D营养状况与北京郊区儿童体格发育正相关,从而对儿童骨量增加起到间接促进作用。     

昆明主城区夏季小学生维生素D与体格生长的相关性分析研究

目的 研究昆明主城区夏季小学生维生素D与体格生长的相关性,为预防儿童身材矮小及发生肥胖提供临床数据依据。方法 采用分层随机抽样方法,选取2018年6-8月在昆明市4个区591名研究对象,对研究对象进行体格测量、血清25-(OH)D测定及超声骨密度检测。比较不同年级组的血清25-(OH)D、体重指数(BMI)及骨强度Z值,不同年级段男、女儿童维生素D营养状况,分析25-(OH)D水平与BMI、骨强度Z值及身高的相关性。结果 相同年级儿童男女在身高、体重和BMI值上有显著差异,随着年级的增长,儿童血清25-(OH)D水平呈降低趋势(F＝37.646,P<0.001),BMI呈上升趋势(F＝1 343.002,P＝0.001),骨强度Z值呈下降趋势(F＝34.489,P<0.001);随着年级的增长,不同性别研究对象的维生素D不足与缺乏者占比呈略升高趋势(P>0.05);总体上,男童维生素D充足的比例为48.38%,女童为48.06%,25-(OH)D水平与BMI呈负相关性(r=-0.673,P<0.01),与骨强度Z值呈正相关性(r=0.514,P<0.01),与身高呈正相关性(r=0.561,P<0.01)。结论 本研究中的小学生仍有一半以上存在25-(OH)D水平不足或缺乏,儿童需增加户外锻炼,口服维生素D制剂,以减少儿童矮小症、肥胖等疾病发生。     

0～3岁婴幼儿维生素D营养状况与定量超声骨密度之间关系的探讨

目的分析研究0~3岁婴幼儿维生素D营养状况与定量超声骨密度之间关系。方法对2015年12月~2016年12月在我院进行健康检查的342例0~3岁婴幼儿进行研究,根据婴幼儿体内血清25-(OH)D水平将其分为充足组(≥75nmol/L),正常组(50~75nmol/L)和缺乏组(﹤50nmol/L)。分析比较三组婴幼儿定量超声骨密度的情况。结果结果表明,缺乏组、正常组和充足组婴幼儿骨密度水平分别为(3085.7±308.6)、(3102.5±268.5)、(3157.3±345.1),各组相应骨密度异常率分别为31.57%、34.62%、31.37%,经统计学比较三组之间均无统计学差异(P﹥0.05);经相关性研究显示,维生素D营养状况与定量超声骨密度之间无显著相关性(r=0.18,P﹥0.05)。结论 0~3岁婴幼儿维生素D营养状况与定量超声骨密度之间无显著相关性,定量超声骨密度水平是否能作为婴幼儿维生素D营养状况评价标准需进一步研究。     

0～7岁儿童血清25-(OH)D水平与骨密度的相关性研究

目的研究0~7岁儿童血清25-(OH)D水平与骨密度的相关性。方法选取2015年1月-2016年12月在徐州医科大学附属徐州儿童医院门诊儿保科体检的0~7岁儿童450例为研究对象,采用直接竞争化学发光酶免疫法测定25-(OH)D水平,超声骨密度仪测量左侧胫骨骨密度。比较不同年龄段儿童25-(OH)D水平和骨密度值,并采用Pearson直线相关分析分析两者相关性。结果血清25-(OH)D均值为(32.31±12.47)ng/ml,血清25-(OH)D水平、维生素D的充足率均随年龄增长而逐渐下降(P0.05);骨密度Z值的均值为(-0.31±0.17),各年龄段儿童骨密度比较差异无统计学意义(P0.05);血清25-(OH)D水平缺乏时,血清25-(OH)D水平与骨密度呈正相关(r=0.743,P=0.000)。结论 0~7岁儿童普遍存在维生素D缺乏和不足的现象,血清25-(OH)D水平与骨密度仅在维生素D缺乏时存在相关性,临床上应该两种方法结合检查,科学补充钙剂及维生素D。     

