200例学龄前儿童血清25羟维生素D水平及其与体格发育指标的关系分析

目的调查学龄前儿童血清25羟维生素D[25(OH)D]水平调查及其与体格发育指标的关系。方法选取2014年8月至2017年8月在我院门诊体检的200例1～6岁学龄前儿童为对象,均检测所有学龄前儿童的血清25(OH)D,分别记录1～3岁幼儿(100人)和4～6岁学龄前儿童(100人)的血清25(OH)D水平,按照检测结果将其均分为维生素D缺乏组和正常组各为120例和80例,比较两组儿童的平均身高、体重、体质指数(BMI)以及血清25(OH)D与体格发育指标的关系。结果 1～3岁的幼儿期25(OH)D的平均水平为(77.98±14.47)ng/mL,明显高于4～6岁的学龄前儿童的(55.78±12.53)ng/mL,幼儿维生素缺乏率为30.00%,学龄前儿童为45.00%,差异均有统计学意义(P0.05);维生素D缺乏组的平均身高、体重、BMI、25(OH)D的检测结果分别为(96.58±4.69)cm、(14.97±1.43)kg、(5.86±1.56)kg/m2、(29.05±8.47)ng/mL均低于正常组的(107.48±5.13)cm和(19.97±3.43)kg、(8.98±2.36)kg/m2、(78.52±15.53)ng/mL,差异均有统计学意义(P0.05),学龄前儿童体格发育指标与血清25(OH)D水平呈正相关(P0.05)。结论学龄前儿童血清25(OH)D水平与身高体重等体格发育关系密切,必须引起重视。     

健康学龄前351名儿童25-羟维生素D水平及影响因素

目的 了解上海市学龄前儿童的维生素D水平并分析其影响因素,为防治该地区维生素D缺乏提供理论依据。方法 随机抽取上海市浦东新区3家幼儿园共351名3～6岁学龄前儿童(男:185名,女:166名),采用液相色谱串联质谱法(LC-MS/MS)测定测血清25-羟维生素 D[25-(OH)D]水平,并通过标准问卷获得相关影响因素数据。结果 受试学龄前儿童血清25-羟维生素 D[25-(OH)D]的平均水平为(28.14±6.70) ng/ml。维生素D缺乏[25-(OH)D＜20 ng/ml]为35例(10.0％),维生素D适宜水平(20～100 ng/ml)为316例(90.0%)。多因素分析结果显示维生素D制剂补充频率低及大年龄组(≥6岁)是学龄前儿童25-(OH)D缺乏的高危因素(P＜0.05)。结论 年龄和维生素D制剂补充与学龄前儿童维生素D水平明显相关,大年龄组(≥6岁)儿童维生素D制剂补充率相对较低。针对目前学龄前儿童仍存在维生素D缺乏的情况,应该加强儿童保健的科普教育,结合个体情况提高维生素D的补充率,同时增加儿童户外活动,促进学龄前儿童健康。     

1～6岁460名学龄前儿童血清25-羟基维生素D水平及其与体格发育的关系分析

目的探讨1~6岁学龄前儿童血清25-羟基维生素D[25-(OH)D]水平及其与体格发育的关系。方法回顾性分析2014年4月—2015年5月于本院体检的460名1~6岁学龄前儿童临床资料,检测所有受试儿血清25-(OH)D水平,记录不同年龄患儿(1~3岁幼儿和4~6岁学龄前期儿童)血清25-(OH)D水平及维生素D缺乏率差异。将460名儿童分为维生素D缺乏组(n=248)和正常组(n=212),比较两组儿童平均身高、体重的差异;血清25-(OH)D水平与身高、体重等体格发育指标的关系采用Pearson线性相关分析法评估。结果 1~3岁的幼儿血清25-(OH)D水平为(78.65±13.38)nmol/L,显著高于4~6岁学龄前期儿童的(54.27±12.95)nmol/L,且维生素D缺乏率(11.17%,21/188)显著低于学龄前期儿童(18.38%,50/272),差异均有统计学意义(均P0.05)。维生素D缺乏组儿童平均身高、体重等体格发育指标检测结果 [(98.67±3.83)cm、(15.63±1.96)kg]均明显低于正常组儿童[(106.83±4.15)cm、(18.35±2.05)kg],差异均有统计学意义(均P0.05)。Pearson线性相关分析结果显示,1~6岁学龄前儿童血清25-(OH)D水平检测结果与身高、体重等体格发育指标均呈正相关(均P0.05)。结论 1~6岁学龄前儿童血清25-(OH)D水平同其体格发育关系密切,需引起重视。     

