2018～2023年北京市某医院患者血清维生素D水平特征分析

目的 分析2018年4月至2023年3月北京清华长庚医院成年患者血清25-羟基维生素D[25(OH)D]水平的分布特征和变化趋势。方法 共纳入9 470例在2018年4月至2023年3月于北京清华长庚医院进行血清25(OH)D检测的患者,回顾性分析患者25(OH)D水平在不同性别、年龄、检测季节和年份之间的差异。结果 全体受试者的25(OH)D水平的中位数(四分位数)为16.52(11.58,23.26)ng/mL,其中有6 019(63.6%)例患者为维生素D缺乏(<20ng/mL),2 398(25.3%)例患者为维生素D不足(20～30ng/mL),仅有1 053(11.1%)例患者为维生素D充足状态(>30ng/mL)。患者的25(OH)D水平在不同年龄间和检测的不同季节间差异明显,主要表现为18～39岁年龄组人群较低,春季和秋季水平较低。从2018年到2023年5年间逐年分析显示患者的25(OH)D水平没有明显随年份的变化趋势。结论 目前医院患者的维生素D水平偏低,18～39岁年龄组人群和春季、冬季检测的患者中25(OH)D缺乏的比例较高,提示临床医护应关注就诊患...     

河南省1～7岁健康儿童血清25(OH)D水平分析

目的 了解河南省1～7岁健康儿童维生素D营养状况,为儿童合理补充维生素D、防治维生素D缺乏提供科学依据.方法 采用分层整群随机抽样法,选取河南省六个地区的妇幼保健院和社区卫生服务站进行体检的1～7岁健康儿童392名,采用化学发光法检测血清25 (OH)D水平,比较不同年龄段、不同性别儿童维生素D不足与缺乏情况.结果 392名1～7岁健康儿童血清25(OH)D平均水平为42.7±15.8nmol/L,不足与缺乏率达59.4％ (233/392),男女童之间差异无统计学意义(=0.500,P=0.618;x2 =0.051,P=0.822);不同年龄组维生素D平均水平及其不足与缺乏比例差异具有统计学意义(F=12.748,P＜0.001;x2=37.077,P＜0.001);维生素D水平随年龄增长而降低,不足与缺乏比例随年龄增长而升高.结论 河南省1～7岁健康儿童维生素D营养状况较差,且与年龄密切相关,应适当增加儿童日照时间,加强合理补充维生素D的科普宣传.     

血清25-羟维生素D在过敏性紫癜中的研究

目的 探讨血清25-羟维生素D[25-（OH）D] 维生素D水平与HSP发病的关系。方法 选择2017年12月~2018年12月至我院就诊的过敏性紫癜患儿49例设为实验组,另选取40例健康儿童设为健康对照组,采用化学发光法测定两组血清25-羟维生素D水平,免疫浊度法测定补体、免疫球蛋白并进行比较,分析其相关性。结果 实验组血清25-（OH）D水平为（19.061±6.572）ng/ml,低于健康对照组的（30.789±1.880）ng/ml,差异有统计学意义（t=-11.628,P＜0.05）;Pearson相关分析或Spearman秩相关分析示,实验组血清25-羟维生素D水平与免疫球蛋白IgA水平呈负相关（r=-0.352,P＜0.05）,与补体（C3、C4）、免疫球蛋白（IgG、IgM）水平间无明显相关性（r=0.199、0.248、-0.165、-0.204,均P＞0.05）。结论 过敏性紫癜患儿中25羟维生素D可能参与了过敏性紫癜的发病过程。     

溃疡性结肠炎患者血清25(OH)维生素D水平与疾病活动性的相关性

目的检测溃疡性结肠炎患者血清25(OH)维生素D水平,并分析25(OH)维生素D水平与疾病活动性的关系,探讨其临床意义。方法选择40例溃疡性结肠炎患者和30例健康对照者为研究对象,采用ELISA法检测溃疡性结肠炎患者和健康体检者血清中25(OH)维生素D水平,应用Mayo评分法对UC病人的疾病活动度进行分级,将维生素D水平与UC患者临床资料以及疾病活动度进行相关性分析。结果溃疡性结肠炎患者血清25(OH)维生素D水平(15.8±12.3)ng/ml明显低于健康对照组(42.5±26.7)ng/ml,p0.05,血清25(OH)维生素D水平与患者年龄、性别、病程、是否吸烟、抗生素的应用、5-氨基水杨酸的应用及非甾体类抗炎药的应用无相关性,但与皮质类固醇激素的应用及溃疡性结肠炎的活动性相关。结论溃疡性结肠炎患者低储备维生素D水平与疾病活动性及皮质类固醇激素的应用相关。     