广州市儿童维生素D水平及其与甲状旁腺素的关系

了解广州市儿童维生素D水平及其与甲状旁腺素(PTH)的关系,为减少儿童维生素D缺乏性疾病的发生和改善儿童骨骼健康提供科学依据.方法 采用横断面研究,对2015年广州市某妇幼保健院健康体检的976名儿童进行体格检查,采集空腹静脉血,用化学发光法检测血清25-羟维生素D[25(OH)D]和甲状滂腺素(PTH).结果 儿童血清25(OH)D平均水平为(90.67±36.55) nmol/L,其中男童为(90.14±34.89) nmol/L,女童为(91.33±38.58) nmol/L,差异无统计学意义(P>0.05).维生素D缺乏率及不足率分别为11.37%和25.31%,性别间差异无统计学意义(P>0.05).不同年龄儿童血清25(OH)D水平差异有统计学意义(F=55.547,P<0.05),血清25(OH)D水平随年龄增长呈下降趋势.不同年龄儿童维生素D营养状况差异有统计学意义(x2=87.352,P< 0.05),维生素D缺乏率及不足率随年龄增长而升高(x2趋势=68.909,P<0.05).儿童血清PTH平均水平为(2.38±1.29) pmol/L,维生素D缺乏及不足儿童血清PTH水平均高于维生素D充足儿童,差异有统计学意义(F=10.427,P<0.05).血清25(OH)D水平与PTH呈负相关(r=-0.149,P=0.000).结论 广州市0~16岁儿童维生素D缺乏率及不足率较高,年长儿童维生素D营养状况较年幼儿童差,血清25(OH)D与PTH水平呈负相关.应采取合理措施改善儿童维生素D的营养状况.     

龙泉市2～6岁儿童维生素D营养状况调查

目的了解并分析龙泉市2~6岁儿童维生素D营养状况。方法选取龙泉市妇幼保健所健康体检2~6岁儿童进行血清25(OH)D测定,并分析不同性别、季节和骨密度儿童的维生素D缺乏状况。结果 3 582名儿童血清25(OH)D平均水平为(59.17±21.69)nmol/L,不同年龄组儿童25(OH)D水平差异有统计学意义(P0.05);维生素D缺乏检出率为24.96%,其中女童为29.68%,高于男童的19.86%(P0.01)。冬春季节儿童维生素D缺乏检出率为42.94%,高于夏秋季节的2.27%(P0.01)。骨密度不足儿童维生素D缺乏检出率为55.34%,高于骨密度正常者的18.62%(P0.01)。结论龙泉市儿童维生素D缺乏状况不容乐观,特别是骨密度不足者,应适量补充维生素D,增加外出活动时间。     

南京市0～10岁儿童血清25-(OH)D最佳水平的探讨

[目的]探讨0～10岁儿童维持正常骨代谢的最佳25羟-维生素D[25-(OH)D]水平,为临床评估维生素D营养状况和合理使用维生素D制剂提供参考.[方法]以142名0～10岁健康和患呼吸系感染性疾病儿童为研究对象,抽取空腹静脉血检测血清中甲状旁腺激素(PTH)、骨碱性磷酸酶(BAP)、25-(OH)D、血钙、血磷的水平.通过分析25-(0H)D与甲状旁腺激素(PTH)、骨碱性磷酸酶(BAP)、钙磷浓度积(Ca×P)的量-量反应曲线确定维持正常骨代谢的最佳25-(OH)D水平.[结果]25-(OH)D与PTH、BAP的量-量反应曲线显示,在25-(OH)D≤50nmol/L时,PTH、BAP和25-(OH)D水平均显著相关(rPTH=-0.864,P＜0.01;rBAP=-0.856.P＜0.01),50 nmol/L＜25-(OH)D＜60 nmol/L时.血清PTH、BAP保持在一稳定水平.25-(OH)D与钙磷浓度积(Ca×P)的量-量反应曲线显示,25-(OH)D≤50nmol/L时,钙磷浓度积随25-(OH)D水平增加而增高,但相关分析显示两者无显著相关关系(r=0.037,P＞0.05).在50nmol/L＜25-(OH)D＜60 nmol/L时,钙磷浓度积保持在一较稳定水平.[结论]南京市0～10岁年龄段儿童中,血清25-(OH)D水平在50～60 nmol/L时可能是维持正常骨代谢的最佳浓度.     