健康学龄前351名儿童25-羟维生素D水平及影响因素

目的 了解上海市学龄前儿童的维生素D水平并分析其影响因素,为防治该地区维生素D缺乏提供理论依据。方法 随机抽取上海市浦东新区3家幼儿园共351名3～6岁学龄前儿童(男:185名,女:166名),采用液相色谱串联质谱法(LC-MS/MS)测定测血清25-羟维生素 D[25-(OH)D]水平,并通过标准问卷获得相关影响因素数据。结果 受试学龄前儿童血清25-羟维生素 D[25-(OH)D]的平均水平为(28.14±6.70) ng/ml。维生素D缺乏[25-(OH)D＜20 ng/ml]为35例(10.0％),维生素D适宜水平(20～100 ng/ml)为316例(90.0%)。多因素分析结果显示维生素D制剂补充频率低及大年龄组(≥6岁)是学龄前儿童25-(OH)D缺乏的高危因素(P＜0.05)。结论 年龄和维生素D制剂补充与学龄前儿童维生素D水平明显相关,大年龄组(≥6岁)儿童维生素D制剂补充率相对较低。针对目前学龄前儿童仍存在维生素D缺乏的情况,应该加强儿童保健的科普教育,结合个体情况提高维生素D的补充率,同时增加儿童户外活动,促进学龄前儿童健康。     

泰州市儿童血清25羟维生素D水平分析

目的 通过对泰州地区部分儿童血清25羟维生素D检测,了解健康儿童25羟维生素D水平,为佝偻病防治提供依据。方法 选取2013年10月-2014年9月儿保门诊儿童共476 例。取清晨空腹血,采用串联质谱法检测其血清25羟维生素D水平。结果 泰州市儿童各年龄组血清25羟维生素D水平均呈偏态分布,以中位数表示,分别为婴儿组、幼儿组、学龄前期组、学龄组。经秩和检验,不同年龄组维生素D水平差异有统计学意义(P<0.05)。各年龄组维生素D水平男女性别差异无统计学意义(P>0.05)。476例儿童中, 维生素D严重缺乏(≤5 ng/ml)占3.15%(15/476); 缺乏(≤15 ng/ml) 占38.45%(183/476);不足或以下(15～20 ng/ml)占17.86% (85/476);充足(>20 ng/ml)占40.55%(193/467) ;过量(>100 ng/ml)为0。维生素D不足(≤20 ng/ml) 的儿童占59.45% (283/476),其中婴儿组为9.3% (8/476);幼儿组为36.21%(42/467);学龄前组为70.13%(54/567 );学龄期组为90.86%(179/476),以学龄期儿童为主,各组间差异有统计学意义(P<0.05)。不同季节血清维生素D值差异有统计学意义(P<0.05)。结论 泰州市儿童维生素D水平随年龄增长而下降,学龄儿童维生素D缺乏尤为严重,3岁以上儿童需注意补充维生素D,尤其是冬季。     

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。     

维生素D水平与学龄前儿童认知行为发育的相关性

目的分析维生素D水平与学龄前儿童认知行为发育的相关性,为维生素D缺乏的预防和干预提供理论依据。方法选取2018年1月-2019年10月深圳市福田区1 072例3～7岁儿童,检测血清25-(OH)维生素D水平,分为缺乏组、不足组、充足组。采用《0～6岁发育筛查测验》(DST)和Achenbach儿童行为量表评估儿童认知和行为发育情况。比较3组学龄前儿童发育商(DQ)、智力指数(MI)、行为因子得分。结果 1 072例学龄前儿童血清25-(OH)维生素D水平为(27.95±7.67) ng/ml,其中缺乏、不足、充足率分别为14.83%、51.40%、33.77%。3岁组、4岁组、5岁组、6岁组学龄前儿童血清维生素D水平分别为(30.22±7.70) ng/ml、(26.61±6.96) ng/ml、(25.49±7.12) ng/ml、(24.36±6.48) ng/ml,差异有统计学意义(P0.01)。各年龄组学龄前儿童血清维生素D缺乏率比较差异有统计学意义(P0.01)。缺乏组、不足组、充足组DQ比较差异无统计学意义(P0.05),MI比较差异有统计学意义(P0.05)。缺乏组、不足组、充足组学龄前儿童行为问题发生率分别为15.96%(19例)、11.76%(14例)、13.45%(16例),差异无统计学意义(P0.05)。3组4～5岁男童攻击因子得分、4～5岁女童肥胖因子得分、6岁女童体诉因子得分比较差异均有统计学意义(均P0.05)。结论维生素D缺乏可能对学龄前儿童的认知行为发育有不良影响,应及时补充。     