原发性肝癌患者血清25-羟基维生素D3水平与免疫抑制因子IL-10的关系

目的 探究原发性肝癌患者血清25-羟基维生素D3[25-（OH）D3]的变化及其与免疫抑制因子IL-10的关系。方法 选取2014年2月~2019年7月于我院就诊的60例原发性肝癌患者作为疾病组,另外选择同期60名健康体检人群作为健康对照组,采用电化学发光法测定两组血清25-（OH）D3浓度,酶联免疫吸附试验测定血清IL-10浓度。Spearman法分析25-（OH）D3与IL-10间的相关性。结果 疾病组血清25-（OH）D3浓度低于健康对照组[（13.65±7.92）ng/ml vs （26.15±8.33）ng/ml],差异有统计学意义（P＜0.05）;疾病组IL-10浓度高于健康对照组[（89.71±26.59）ng/ml vs （26.18±8.15）ng/ml],差异有统计学意义（P＜0.05）。血清25-（OH）D3可能与淋巴结转移和肿瘤分期密切相关,与IL-10浓度呈负相关（r=-0.568,P＜0.05）。结论 原发性肝癌患者存在25-（OH）D3缺乏现象,且与肿瘤进展和免疫抑制密切相关。     

荣成地区3260名儿童血清25-羟维生素D水平调查

目的了解荣成地区儿童的血清25-羟维生素D的水平,为临床应用维生素D制剂提供参考。方法以在荣成市妇幼保健院进行系统化管理的儿童在2008年10月1日～2009年3月31日半年来儿童保健科做保健3月-6岁儿童,取清晨空腹静脉血,用酶联免疫法检测血清25-羟维生素D平均水平。结果荣成地区儿童健康儿童血清25-羟维生素D水平为(89.4±29.3)nmol/L,如以25-羟维生素D50nmol/L作为维生素D缺乏的标准,则其发生率为8.5%,上述指标随年龄增长呈有规律的波动趋势。结论荣成地区健康儿童的维生素D营养状况好;血清25-羟维生素D水平随年龄波动。     

乌鲁木齐城区健康成年人维生素D营养状况调查分析

目的 调查分析新疆乌鲁木齐城区汉、维族成年人维生素D营养状况并分析与民族、性别、年龄的关系.方法 选自2013年5月至6月在乌鲁木齐城区采用随机整群抽样方法,采集1858名居民的血样,其中汉族1046名,维吾尔族812名成人,采用电化学发光法进行血清25羟维生素D [25(OH) D]检测,分析居民维生素D营养状况及与不同民族、性别、年龄的关系.结果 (1)汉、维族25 (OH)D水平为19.16±8.10ng/mL和13.09±6.98ng/mL,汉族明显高于维族(P＜0.0001),男性高于女性(汉族P=0.202,维族P＜0.0001);(2)汉族维生素D缺乏、不足、充足分别占64.5％、25.1％、10.3％,维族分别占88.5％、8.0％、3.4％,维族女性维生素D缺乏最明显(92.2％);(3)青、中、老年组汉族维生素D缺乏的患病率分别为72.2％、63.2％、54.1％,维族为90.0％、86.0％、88.1％.汉族随着年龄增大维生素D缺乏患病率降低.年龄细分后,汉族＞ 80岁和维族＞75岁患病率开始增加.结论 新疆乌市汉维族维生素D普遍缺乏,明显高于我国其他地区.维族高于汉族,女性高于男性,高龄老人维生素D缺乏患病率增加,维生素D营养状况有待改善.     

