儿童肺部感染程度与维生素D水平的相关性研究

目的探讨儿童肺部感染程度与维生素D水平的相关性。方法选取2012年2月-2015年11月于西安交通大学第一附属医院就诊的社区获得性肺炎(CAP)患儿124例,按照病情轻重分为重症肺部感染组(n=42)与普通肺部感染组(n=82),同时选择同期体检的正常儿童90例作为对照组。比较3组儿童的维生素D水平,并对儿童肺部感染程度与维生素D水平的关系进行探讨。结果对照组儿童、普通肺部感染组及重症肺部感染组患儿25-羟基维生素D3[25(OH)D3]水平逐渐降低,3组儿童25(OH)D3水平比较,差异有统计学意义(F=34.230,P0.05);普通肺部感染组与重症肺部感染组患儿25(OH)D3水平比较,差异有统计学意义(LSD-t=15.353,P0.05);普通肺部感染组患儿与对照组儿童25(OH)D3水平比较,差异有统计学意义(LSD-t=9.581,P0.05);重症肺部感染组患儿与对照组儿童25(OH)D3水平比较,差异有统计学意义(LSD-t=22.721,P0.05)。Spearman相关分析结果显示,儿童肺部感染程度与25(OH)D3水平呈显著负相关(r=-0.379,P0.01,95%CI=-0.581~-0.124)。结论儿童肺部感染程度与维生素D水平密切相关。     

维生素D摄入量与血清25(OH)D水平的剂量反应关系：Meta分析

目的 评价维生素D摄入对血清25(OH)D水平的影响及其剂量反应关系。方法 在Pubmed、Embase、Cochrane数据库中系统检索关于维生素D摄入与血清25(OH)D水平关系的随机对照试验研究的文献。选择紫外线指数(UVI)<3,日光照射皮肤合成维生素D可以忽略不计的试验。使用Cochrane质量评价工具对纳入文献进行质量评价,采用混合效应模型分析维生素D摄入与25(OH)D的剂量反应关系,采用Stata软件进行干预效果分析及亚组分析、敏感性分析和发表偏倚分析。结果 最终纳入18篇随机对照干预试验文献,共49组数据,1892人纳入分析（2014年之后的8篇研究23组数据1134人纳入分析,和2014年之前的10篇研究26组数据,758人纳入分析）。血清25(OH)D水平与维生素D总摄入量呈对数线性关联。未调整其他变量时,维生素D摄入量的对数（β=15.15,95%CI:12.43,17.88,P<0.0001）与血清25(OH)D水平呈正相关。维生素D干预组血清25(OH)D水平较对照组高31.62 nmol/L,95%CI为(27.06,36.19)（异质性为I2...     

维生素D与癌症: 研究现状和展望

  目的  探讨铁对大鼠血清25-（OH）D₃、1,25-（OH）₂D₃水平以及大鼠肾脏维生素D受体（VDR）表达的影响。  方法  30只刚断乳雄性SD大鼠适应性喂养7 d,按体重随机分为对照组（n = 6）和模型组（n = 24）,对照组大鼠饲喂正常饲料,模型组饲喂缺铁饲料,连续6周。造模成功后将模型组大鼠按血红蛋白（Hb）水平随机分为缺铁组、低、中和高铁组,每组6只;对照组与缺铁组大鼠灌胃生理盐水,低、中和高铁组大鼠分别给予11、33和99 mg/kg的右旋糖酐铁灌胃;连续4周后,8 % 水合氯醛麻醉大鼠,腹主动脉取血,分离血清,取动物肾脏组织, – 80 ℃冻存备用;采用酶联免疫试剂盒法检测大鼠血清25-（OH）D₃、1,25-（OH）₂D₃水平,生化试剂盒法检测大鼠肾脏组织铁含量,Western blot和免疫组化法检测大鼠肾脏维生素D受体（VDR）蛋白表达水平。  结果  与对照组比较,造模后模型组大鼠Hb水平降低,差异有统计学意义（P < 0.05）;与缺铁组比较,低、中和高铁组大鼠Hb水平明显升高（P < 0.05）;与对照组比较,缺铁组大鼠血清中25-（OH）D₃、1,25-（OH）₂D₃水平下降,VDR蛋白表达水平降低,差异有统计学意义（P < 0.05）;与缺铁组比较,低、中和高铁组大鼠血清中25-（OH）D₃、1,25-（OH）₂D₃水平升高,差异有统计学意义（P < 0.05）;随着干预铁的浓度增加,VDR蛋白的表达呈逐渐上调趋势。  结论  机体铁含量影响VD₃的活化以及肾脏VDR蛋白的表达。     