新会地区婴幼儿维生素D的营养状况研究

目的了解江门市新会地区婴幼儿维生素D的营养状况,为指导维生素D的合理应用提供依据。方法随机选取2013年4月-2014年3月在广东省江门市新会区妇女儿童医院儿童保健门诊健康体检的0~3岁儿童300例,采用高效液相色谱-串联质谱法测定血清25羟基维生素D水平。结果新会地区婴幼儿血清25-(OH)D平均水平为(29.13±8.12)ng/ml,血清25-(OH)D水平随年龄增加而下降,不同年龄段和不同季节血清25-(OH)D比较差异有统计学意义(P0.05),维生素D的缺乏率为2.3%、不足率为8.0%,不同年龄段维生素D不足率比较差异有统计学意义(P0.05)。结论新会地区婴幼儿维生素D营养状况较好,应重点加强幼儿维生素D的补充。通过定期检测血清25-(OH)D了解体内维生素D水平,科学指导维生素D的补充,消除家长对过量中毒的担忧,从而增加家长的依从性。     

血清25羟维生素D水平在抽动障碍儿童中的临床研究

目的探讨抽动障碍(TD)儿童血清25羟维生素D [25 (OH) D]水平与TD的临床关系。方法随机选取2017年1月-2018年7月该院儿科门诊111例确诊的TD儿童作为TD组,同期随机将儿童保健门诊体检的111例健康儿童作为健康组。结果 TD组儿童血清25 (OH) D水平(22. 60±2. 86 ng/ml)低于健康组的(33. 28±2. 42 ng/ml)(P0. 01); TD儿童血清25 (OH) D不足率高于健康组(P0. 01);但暂时性抽动障碍(TTD)、慢性抽动障碍(CTD)以及抽动秽语综合征(TS)组儿童血清25 (OH) D水平差异无统计学意义(P0. 05)。结论维生素D不足可能与TD发病存在一定关联,但仍需进一步大样本研究证实。     

某儿童医院3 089例0~16岁儿童维生素D水平回顾性分析

目的 了解本地区0~16岁儿童25(OH)D的水平,为本地区0~16岁儿童合理补充维生素D提供科学依据。 方法 回顾性分析2019年1月—2020年10月在本院儿童保健科进行健康体检的3 089例儿童血清25(OH)D水平,并分析其与性别、年龄、季节之间的关系。 结果 3 089例0~16岁儿童的25(OH)D平均水平为(30.80±13.31)ng/ml,其中25(OH)D严重缺乏者29例(0.94%),血清25(OH)D水平为(7.80±1.26)ng/ml;缺乏者570例(18.45%),25(OH)D水平为(16.41±2.66)ng/ml;不足者1 098例(35.55%),25(OH)D水平为(24.87±2.86)ng/ml;充足者1 392例(45.06%),25(OH)D水平为(41.85±11.56)ng/ml。不同性别间25(OH)D的水平差异也有一定的统计学意义。随着年龄增加维生素D水平逐渐下降,充足率逐渐降低,严重缺乏、缺乏、不足率升高,差异有统计学意义。不同季节中以夏、秋季水平较高,春季较低、冬季最低,差异有统计学意义。 结论 本地区0~16岁儿童血清25(OH)D水平充足比率偏低,应注意增加维生素D的补充及户外活动时间。     

Analysis of the distributional impact of out-of-pocket health payments: evidence from a public health insurance program for the poor in Mexico

Many governments have health programs focused on improving health among the poor and these have an impact on out-of-pocket health payments made by individuals. Therefore, one of the objectives of these programs is to reach the poorest and reduce their out-of-pocket expenditure. In this paper we propose the distributional poverty impact approach to measure the poverty impact of out-of-pocket health payments of different health financing policies. This approach is comparable to the impoverishment methodology proposed by Wagstaff and van Doorslaer (2003) that compares poverty indices before and after out-of-pocket health payments. In order to escape the specification of a particular poverty index, we use the marginal dominance approach that uses non-intersecting curves and can rank poverty reducing health financing policies. We present an empirical application of the out-of-pocket health payments for an innovative social financing policy implemented in Mexico named Seguro Popular. The paper finds evidence that Seguro Popular program has a better distributional poverty impact when families face illness when compared to other poverty reducing policies. The empirical dominance approach uses data from Mexico in 2006 and considers international poverty standards of $2 per person per day.     