Association of modifiable and nonmodifiable factors with vitamin D status in pregnant women and neonates in Oakland, CA

There is little information on the contribution of modifiable vs nonmodifiable factors to maternal and neonatal vitamin D status in temperate regions of the United States. The purpose of this cross-sectional observation study conducted between December 2006 and February 2008 was to identify associations between observed and measured maternal characteristics and vitamin D status at term in pregnant women and their infants in a multiethnic community in Oakland, CA. Two hundred seventy-five pregnant women aged 18 to 45 years and carrying a singleton fetus were recruited and data from 210 mother-infant pairs were included in analyses. Analysis of covariance identified predictors of maternal and cord serum 25-hydroxyvitamin D [25(OH)D] in a multivariate model considering vitamin D intake, lifestyle factors, and skin pigmentation. Maternal serum 25(OH)D was significantly associated with season of delivery (P=0.0002), average daily D intake (P=0.0008), right upper inner arm pigmentation (P=0.0035), and maternal pre- or early-pregnancy body mass index (calculated as kg/m²) (P=0.0207). The same factors were significant for cord serum 25(OH)D, which was highly correlated with maternal serum 25(OH)D (r=0.79; P<0.0001). During the year, 54% of mothers and 90% of neonates had 25(OH)D <30 ng/mL (<75 nmol/L). Of women taking daily prenatal vitamin/mineral supplements (400 IU vitamin D), 50.7% had serum 25(OH)D <30 ng/mL (<75 nmol/L). In conclusion, 25(OH)D <30 ng/mL (<75 nmol/L) was prevalent in mothers and neonates across racial groups and seasons, and vitamin D status was associated with both modifiable and nonmodifiable risk factors.     

Bone mineral density,vitamin D,and nutritional status of children submitted to hematopoietic stem cell transplantation

ObjectiveThe aim of the study was to evaluate the effect of allogeneic hematopoietic stem cell transplantation (HSCT) on bone mineral density (BMD), serum vitamin D levels, and nutritional status of 50 patients between ages 4 and 20 y.MethodsWe conducted pre-HSCT and 6-mo post-HSCT evaluations. We measured BMD at the lumbar spine (LS) and total body (TB) by dual energy x-ray absorptiometry (DXA); body composition by bioimpedance analysis, and dietary intakes of calcium and vitamin D using the 24-h recall and semiquantitative food frequency questionnaire methods.ResultsWe observed a significant reduction in BMD 6 mo post-HSCT. Nearly half (48%) of patients had reductions at the LS (average −9.6% ± 6.0%), and patients who developed graft-versus-host disease (GVHD) had the greatest reductions (−5.6% versus 1.2%, P < 0.01). We also found reductions in serum levels of 25-hydroxyvitamin D (25-OHD), from 25.6 ± 10.9 ng/dL to 20.4 ± 11.4 ng/dL (P < 0.05), and in body weight. Corticosteroid treatment duration, severity of chronic GVHD, serum 25-OHD levels, and family history of osteoporosis were all risk factors associated with variations in BMD at the LS.ConclusionHSCT in children and adolescents negatively effects their BMD, nutritional status, and vitamin D levels. We suggest that early routine assessment be done to permit prevention and treatment.     