血清25-羟维生素D水平对儿童免疫功能的影响

目的探讨25-（OH）VitD水平与儿童免疫功能之间的关系。方法随机选取山西省妇幼保健院门诊进行健康体检的3～8岁儿童117名,采用酶联免疫法检测25-（OH）VitD水平,流式细胞术检测细胞免疫功能。按照血清25-（OH）VitD浓度将病例分为两组：维生素D缺乏组（〈50nmol／L）及维生素D正常组（≥50nm01／L）,比较各组免疫功能以及发生RRI的情况。结果维生素D缺乏组发生RRI的人数明显高于正常组的发生人数,有显著性差异（P〈0.05）。且维生素D缺乏组儿童的免疫功能明显低于正常组的儿童,主要表现在IgA和CD3＋以及NK的降低,有显著性差异（P〈0.05）。结论维生素D缺乏可造成儿童体液及细胞免疫能力的降低,容易导致儿童反复呼吸道感染的发生,针对反复呼吸道感染的患儿及时补充维生素D,对降低呼吸道感染的再次发生起着积极的作用。     

郑州地区1180例儿童维生素A、D、E水平研究

目的 了解郑州地区儿童维生素的水平,为临床诊治提供参考.方法 以2016年3月至12月期间在郑州大学第三附属医院儿科门诊健康体检的儿童为研究对象,测量血清25羟维生素D[25(OH)D]、维生素A、E的水平.结果 1180名儿童中,男童755例,女童425例,维生素A平均水平0.22±0.07 mg/L,总体缺乏率为45.34％;维生素D平均水平为64.25±19.65 nmol/L,总体缺乏率为30.51％;维生素E平均水平为4.95±1.64 mg/L,总体缺乏率为51.10％.男童和女童血清维生素E水平差异具有统计学意义(P＜0.05);郑州市城乡儿童三种血清维生素水平差异均具有统计学意义(P＜0.05).结论 儿童维生素的水平缺乏情况,应引起我们的重视,尤其是维生素E,城乡儿童仍然需要进行及时的维生素补充,以预防儿童维生素缺乏症及其并发症的发生.     

维生素D水平与平均血小板体积变化的相关性研究

目的 探讨维生素D水平与平均血小板体积（MPV）的相关性。方法 选取患者420例测定维生素D水平及MPV。根据测得维生素D水平将病例分为组1：维生素D〈10ng/mL;组2：维生素D为10~20ng/mL;组3：维生素D〉20ng/mL。比较各组检测结果,分析维生素D水平与MPV变化的相关性。结果 三组维生素D水平分别为8.9±2.1ng/mL,14.3±1.7 ng/mL,24.2±5.9 ng/mL,差异有统计学意义（P〈0.001）。三组患者MPV分别为8.3±1.7fL,8.0±1.4fL,7.3±1.5fL。组3与组1、组2 MPV差异有统计学意义（P〈0.001;P=0.006）。维生素D水平与MPV存在负相关（r2=0.337,P〈0.001）。结论 维生素D水平与MPV密切相关,维生素D的缺乏可能导致MPV升高。     

Assessment of vitamin D status in healthy children and adolescents living in Tehran and its relation to iPTH,gender, weight and height

Abstract

This study was conducted to determine the frequency of vitamin D deficiency and its correlation with different factors. Three hundred and thirteen healthy children and adolescents (192 females and 121 males aged 8–18 years, mean ± SD, 12.7 ± 2.3 years) were enrolled, and measurements of serum 25-hydroxyvitamin D [25(OH)D] (using EIA) and intact parathyroid hormone (iPTH) (using immunoradiometric assay (IRMA)) were conducted. The grades of vitamin D status were defined according to blood level of 25(OH)D as follows: severely deficient < 12.5; deficient, ≥ 12.5 and < 25; insufficient, ≥ 25 and < 50; normal ≥ 50 and < 250 nmol/L. Severe deficiency was detected in 25% of subjects (males 8%; females 92%), deficiency in 27% (males 34%; females 66%) and insufficiency in 26% (males 58%; females 42%). The mean 25(OH)D level in males was significantly greater than that in females (p < 0.001), and this level was significantly higher in prepubertal compared to pubertal subjects (p < 0.001). 25(OH)D had a negative correlation with iPTH (p < 0.001). The curve of iPTH began to rise when 25(OH)D reached 75 nmol/L. The level of 25(OH)D had a negative correlation with BMI-SDS and height-SDS in females (p-value, 0.01 and 0.039, respectively). The subjects did not have any signs or symptoms of rickets. Frequency of vitamin D deficiency did not have any significant seasonal variation. Furthermore, vitamin D deficiency was not found to be related to the type or location of the subjects' homes. In this study, subclinical vitamin D deficiency was significantly more prevalent in females, particularly those undergoing puberty. Children who were obese and taller than average, had lower levels of 25(OH)D, and level of 25(OH)D should be maintained > 75 nmol/L in order to prevent PTH rising.     