维生素D缺乏性佝偻病发病概况与防治

据6省区妇幼卫生示范县佝偻病流行病学调查表明,0～3岁儿童平均患病率为38.4％。通过对不同人群、不同季节与投给不同剂量VD后血中25(OH)D_3水平的实验观察,以及VD体内代谢与VD中毒的实验临床研究,为合理使用VD提供了理论与实践依据。同时结合我国具体情况提出了适合中国国情的佝偻病早期综合防治方法和措施。     

皮层下动脉硬化性脑病和维生素D水平的相关性研究

目的探讨皮质下动脉硬化性脑病(SAE)患者的血清维生素D水平及其与年龄、血糖、血脂、血压和胰岛素水平的关系。方法选择100例SAE患者和50例健康人群,采用酶联免疫吸附法测定两组患者血清25(OH)D水平以及血压、空腹血糖、血脂和胰岛素水平,并进行两组间的比较。结果与健康组相比,SAE组患者收缩压、舒张压、空腹血糖、总胆固醇、胰岛素水平显著升高,血清25(OH)D水平显著降低,差异具有统计学意义(p<0.05,p<0.01)。甘油三酯、脂蛋白差异无显著性(p>0.05)。SAE组患者血清25(OH)D水平与年龄、收缩压、舒张压和空腹血糖负相关(p<0.05,p<0.01)。与甘油三酯、脂蛋白、胆固醇和胰岛素水平无相关性(p>0.05)。结论皮质下动脉硬化病患者的血清25(OH)D水平降低,可能通过影响机体能量代谢参与皮质下动脉硬化性脑病的发生和发展。     

芜湖市6373例儿童血清25-羟维生素D3水平监测结果分析

目的 了解芜湖市儿童25-羟维生素D3(25-(OH) D3)的营养状况.方法 选取在芜湖市妇幼保健院进行25-(OH) D3检测的儿童共6373人,分析不同性别、年龄、季节及湿疹儿童的25-(OH) D3水平.结果 芜湖市6373名儿童血清25-(OH) D3平均浓度为(34.53 ±8.25) ng/ml,维生素D营养不良检出率为21.60％.以秋季儿童血清水平最高(39.39±7.44) ng/ml,不同季节儿童血清25-(OH) D3浓度(F=178.720,P＜0.001)及维生素D营养不良检出率(x2=294.139,P＜0.001)差异有统计学意义.患湿疹儿童血清25-(OH) D3浓度更低(F血清25-(OH)D3=7.441,P＜0.001),维生素D营养不良检出率更高(x2=5.519,P=0.019),差异有统计学意义.结论 芜湖市儿童血清25-(OH) D3水平、维生素D营养不良检出率与季节相关,湿疹患儿血清25-(OH) D3浓度低,维生素D营养不良检出率高.     

大连地区部分成年病人维生素D的营养状况调查

目的:了解大连市区成人维生素D营养状况. 方法:对2012年2月至2013年4月我院营养门诊病人首次测定的25(OH)D结果进行收集和分析. 结果:共395例病人的25(OH)D结果纳入分析,血清25(OH)D平均水平为(15.05±9.36)ng/ml,维生素D缺乏和不足率分别为30.63％和63.04％.在冬春季(n=190)和夏秋季(n=205)的血清25(OH)D平均水平为(12.89±8.12)ng/ml和(17.06±9.98) ng/ml,维生素D缺乏率分别为40％和21.95％,维生素D不足率分别为55.26％和70.24％;血清25(OH)D水平存在季节性差异(P＜0.01). 结论:大连市居民成人维生素D缺乏和不足的比例较高,需要加强干预.     