Vitamin D: Deficiency,Sufficiency and Toxicity

The plethora of vitamin D studies over the recent years highlight the pleomorphic effects of vitamin D outside its conventional role in calcium and bone homeostasis. Vitamin D deficiency, though common and known, still faces several challenges among the medical community in terms of proper diagnosis and correction. In this review, the different levels of vitamin D and its clinical implications are highlighted. Recommendations and consensuses for the appropriate dose and duration for each vitamin D status are also emphasized.     

Relative concentrations of 25-hydroxyvitamin D2/D3 and 1,25-dihydroxyvitamin D2/D3 in maternal plasma at delivery

Quantitation of circulating 25-OH-D₂, 25-OH-D₃, 1,25-(OH)₂-D₂ and 1,25-(OH)₂-D₃ was performed on the plasma from 10 women collected at delivery following full term pregnancies. These data indicate that approximately 50% of the circulating 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D in these women are in the vitamin D₂ form. Further, they demonstrate that vitamin D₂ contributes significantly to the total vitamin D status of these individuals and cannot be considered of trivial importance. It is apparent from this study that assay techniques which specifically quantitate vitamin D₂, as well as D₃ must be employed when measuring the total vitamin D status of individuals who are consuming significant quantities of dietary vitamin D₂.     

An update on UK Vitamin D intakes and status,and issues for food fortification and supplementation

Vitamin D is unique among the essential nutrients in that it can be made in the body via exposure of the skin to sunlight. There are few rich sources of vitamin D in the diet. Vitamin D is essential for maintaining healthy bones and deficiency of vitamin D causes rickets in children and osteomalacia in adults. In the UK, there is evidence that low vitamin D status is prevalent in the population and older adults living in institutions are particularly at risk. There are two forms of vitamin D that can be added to foods and drinks: vitamin D₂ and D₃. They have somewhat different structures, and there are some differences in the way they are metabolised by the body. Overall, the evidence for the relative effectiveness of vitamin D₂ vs. D₃ is mixed, and more studies are needed to provide a clearer picture. However, there does seem to be some indication that D₃ is more effective than D₂ in raising vitamin D status.     

Plasma 25-Hydroxyvitamin D Responses of Younger and Older Men to Three Weeks of Supplementation with 1800 IU/day of Vitamin D

Objective: The objective of this study was to compare changes in plasma 25-hydroxyvitamin D (25(OH)D) levels of younger and older men after three weeks of oral vitamin D supplementation.

Methods: Nine younger men (22 to 28 years) and nine older men (65 to 73 years) with self-reported vitamin D intakes below 200 IU/d were enrolled in February and randomized to 1800 IU/d of ergocalciferol (vitamin D₂, n=11) or to a control group (n=7) and followed for three weeks. Blood was collected at baseline, and after one, two and three weeks for measurement of plasma concentrations of total 25(OH)D, 25(OH)D₂ and 25(OH)D₃.

Results: In both the younger and older supplemented men, 25(OH)D₂ and total 25(OH)D concentrations increased significantly during the study, whereas values of these metabolites did not change in younger or older control subjects. No group showed significant changes in 25-hydroxyvitamin D₃. There was a significant interaction between age group and supplement group, suggesting that the effect of vitamin D₂ supplementation on changes in 25(OH)D₂ changes with age. The mean increase in 25(OH)D₂ was greater in the younger supplemented men than in the older supplemented men (37±9 nmol/L vs. 19.5 nmol/L, p=0.027), and this accounted for their significantly greater increase in total 25(OH)D.

Conclusion: These data are consistent with an age-related decline in the absorption, transport or liver hydroxylation of orally-consumed vitamin D.     