Hospital-acquired malnutrition in children with mild clinical conditions

ObjectiveLittle is known about the incidence and risk factors of hospital-acquired malnutrition in children with mild illness (grade 1 clinical conditions) and its timing of occurrence. The aim of this study was to recognize any early stage of denutrition and possible risk factors leading to nutritional deterioration in children hospitalized due to mild clinical conditions.MethodsFour hundred ninety-six children (age 1–192 mo) with mild clinical conditions were studied. Weight and height were measured. Weight was assessed daily and body mass index (BMI) Z-score was calculated for all patients.ResultsChildren with a BMI Z-score <?2 SD on admission showed a mean BMI decrease at the end of their hospital stay, which was significantly higher than in children who showed a better nutritional condition at admission. Risk factors for hospital-acquired malnutrition were an age <24 mo, a duration of hospital stay >5 d, fever, and night-time abdominal pain.ConclusionHospital stay has an impact on the nutritional status of children affected by mild clinical conditions. Children already malnourished on admission were found to be at risk for further nutritional deterioration during their hospital stay; and in all groups of children identified by their BMI Z-score at admission, nutritional status declined progressively.     

海口地区0~6岁儿童25羟维生素D水平及维生素D受体基因多态性与骨密度关联性分析

目的 调查海口地区0~6岁儿童血清25羟维生素D[25-（OH）D]水平及维生素D受体（VDR）基因多态性与骨密度（BMD）的关联性。方法 选取2020年1—12月在海南省某专科医院医学中心进行健康体检的0~6岁健康儿童作为调查对象,检测其血清25-（OH）D水平、VDR基因多态性及BMD,比较不同性别、年龄、体质指数（BMI）、BMD儿童的血清25-（OH）D水平,比较BMD正常和异常儿童的VDR基因多态性,分析VDR基因多态性与BMD的关联性。结果 共纳入1 580名0~6岁健康儿童,男童838人,女童742人,平均年龄（2.49±1.20）岁。血清25-（OH）D水平为（34.66±5.87）ng/mL,维生素D缺乏、不足、充足儿童比例分别为4.49%、21.01%、74.49%。不同性别儿童血清25-（OH）D水平、维生素D营养状态分布差异无统计学意义（均P>0.05）;不同年龄、BMI、BMD儿童血清25-（OH）D水平、维生素D营养状态分布差异有统计学意义（P<0.05或P<0.01）。基因分型检测结果显示,0~6岁健康儿童VDR基因ApaⅠ位点存在多态性,基因型为AA、Aa、aa。BMD正常和异常儿童VDR基因ApaⅠ位点基因型、等位基因分布差异有统计学意义（均P<0.01）。多因素Logistic回归分析结果显示,VDR基因ApaⅠ位点基因型aa型（OR=3.729）、携带a等位基因（OR=2.656）儿童发生BMD异常的风险较高。结论 海口地区0~6岁儿童血清25-（OH）D水平与儿童年龄、BMI、BMD有关,且儿童VDR基因多态性与BMD异常的发生密切相关。     

黔南州3～6岁农村布依族与苗族儿童维生素D营养状况及骨密度的比较研究

目的:探讨黔南州3～6岁农村布依族与苗族儿童维生素D营养状况及骨密度水平,并比较两民族相关影响因素的差异,为少数民族贫困地区农村儿童骨骼生长发育的研究提供依据。方法:2012年1～12月共收集1 147名儿童作为研究对象,按民族分为布依族组(589名)和苗族组(558名),两组按年龄均分为4个年龄组,3岁、4岁、5岁和6岁年龄组。分别进行问卷调查,测量两组各年龄段儿童身高、体重、骨密度及血清25羟维生素D〔25-(OH)D〕、骨特异性碱性磷酸酶(BAP)、甲状旁腺激素(PTH)含量,并对影响维生素D营养状况相关因素进行Logistic多元回归分析。结果:①两民族维生素D营养状况检查结果比较:布依族组589人中,严重缺乏3人(0.51%),缺乏7人(1.19%),不足187人(31.75%),充足392人(66.55%),中毒0人(0.00%);苗族组558人中,严重缺乏18人(3.23%),缺乏25人(4.48%),不足179人(32.08%),充足336人(60.22%),中毒0人(0.00%)。②两民族儿童维生素D营养状况影响因素比较:布依族组鸡蛋摄入量、动物肝摄入量、鱼类摄入量、牛奶摄入量、酸性食物、腌制或高磷食品、家庭经济收入等与苗族组比较,差异有统计学意义(P﹤0.01)。③两民族实验室检查指标比较:布依族组各年龄段儿童血清25-(OH)D3、BAP、PTH含量与苗族组比较,差异有统计学意义(P﹤0.01)。④两民族骨发育指标比较:布依族组各年龄段儿童身高、BMD含量与苗族组比较,差异有统计学意义(P﹤0.01)。结论:黔南州农村布依族与苗族3～6岁儿童维生素D营养状况有一定的差别,其影响因素为鸡蛋摄入量、动物肝摄入量、鱼类摄入量、牛奶摄入量、酸性食物、腌制或高磷食品、家庭经济收入等。     

