北京市儿童血清25－羟基维生素D的水平探讨

对北京地区０～１３岁健康儿童２８５名进行血清２５（ＯＨ）Ｄ水平测定，均值为（５７．５±１９．８）ｎｍｏｌ／Ｌ。同时对２５名乳儿肝炎患儿血清２５（ＯＨ）Ｄ水平测定，其均值为（２２．５±１７．４）ｎｍｏｌ／Ｌ，明显低于健康儿童，说明血清２５（ＯＨ）Ｄ是一个敏感的生化指标，对儿科临床诊断有一定的参考价值。     

单纯性肥胖青少年性发育的调查分析

用放免法测定肥胖组与对照组男女儿童血清睾酮、脱氢表雄酮硫酸酯（ＤＨＥＡＳ）的含量及性征与性成熟的状况。结果显示肥胖组男性儿童血清睾酮含量为（１０．３６±５．７２）ｎｍｏｌ／Ｌ，对照组为（８．６５±４．２１）ｎｍｏｌ／Ｌ，肥胖组显著地高于对照组（Ｐ＜０．０１）。肥胖组女性儿童血清ＤＨＥＡＳ含量为（８．２５±６．４７）ｐｍｏｌ／Ｌ，对照组为（５．６３±４．９８）ｐｍｏｌ／Ｌ，肥胖组亦明显高于对照组（Ｐ＜０．０１）。肥胖组男性睾丸的纵横径及阴茎的长度和围度与对照组比较均有显著性差异（Ｐ＜０．０１）。肥胖组男性首次遗精年龄及女性月经初潮年龄和第二性征发育均早于对照组，在统计学上均有显著意义（Ｐ＜０．０１）。提示肥胖组性激素分泌及性发育、性成熟均明显高于、早于对照组。由此可见肥胖促进了性发育和性成熟，使得肥胖儿易出现性早熟的倾向，因此对单纯性肥胖青少年的性教育显得更加重要。     

广西北海市6—14岁学生血清rT3的测定

本文介绍了用放射免疫分析法测定广西北海市２３２名６～１４岁学生血清中３，３＇，５＇──三碘甲腺原氨酸（ｒＴ＿３）的含量，结果为０．６１±０．１５ｎｍｏｌ／Ｌ。并对测定结果进行了分析。此数值可考虑作为我区正常儿童的ｒＴａ正常值。另外，测定了缺碘病区的７７名学生ｒＴ３的含量，结果为０．７８±０．２１ｎｍｏｌ／Ｌ。可见明显高放正常儿童的数值，其原因尚待进一步研究。     

矽尘接触者血脂质过氧化与微量元素铜、锌的相关分析

作者测试了１１６名矽尘接触者和８９名对照者血中脂质过氧化作用指标［丙二醛（ＭＤＡ）、过氧化物歧化酶（ＳＯＤ）、谷胱甘肽过氧化物酶（ＧＳＨ－Ｐｘ）］和血清铜、锌含量。结果显示，ＭＤＡ、ＳＯＤ、ＧＳＨ－Ｐｘ矽尘组分别为（５．５３１±１．８７２）μｍｏｌ／Ｌ、（２３９６±４１３）μｍｏｌ／（ｍｉｎ·ｇ）、（３５．０６±８．９４）μｍｏｌ／（ｍｉｎ·ｇ），均显著高于对照组。血清铜、锌、铜／锌比值矽尘组分别为（２４．８０±６．５６）μｍｏｌ／Ｌ、（１３．１１±４．６６）μｍｏｌ／Ｌ、２．２１±０．８７，血清铜、铜／锌比值明显高于对照组，而血清锌两组无显著差异。各指标间相关分析表明，ＭＤＡ与Ｃｕ、ＭＤＡ与Ｃｕ／Ｚｎ；ＳＯＤ与Ｃｕ、ＳＯＤ与Ｃｕ／Ｚｎ以及Ｃｕ与Ｃｕ／Ｚｎ呈正相关。其他指标之间无相关关系。作者认为生物膜的脂质过氧化和铜代谢在ＳｉＯ２所致的肺纤维化的病理机制中起重要作用，是肺纤维化有意义的指标，对判断肺损伤可能具有一定的价值。     