Vitamin D: An overview of vitamin D status and intake in Europe

In recent years, there have been reports suggesting a high prevalence of low vitamin D intakes and vitamin D deficiency or inadequate vitamin D status in Europe. Coupled with growing concern about the health risks associated with low vitamin D status, this has resulted in increased interest in the topic of vitamin D from healthcare professionals, the media and the public. Adequate vitamin D status has a key role in skeletal health. Prevention of the well‐described vitamin D deficiency disorders of rickets and osteomalacia are clearly important, but there may also be an implication of low vitamin D status in bone loss, muscle weakness and falls and fragility fractures in older people, and these are highly significant public health issues in terms of morbidity, quality of life and costs to health services in Europe. Although there is no agreement on optimal plasma levels of vitamin D, it is apparent that blood 25‐hydroxyvitamin D [25(OH)D] levels are often below recommended ranges for the general population and are particularly low in some subgroups of the population, such as those in institutions or who are housebound and non‐Western immigrants. Reported estimates of vitamin D status within different European countries show large variation. However, comparison of studies across Europe is limited by their use of different methodologies. The prevalence of vitamin D deficiency [often defined as plasma 25(OH)D <25 nmol/l] may be more common in populations with a higher proportion of at‐risk groups, and/or that have low consumption of foods rich in vitamin D (naturally rich or fortified) and low use of vitamin D supplements. The definition of an adequate or optimal vitamin D status is key in determining recommendations for a vitamin D intake that will enable satisfactory status to be maintained all year round, including the winter months. In most European countries, there seems to be a shortfall in achieving current vitamin D recommendations. An exception is Finland, where dietary survey data indicate that recent national policies that include fortification and supplementation, coupled with a high habitual intake of oil‐rich fish, have resulted in an increase in vitamin D intakes, but this may not be a suitable strategy for all European populations. The ongoing standardisation of measurements in vitamin D research will facilitate a stronger evidence base on which policies can be determined. These policies may include promotion of dietary recommendations, food fortification, vitamin D supplementation and judicious sun exposure, but should take into account national, cultural and dietary habits. For European nations with supplementation policies, it is important that relevant parties ensure satisfactory uptake of these particularly in the most vulnerable groups of the population.     

Calcium Absorption Varies within the Reference Range for Serum 25-Hydroxyvitamin D

Background: Calcium absorption is generally considered to be impaired under conditions of vitamin D deficiency, but the vitamin D status that fully normalizes absorption is not known for humans.

Objective: To quantify calcium absorption at two levels of vitamin D repletion, using pharmacokinetic methods and commercially marketed calcium supplements.

Design: Two experiments performed in the spring of the year, one year apart. In the first, in which participants were pretreated with 25-hydroxyvitamin D (25OHD), mean serum 25OHD concentration was 86.5 nmol/L; and in the other, with no pretreatment, mean serum concentration was 50.2 nmol/L. Participants received 500 mg oral calcium loads as a part of a standard low calcium breakfast. A low calcium lunch was provided at mid-day. Blood was obtained fasting and at frequent intervals for 10 to 12 hours thereafter.

Methods: Relative calcium absorption at the two 25OHD concentrations was estimated from the area under the curve (AUC) for the load-induced increment in serum total calcium.

Results: AUC₉ (± SEM), was 3.63 mg hr/dL ± 0.234 in participants pretreated with 25OHD and 2.20 ± 0.240 in those not pretreated (P < 0.001). In brief, absorption was 65% higher at serum 25OHD levels averaging 86.5 nmol/L than at levels averaging 50 nmol/L (both values within the nominal reference range for this analyte).

Conclusions: Despite the fact that the mean serum 25OHD level in the experiment without supplementation was within the current reference ranges, calcium absorptive performance at 50 nmol/L was significantly reduced relative to that at a mean 25OHD level of 86 nmol/L. Thus, individuals with serum 25-hydroxyvitamin D levels at the low end of the current reference ranges may not be getting the full benefit from their calcium intake. We conclude that the lower end of the current reference range is set too low.     