重症肺炎患儿维生素D营养状况的检测及分析

目的 观察重症肺炎患儿与健康儿童血清25-羟基维生素D[25-(OH)D]水平的差别,为补充维生素D减少重症肺炎发生率提供理论基础。方法 采用病例对照研究方法,选取2014年1月-2016年12月期间在延安大学附属医院儿科住院治疗的64例重症肺炎患儿为重症肺炎组,另外选取60例同年龄段同时期进行健康体检的儿童为健康对照组。应用化学发光法检测两组儿童血清25-(OH)D水平并进行比较。结果 重症肺炎组患儿血清25-(OH)D水平明显低于健康对照组(P＜0.01);重症肺炎组维生素D正常(9%)、不足(19%)的构成比均显著低于健康对照组(分别为33%、42%,P均＜0.05),而缺乏(38%)、严重缺乏(30%)的构成比均显著高于健康对照组(分别为15%、10%,P均＜0.01)。结论 维生素D不足在儿童中普遍存在,重症肺炎患儿血清25-(OH)D水平显著低于健康儿童,补充维生素D对降低婴幼儿重症肺炎发病率的意义有待进一步研究。     

北京市亚北地区0～6岁儿童维生素D营养状况调查分析

目的:了解北京市亚北地区0～6岁儿童维生素D营养状况,为佝偻病防治提供依据。方法:对北京市亚北地区0～6岁210例有可疑VitD摄入不足病史和佝偻病的任何一个非特异性神经精神症状的儿童进行佝偻病相关因素问卷调查、体格检查,采用电化学发光分析仪(竞争法)检测血清25-(OH)D3水平,对结果进行统计学分析。结果:北京市亚北地区0～6岁儿童血清25-(OH)D3平均水平(25.463±7.772)ng/ml,不同年龄段血清25-(OH)D3值差异有统计学意义(P<0.01),性别之间无统计学意义(P>0.05)。维生素D缺乏率24.8%,新生儿、早期婴儿及学龄前儿童维生素D缺乏率高。结论:北京市亚北地区0～6岁儿童维生素D营养状况不如南方地区,应重点加强孕母、早期婴儿及学龄前儿童的维生素D补充。     

3810名0～14岁儿童维生素D营养状况调查

目的调查内蒙古呼伦贝尔市0～14岁儿童维生素D营养状况,为指导儿童进行维生素D缺乏及不足的预防提供参考。方法回顾性分析2016年11月-2017年4月呼伦贝尔市人民医院儿科门诊进行健康体检的3 810名0～14岁儿童的临床资料和血清25(OH)D水平。结果血清25(OH)D水平婴幼儿组40. 83±17. 49,学龄前组23. 46±13. 17,学龄组17. 69±10. 05,3组间存在显著统计学差异。男女童患病率无统计学差异。血清25(OH)D水平在婴儿期随月龄增长逐渐升高,至6月龄后达到较高水平,持续近1岁后随年龄增长逐渐下降。结论儿童维生素D营养状况与性别无关,与年龄相关;今后应加强对新生儿及年长儿童维生素D营养状况的管理。     

孕妇血清维生素D水平与自然流产的相关性研究

目的 探讨妊娠期孕妇血清25-羟维生素D[25-(OH)D]水平与自然流产的相关性.方法 将2015年6月至2017年1月在玉环县人民医院妇科病房住院的136例自然流产孕妇作为观察组,选择同期在玉环县人民医院妇产科门诊正常体检的孕妇60例作为对照组,两组病例均检测血清25-(OH)D水平,比较两组检测结果.结果 观察组血清25-(OH)D水平为(51.76±6.86)nmol/L,对照组血清25-(OH)D水平为(59.55±7.79)nmol/L,观察组血清25-(OH)D水平显著低于对照组(t=7.02,P<0.05);观察组血清25-(OH)D水平缺乏率为44.12%,对照组血清25-(OH)D水平缺乏率为26.67%,观察组血清25-(OH)D水平缺乏率显著高于对照组(χ2=5.34,P<0.05).结论 妊娠期孕妇血清25-羟维生素D缺乏可能增加自然流产发生的风险.     

The potential role of vitamin D enhanced foods in improving vitamin D status

Low vitamin D intake and status have been reported worldwide and many studies have suggested that this low status may be involved in the development of several chronic diseases. There are a limited number of natural dietary sources of vitamin D leading to a real need for alternatives to improve dietary intake. Enhancement of foods with vitamin D is a possible mode for ensuring increased consumption and thus improved vitamin D status. The present review examines studies investigating effects of vitamin D enhanced foods in humans and the feasibility of the approach is discussed.     

Evidence of continuing 'deprivational' vitamin D deficiency in Asians in the UK

In view of the large Asian population in Leicester and the continuing uncertainty about the level of vitamin D deficiency in this group, a preliminary study was undertaken to review the results of all 25(OH) vitamin D assays which had been performed in the previous 2 years with reference to the ethnic origin of the patients.
Results indicated that not only were more assays performed on Asian patients but also that these patients were significantly more likely to have low or undetectable levels of 25(OH) vitamin D. Over 50% of Asian patients screened had subnormal levels of 25(OH) vitamin D. Within the Asian group, women of child-bearing age appeared in substantial numbers amongst those who had low 25(OH) vitamin D levels. The study indicates a continuing problem of vitamin D deficiency in Asians which requires further study.     