Vitamin D Deficiency and Insufficiency in the Georgia Older Americans Nutrition Program

ABSTRACT

Serum 25-hydroxyvitamin D (25(OH)D) status in older adults enrolled in community-based meal programs is not well characterized. The objective was to identify predictors of poor serum 25(OH)D status and the response to vitamin D supplementation in a convenience sample from the Older Americans Act Nutrition Program (OAANP) in northeast Georgia (N = 158, mean age = 77 years, 81% women, 69% Caucasian, 31% African American). Mean serum 25(OH)D was 55 nmol/l, and intakes of vitamin D and calcium from foods were very low. Vitamin D insufficiency (25(OH)D 25- < 50 nmol/l) occurred in 36.7%. Vitamin D deficiency occurred in 8.2% (25(OH)D < 25 nmol/l) and was associated with low milk intake, low sunlight exposure, receiving meals at home, tobacco use, depression, dementia, antianxiety medication, poor instrumental activities of daily living, and low calf circumference (p ≤ 0.05). When non-supplement users (n = 28) were given a multivitamin with vitamin D (10 µg/d) and calcium (450 mg/d) for 4 months, 25(OH)D increased from 50 to 78 nmol/l, the prevalence of poor vitamin D status (25(OH)D < 50 nmol/l) decreased from 61% to 14%, and serum alkaline phosphatase decreased by 10% (p < 0.01). High body weight appeared to attenuate the increase in 25(OH)D in response to the multivitamin supplement (p ≤ 0.05). In conclusion, OAANP services did not prevent poor vitamin D and calcium status, but a supplement with vitamin D and calcium was beneficial.     

Elevated systolic blood pressure of children in the United States is associated with low serum 25-hydroxyvitamin D concentrations related to body mass index: National Health and Examination Survey 2007-2010

A negative association between serum 25-hydroxyvitamn D (25[OH]D) concentrations and blood pressure has been found in adults; whether a similar relationship exists in children remains unclear. We hypothesized that serum 25(OH)D concentrations of children would negatively correlate with blood pressure. Using a nationally representative sample of children aged 8 to 18 years from the National Health and Nutrition Examination Survey 2007-2010 (n = 2908), we compared serum 25(OH)D levels with diastolic and systolic blood pressure by vitamin D nutritional status categories. A high percentage of children were either vitamin D deficient (28.8%) or vitamin D insufficient (48.8%). Prehypertension was defined as blood pressure as ≥90th to <95th percentile and hypertension as ≥95th percentile by age, height, and sex national blood pressure percentile norms for children. Vitamin D–deficient children aged 8 to 13 years had higher systolic blood pressure (104.8 ± 0.7 mm Hg) than did vitamin D–sufficient children (102.3 ± 0.6 mmHg; P < .05). Controlling for age, sex, race/ethnicity, and income, systolic blood pressure was inversely associated with serum 25(OH)D concentrations (P < .03), but not when also controlling for body mass index (P = .63). A higher percentage of vitamin D–deficient and vitamin D–insufficient children (1.7%) vs vitamin D–sufficient children (0.6%) had prehypertension or hypertension. In conclusion, the association of low serum 25(OH)D concentrations with elevated systolic blood pressure in children is likely related to body weight and markers of adiposity.     