湖州市3 724例0~6岁门诊体检儿童维生素D营养状况

目的 了解0～6岁门诊体检儿童的维生素D营养状况,为科学合理地补充维生素D制剂提供理论依据.方法 选取2013年1月至2014年3月在湖州市妇幼保健院儿童保健门诊进行常规体检的3 724例0～6岁儿童,采用电化学发光法检测血清25-(OH)D的水平,比较不同年龄段儿童及不同季节血清25-(OH)D水平及维生素D不足与缺乏情况.结果 0～6岁门诊体检儿童的血清25-(OH)D平均水平为(37.80±11.67) ng/ml,维生素D不足与缺乏的比例为7.33％,男女童之间差异均无统计学意义(t=-1.57,P=0.117;x2=0.37,P=0.543).＞3且≤6岁儿童血清25-(OH)D水平显著低于≤1岁、＞1且≤2岁和＞2且≤3岁儿童[(27.36±8.90) ng/ml比(38.64±12.10) ng/ml,t=18.60,P=0.000;比(41.63±10.31) ng/ml,t=26.07,P=0.000;比(36.85±10.01) ng/ml,t=16.42,P=0.000],维生素D不足与缺乏比例显著高于其他3个年龄段儿童(104/466比122/1 487,x2=69.06,P=0.000;比18/1 106,x2=196.06,P=0.000;比29/665,x2=85.14,P=0.000).冬季儿童25-(OH)D水平显著低于春、夏、秋季[(35.16±11.30) ng/ml比(40.03±12.57) ng/ml,t=9.15,P=0.000;比(36.86±10.60) ng/ml,t=3.34,P =0.001;比(39.99±11.36) ng/ml,t=9.65,P=0.000],维生素D不足与缺乏的比例显著高于其他3个季节(127/1 189比56/849,x2=10.11,P=0.001;比54/787,x2=8.30,P=0.004;比36/899,x2 =31.71,P=0.000).结论 本院0～6岁门诊体检儿童的总体维生素D营养状况良好,冬季和＞3且≤6岁儿童维生素D水平较低、不足与缺乏的比例较高,因此应重视冬季和3岁以上儿童的维生素D补充,适当增加儿童户外活动,同时加强科学预防维生素D缺乏的宣传教育.     

Vitamin D Nutritional Status of Chinese Pregnant Women,Comparing the Chinese National Nutrition Surveillance (CNHS) 2015–2017 with CNHS 2010–2012

Optimal vitamin D (vitD) status is beneficial for both pregnant women and their newborns. The aim of this study was to evaluate the vitamin D status of Chinese pregnant women in the latest China Nutrition and Health Surveillance (CNHS) 2015–2017, analyze the risk factors of vitamin D deficiency (VDD), and compare them with those in CNHS 2010–2012. Serum 25 hydroxyvitamin D (25(OH)D) was measured by ELISA method. City type, district, latitude, location, age, vitamin D supplements intake, education, marital status, annual family income, etc., were recorded. The median 25(OH)D concentration was 13.02 (10.17–17.01) ng/mL in 2015–2017, and 15.48 (11.89–20.09) ng/mL in 2010–2012. The vitamin D sufficient rate was only 12.57% in 2015–2017, comparing to 25.17% in 2010–2012. The risk factors of vitamin D inadequacy (25(OH)D < 20 ng/mL) in 2015–2017 were not exactly consistent with that in 2010–2012. The risk factors included season of spring (p < 0.0001) and winter (p < 0.001), subtropical (p < 0.001), median (p < 0.0001) and warm temperate zones (p < 0.0001), the western (p = 0.027) and the central areas (p = 0.041), while vitD supplements intake (p = 0.021) was a protective factor in pregnant women. In conclusion, vitD inadequacy is very common among Chinese pregnant women. We encourage pregnant women to take more effective sunlight and proper vitD supplements, especially for those from the subtropical, warm and medium temperate zones, the western and the central, and in the seasons of spring and winter.     

Effect of Selected Factors on the Serum 25(OH)D Concentration in Women Treated for Breast Cancer

Maintaining an optimal vitamin D concentration reduces the risk of recurrence and extends survival time in patients after breast cancer treatment. Data on vitamin D deficiency among Polish women after breast cancer therapy are limited. Thus, the aim of the study was the analysis of vitamin D status in post-mastectomy patients, considering such factors as seasons, social habits, vitamin D supplementation and its measurements. The study involved 94 women after breast cancer treatment. Serum vitamin D concentration was measured, and a questionnaire, gathering demographic and clinical data regarding cancer, diet, exposure to sun radiation, and knowledge of recommendations on vitamin D supplementation, was delivered twice, in both winter and in summer. The control group consisted of 94 age-matched women with no oncological history. In women after breast cancer treatment, 25-hydroxyvitamin D (25(OH)D) deficiency was much more frequent than in the general population. Only about half of the patients supplemented vitamin D at the beginning of the study. After the first test and the issuing of recommendations on vitamin D supplementation, the percentage of vitamin D supplemented patients increased by about 30% in study groups. The average dose of supplement also increased. None of the women that were not supplementing vitamin D and were tested again in winter had optimal 25(OH)D concentration. It was concluded that vitamin deficiency is common in women treated for breast cancer. Medical advising about vitamin D supplementation and monitoring of 25(OH)D concentration should be improved.