生长激素治疗前后GHD儿童维生素D变化的研究

【目的】探讨生长激素缺乏症(growth hormone deficiency,GHD)患儿、非GH缺乏性矮身材(non-GHdeficient short stature,NGHDSS)患儿及GHD患儿应用生长激素治疗3个月后的25-羟维生素D3[25-(OH)D3]、1,25-二羟维生素D3[1,25-(OH)2D3、]的变化。【方法】20例GHD患儿在治疗前及治疗3月后分别测血清25-(OH)D3、1,25-(OH)2D3水平并观察他们的身高变化,与20例NGHDSS患儿和20例正常儿童进行对照。放射免疫分析法测定血清25-(OH)D3、1,25-(OH)2D3水平。多组均数比较采用单因素方差分析,治疗前后均数间较采用配对t检验。【结果】GHD患儿治疗前血清25-(OH)D3水平低于正常对照组(P<0.05),治疗3个月后血清25-(OH)D3、1,25-(OH)2D3水平较治疗前增加(P值均<0.05),并高于对照组(P值均<0.05)。NGHDSS患儿血清25-(OH)D3水平高于GHD组(P<0.05),与正常对照组差异无显著性(P>0.05)。NGHDSS患儿血清1,25-(OH)2D3水平与正常对照组及GHD组差异均无显著性(两者P>0.05)。【结论】GHD患者血清25-(OH)D3低于正常,治疗后血清25-(OH)D3、1,25-(OH)2D3水平上升,推测GH通过直接或间接作用增强α羟化酶活性,促进维生素D的代谢。     

Summer and winter prevalence of vitamin D deficiency of young resident doctors in North India

Aim: Vitamin D deficiency is common both in children and adults all over the world. Long indoor working hours may contribute to deficiency in adult populations particularly in those not receiving vitamin D supplementation in any form. The study aimed to evaluate vitamin D status of young resident doctors working in a university hospital in North India. Methods: Serum 25(OH)D, calcium and alkaline phosphatase were measured in a cross‐sectional sample of young resident doctors living in Varanasi, India (latitude 25 degrees North). A total of 80 resident doctors were recruited to participate in the present study with 40 participants enrolled at the end of summer in September 2005, and the remainders were enrolled at the end of winter in March 2006. Results: There was a significant decrease (P < 0.001) in mean 25(OH) vitamin D concentration of the study groups from summer (29 (±21.7) nmol/L) to winter (16.5 (±11.0) nmol/L). In summer, 33 residents had 25 (OH) vitamin D < 50 nmol/L, five had between 50 and 75 nmol/L and only two had >75 nmol/L, but in winter the corresponding numbers were 38, two and none had a concentration >75 nmol/L. No difference in serum calcium and phosphorus was observed; however, alkaline phosphatase was significantly higher in participants sampled in the winter (P < 0.001). Conclusions: Hypovitaminosis D was common among apparently normal young resident doctors engaged in indoor work in both seasons. This may have negative short‐ and long‐term health implications. Provision of vitamin D supplementation (oral cholecalciferol) to young resident doctors and other indoor professionals should be considered.     

Older Mayan residents of the western highlands of Guatemala lack sufficient levels of vitamin D

Vitamin D (VitD) levels in older Mayans are currently unknown. Geographic factors, for example, residences in areas receiving ample sunlight at high altitudes and latitudes near the equator, would favor optimum VitD levels, whereas demographic factors, for example, darker skin pigmentation, clothing practices, and older age, would favor low 25-hydroxy-vitamin D, or 25(OH)D, levels. Conjecturing that demographic factors affecting VitD status might outweigh geographic factors in this population, we hypothesized that older Mayans have suboptimal values of 25(OH)D. We also hypothesized that older Mayans in rural areas would have higher VitD levels than would their urban counterparts. Blood samples were collected from 108 healthy older Mayans (mean age, 69 years) from urban (n = 84, 50% male) and rural settings (n = 24, 50% male) during the summer of 2008 in the highlands of Quetzaltenango, Guatemala. We assessed 25(OH)D concentrations by radioimmunoassay in a US-based laboratory. Mean (SD) serum 25(OH)D values were 53.3 (15.0) nmol/L, and lower 25(OH)D values were associated with increasing age (r = −0.58, P = .004). Of all subjects, 3.7% (n = 4) maintained an optimal status of 25(OH)D (>80 nmol/L), 50% (n = 54) had values between 50 and 80 nmol/L, and 46.3% (n = 50) had levels less than 50 nmol/L. Urban subjects had nonsignificantly higher 25(OH)D values (55.0 ± 15.3 nmol/L) than did rural subjects (47.4 ± 12.4 nmol/L, P = .228). Men had significantly higher values (58.2 ± 16.5 nmol/L) than did women (48.4 ± 11.6 nmol/L, P = .001). We conclude that despite residing in an optimal geographic location to receive adequate sunlight exposure, most older Guatemalan Mayans in Quetzaltenango have suboptimal levels of VitD.     