郑州市学龄前儿童血清25羟维生素D水平分析

目的分析郑州市学龄前儿童25羟维生素D(25-(OH)D)水平,为临床指导补充维生素D提供科学依据。方法分析2017年6月至2018年6月来院体检的0~6岁儿童25-(OH)D资料,采用电化学发光免疫分析法检测25-(OH)D水平。将研究对象按年龄,性别及不同季节进行分组分析。结果965例学龄前儿童血清25-(OH)D平均水平为(33.32±14.06)ng/mL,缺乏与不足占44.04%。不同年龄组相比,具有统计学意义(P<0.001),25-(OH)D水平及充足率随儿童年龄增长出现先升高后降低的趋势,其中1岁组最高,其次为6~11月龄。5岁组男童的25-(OH)D平均水平较女童偏高(P<0.05),其他各年龄组男女水平无统计学意义(P>0.05)。不同季节儿童25-(OH)D水平比较,夏季组最高,秋季组次之,春季组和冬季组明显较低(P<0.01)。结论郑州市学龄前儿童维生素D缺乏与不足比例较高,尤其2岁以上儿童维生素D营养状况令人堪忧。临床应加强儿童保健的科普宣教,根据维生素D营养状况指导用药,以降低儿童维生素D缺乏的发病率。     

Multinutrient-Fortified Juices Improve Vitamin D and Vitamin E Status in Children: A Randomized Controlled Trial

BackgroundProvision of fortified juices may provide a convenient method to maintain and increase blood fat-soluble vitamins.ObjectiveTo determine whether children consuming orange juice fortified with calcium and combinations of vitamins D, E, and A could increase serum 25-hydroxyvitamin D [25(OH)D], α-tocopherol, and retinol levels.DesignA 12-week randomized, double-blind, controlled trial.Participants/settingOne hundred eighty participants (aged 8.04±1.42 years) were recruited at Tufts (n=70) and Boston University (n=110) during 2005-2006. Of those recruited, 176 children were randomized into three groups: CaD (700 mg calcium+200 IU vitamin D), CaDEA (700 mg calcium+200 IU vitamin D+12 IU vitamin E+2,000 IU vitamin A as beta carotene), or Ca (700 mg calcium). Children consumed two 240-mL glasses of CaD, CaDEA, or Ca fortified orange juice daily for 12 weeks.Main outcome measuresSerum 25(OH)D, α-tocopherol, and retinol concentrations.Statistical analysesChanges in 25(OH)D, α-tocopherol, retinol, and parathyroid hormone concentrations were examined. Covariates included sex, age, race/ethnicity, body mass index, and baseline 25(OH)D, α-tocopherol, retinol, or parathyroid hormone levels. Multivariate models and repeated measures analysis of variance tested for group differences with pre–post measures (n=141).ResultsBaseline 25(OH)D was 68.4±27.7 nmol/L (27.4±11.10 ng/mL) ), with 21.7% of participants having inadequate 25(OH)D (<50 nmol/L [20.03 ng/mL]). The CaD group's 25(OH)D increase was greater than that of the Ca group (12.7 nmol/L [5.09 ng/mL], 95% CI 1.3 to 24.1; P=0.029). The CaDEA group's increase in α-tocopherol concentration was greater than that in the Ca or CaD groups (3.79 μmol/L [0.16 μg/mL], 95% CI 2.5 to 5.1 and 3.09 μmol/L [0.13 μg/mL], 95% CI −1.8 to 4.3), respectively (P<0.0001). Retinol levels did not change, and body weight remained as expected for growth.ConclusionsDaily consumption of orange juice providing 200 IU vitamin D and 12 IU vitamin E increased 25(OH)D and α-tocopherol concentrations in young children within 12 weeks.