Vitamin D deficiency and bone mineral density in postmenopausal women receiving aromatase inhibitors for early breast cancer

Objective

Aromatase inhibitors (AI) treatment leads to an increased risk of bone loss and fractures. In a group of women with early breast cancer (EBC) and baseline Vitamin D deficiency (<30 ng/ml) who are treated with AI, we aim to describe: serum levels of Vitamin D, bone mineral density (BMD), calcium intake, and the increase of serum 25(OH)D accomplished in 3 months of treatment with Vitamin D supplements.

Study design

Prospective, non-randomized clinical trial.

Methods

In 232 consecutively included women with EBC in treatment with AI, we assessed baseline calcium intake, serum levels of 25(OH)D, BMD and, spine X-ray. All received Calcium and Vitamin D supplements, and those with vitamin deficiency received 16,000 IU Vitamin D every 2 weeks. Serum levels of 25(OH)D were newly assessed after treatment. All the baseline evaluation was performed before starting AI treatment.

Results

Mean age at baseline (±SD) was 63.2 ± 8.8 years. In 150 (64.9%) cases, the women had been treated previously with tamoxifen; 101 (43.7%) started exemestane, 119 (51.5%) letrozole, and 11 (4.8%) anastrozole. The AI were initiated within 6 weeks after surgery or after the last cycle of chemotherapy.At baseline, 88.1% had 25(OH)D levels <30 ng/ml, 21.2% had severe deficiency (<10 ng/ml), and 25% of the participants had osteoporosis. Mean daily calcium intake was low (841 ± 338).We found a significant association between 25(OH)D levels and BMD at baseline, which remained significant in femoral neck BMD after multivariate adjustment.Plasma 25(OH)D levels improved significantly at 3 months follow-up in those treated with high dose Vitamin D supplements: mean increase 32.55 ng/ml (95%CI 28.06–37.03).

Conclusions

Our study suggests a high prevalence of commonly unrecognized Vitamin D deficiency in women with EBC treated with AI, a known osteopenic agent. Our results support the need for a routine assessment of 25(OH)D levels and, when necessary, supplementation in these patients.     

Prevalence of Vitamin D Deficiency in Korean Children Presenting with Nonspecific Lower-Extremity Pain

Purpose

Although interest in the role played by vitamin D in bone health is increasing, little is known about the role of this vitamin in musculoskeletal pain in children. This study aimed to assess the prevalence of vitamin D deficiency in children presenting with nonspecific lower extremity pains.

Materials and Methods

From 2011 to 2012, 183 children underwent evaluation for nonspecific lower-extremity pains. Patients with valid causes, such as fractures or transient synovitis, were excluded, as were those with underlying medical conditions, such as cerebral palsy and metabolic disease. Ultimately, 140 patients met the inclusion criteria. Levels of serum 25-hydroxy vitamin D [25-(OH)D], the ideal indicator of vitamin D status, were measured in these children.

Results

Eighty-seven boys (62.1%) and 53 girls (37.9%) were included. The mean age at presentation was 5.2 years (range, 2-15). Serum 25-(OH)D levels were <10 ng/mL in 5.7% of patients, 10 to <20 ng/mL in 51.4%, 20 to <30 ng/mL in 37.9%, and ≥30 ng/mL in only 5.0%. Most patients visited the hospital in the winter (41.4%) (summer, 12.9%), and serum 25-(OH)D levels were also lowest in the winter (17.2±5.5 ng/mL).

Conclusion

This study found a high prevalence of vitamin D deficiency or insufficiency in Korean children with nonspecific lower-extremity pains, indicating a positive association between vitamin D deficiency and growing pains. More attention should be directed toward vitamin D and its role in the optimization of bone health.     