不同季节112例母婴维生素D营养状况分析

目的 以血清25-(OH)D为检测指标, 了解不同季节、不同居住环境孕妇及其新生儿的维生素D营养状况及母婴血清维生素D的相关性。方法 选取冬季(2010年12月-2011年2月)和夏季(2011年6月-2011年8月)在河北北方学院附属第二医院妇产科正常分娩的孕妇及其新生儿为研究对象。72对孕妇及其新生儿为冬季组, 40对孕妇及其新生儿为夏季组。孕妇于分娩前采集静脉血, 新生儿于娩出后采集脐血, 分离血清。酶联免疫法测定血清25-(OH)D水平。维生素D营养状况采用三分法:1)维生素D缺乏:25-(OH)D＜50 nmol/L;2)维生素D不足:50 nmol/L≤25-(OH)D＜75 nmol/L;3)维生素D充足:25-(OH)D≥75 nmol/L。结果 1)冬季和夏季孕妇血清25-(OH)D水平分别为(19.48±7.04)nmol/L和(53.15±17.50)nmol/L, 冬季显著低于夏季;对应的新生儿脐血25-(OH)D水平分别为(19.95±6.79)nmol/L和(47.39±15.31)nmol/L, 冬季显著低于夏季。2)冬季孕妇25-(OH)D水平为9.19~36.99 nmol/L, 新生儿25-(OH)D水平为7.78~37.36 nmol/L, 冬季孕妇及新生儿维生素D缺乏率为100%。夏季孕妇25-(OH)D水平为26.72~103.90 nmol/L, 新生儿25-(OH)D水平为20.76~79.91 nmol/L, 夏季孕妇和新生儿维生素D缺乏率分别为47.5%和62.5%。3)孕妇与新生儿25-(OH)D水平具有显著正相关(r=0.902)。4)冬季组孕妇及其新生儿25-(OH)D水平无城乡之间的差异;夏季组孕妇及其新生儿25-(OH)D水平存在城乡之间的差异, 农村孕妇及其新生儿25-(OH)D水平高于城市。结论 孕妇及其新生儿25-(OH)D水平存在明显的季节差异。冬季孕妇及其新生儿普遍维生素D缺乏, 即使夏季孕妇及其新生儿维生素D缺乏比率也较高。     

Mobilising vitamin D from adipose tissue: The potential impact of exercise

Vitamin D is lipophilic and accumulates substantially in adipose tissue. Even without supplementation, the amount of vitamin D in the adipose of a typical adult is equivalent to several months of the daily reference nutrient intake (RNI). Paradoxically, despite the large amounts of vitamin D located in adipose tissue, individuals with obesity are often vitamin D deficient according to consensus measures of vitamin D status (serum 25‐hydroxyvitamin D concentrations). Thus, it appears that vitamin D can become ‘trapped’ in adipose tissue, potentially due to insufficient lipolytic stimulation and/or due to tissue dysfunction/adaptation resulting from adipose expansion. Emerging evidence suggests that exercise may mobilise vitamin D from adipose (even in the absence of weight loss). If exercise helps to mobilise vitamin D from adipose tissue, then this could have important ramifications for practitioners and policymakers regarding the management of low circulating levels of vitamin D, as well as chronically low levels of physical activity, obesity and associated health conditions. This perspective led us to design a study to examine the impact of exercise on vitamin D status, vitamin D turnover and adipose tissue vitamin D content (the VitaDEx project). The VitaDEx project will determine whether increasing physical activity (via exercise) represents a potentially useful strategy to mobilise vitamin D from adipose tissue.