High Prevalence of Vitamin D Deficiency in Adults Aged 50 Years and Older in Gwangju,Korea: the Dong-gu Study

Vitamin D plays an important role in bone metabolism and maintaining bone health. Recently, new evidence has revealed that vitamin D affects chronic diseases such as autoimmune diseases, cardiovascular diseases and certain cancers. The aim of this study was to evaluate the vitamin D status and the prevalence of vitamin D deficiency in an urban Korean population. This study included 8,976 participants (3,587 men and 5,389 women) aged 50 yr and older. Serum 25(OH)D level was measured by chemiluminescent microparticle immunoassay. The prevalence of vitamin D deficiency [25(OH)D < 20 ng/mL] was 59.7% and 86.5% in men and women, respectively. The prevalence of vitamin D deficiency increased significantly with age in men, but not in women and it decreased from April to July, more prominently in men than in women. These results suggest that sun exposure, intake of vitamin D supplement, and regular physical activities is recommended in an urban Koreans, especially in women.     

中国4城市2—7岁分析人群维生素B12营养状况流行病学调查

目的了解4城市2～7岁分析人群维生素B12的营养状况。方法2007年5～9月和2008年5—10月,对2002名2～7岁分析人群进行体格检查、膳食调查、血常规检查及血清维生素B12水平测定,其中重庆市485名、北京市513名、珠海市503名、武汉市501名。结果①2002名2～7岁分析人群平均维生素B12水平（ng·L^-1）为775±312,市区（835±271）高于郊区（720±338）,P〈0．001;其中重庆市为756±220、北京市为840±414、珠海市为772±245、武汉市为736±317,地区间差异有统计学意义,P〈0．001。②2～7岁分析人群维生素B12水平性别差异不显著,P〉0．05;2—5岁组维生素B12水平随年龄增长呈降低趋势,r=-0．146,P〈0．001;5岁～组和〈7岁组维生素B12水平相近。（3）4城市分析人群维生素B12减少（〈300）检出率为4．7％。其中维生素B12缺乏（〈200）检出率为1．5％,边缘性缺乏（200—300）检出率为3．2％。重庆市、北京市、珠海市和武汉市分析人群血清维生素B12减少检出率分别为2．1％、3．9％、3．2％和9．6％。④分析人群维生素B12水平主要受膳食维生素B12摄入量的影响,P〈0．001。分析人群平均膳食维生素B12摄入量（μg·d^-1）市区（2．4±2．0）高于郊区（2．0±1．4）,P〈0．05;重庆市、北市京、珠海市和武汉市分析人群平均膳食维生素B,2摄入量分别为1．9±1．3、2．8±1．6、2．6±1．8和1．6±1．2,差异有显著统计学意义,P〈0．001。⑤分析人群维生素B12水平与Hb水平呈低度相关,P〈0．001。结论4城市分析人群存在维生素B12减少,以边缘性缺乏为主。儿童维生素B12营养状况受膳食维生素B12摄入量的影响,分析人群血清维生素B12水平何时达到成人水平有待研究。     

常住北京市城区少儿血清维生素A和25-羟基维生素D水平分析

目的:检测北京市城区少儿冬季血清维生素A(VA)和25-羟基维生素D(25-OH VD)水平,分析营养状况。方法:2012年12月至2013年2月本院儿童保健门诊体检的0-14岁少儿292例,按年龄分为0-1岁、2-3岁、4-6岁和7-14岁四组,完成问卷调查和体格检查后,采用高效液相色谱法测定每例少儿血清VA水平,采用高效液相质谱串联法测定每例少儿血清25-OH VD水平,分析各年龄组VA、25-OH VD水平差异及每组低水平VA、25-OH VD检出率。结果:(1)292例少儿血清VA平均水平为(1.09±0.29)μmol/L,不同年龄组VA水平有显著性差异(F=10.96,P0.01),以0-1岁组最低(0.9±0.31)μmol/L;所有受检少儿低水平VA检出率为43.84%(128/292),不同年龄组低水平VA检出率有显著性差异(χ2=34.74,P0.01),0-1岁组检出率最高(76.32%)。(2)292例少儿血清25-OH VD平均水平(22.12±8.51)ng/ml,不同年龄组水平有显著性差异(F=7.56,P0.01),7-14岁组最低(18.34±6.34)ng/ml;所有受检者中低水平25-OH VD检出率为80.17%(233/292),不同年龄组低水平25-OH VD检出率有显著性差异(χ2=13.79,P0.05),4-6岁组最高(87.05%)。结论:冬季,常住北京市城区0-1岁幼儿的VA最低,7-14岁的25-OH VD最低,值得关注。