深圳市成人２５ （ＯＨ）ＶＤ 水平及其 与血糖的相关性研究

摘要：目的　了解深圳市企事业单位职工２５ （ＯＨ）维生素Ｄ ［２５ （ＯＨ）ＶＤ］的营养状况，并分析其与 血糖及糖化血红蛋白的相关性。方法　选取２０１３年７～１２月在深圳市某体检中心体检的深圳市机关和企事 业单位员工作为研究对象，采集空腹外周静脉血，采用酶联免疫法对血浆２５ （ＯＨ）ＶＤ 的含量进行检测， 并对血糖及糖化血红蛋白进行检测。分析检测指标的异常情况。结果　深圳企事业单位人群中２５ （ＯＨ） ＶＤ 的平均水平为（６０．９８±１５．９２）ｎｍｏｌ／Ｌ，２５ （ＯＨ）ＶＤ 缺乏或不足率为８３．３７％， 且性别之间２５ （ＯＨ）ＶＤ 的营养水平及不足与缺乏率差异有统计学意义；血糖及糖化血红蛋白的平均水平分别为（５．４５± ０．８８）ｍｍｏｌ／Ｌ 及（５．６９±０．５９）％ ；扣除年龄、性别及ＢＭＩ的影响，血清２５ （ＯＨ）ＶＤ 水平与血糖呈负 相关（狉＝－０．０６２，犘＜０．０１），与糖化血红蛋白有一定的相关性（狉＝ －０．０５１，犘＜０．０１）。结论　正常人 群中２５ （ＯＨ）ＶＤ 水平与血糖及糖化血红蛋白有一定的相关性，维持人体正常２５ （ＯＨ）ＶＤ 水平可能对 预防糖尿病的发生、降低糖尿病的患病率起到一定作用。 关键词：２５ （ＯＨ）ＶＤ；２５ （ＯＨ）ＶＤ 缺乏；血糖；糖化血红蛋白；相关性；深圳市；成人 中图分类号：Ｒ１９３　　文献标识码：Ａ　　文章编号：１００９ ６６３９ （２０１８）０３ ０１９２ ０５     

血清25羟基维生素D3对佝偻病的诊断价值

采用竞争蛋白结合法，测定佝偻病患儿与健康儿童血清２５羟基维生素Ｄ３（２５ＯＨＤ３）浓度。结果表明：佝偻病患儿血清２５（ＯＨ）Ｄ３浓度明显低于健康儿童组．佝偻病激期，血清２５（ＯＨ）Ｄ３水平明显低于初期水平，恢复期上升．且初期、激期、恢复期３组比较差异显著。提示血清２５（ＯＨ）Ｄ３可做为佝偻病的早期诊断指标，而且对判定佝偻病病期有极大的临床意义．     

老年人体内维生素D,PTH和骨矿含量调查

对９８名６５～７５岁的健康退休工人分别用放射免疫分析和免疫放射法测定血浆２５（ＯＨ）Ｄ和ＰＴＨ的含量，应用ＤＰＸ－Ｌ双能骨矿测定仪测定腰椎及髋部ＢＭＣ。结果表明：（１）该人群春季血浆２５（ＯＨ）Ｄ水平较低，男性为１１．４±５．０ｎｇ／ｍｌ，女性为１５．５±５．３ｎｇ／ｍｌ，其水平与腰椎及髋部ＢＭＣ没有关系。（２）老年女性血浆２５（ＯＨ）Ｄ浓度与血浆ＰＴＨ浓度呈负相关，而这种关系在老年男性不存在。（３）老年女性骨面积和体重身高校正后的股骨颈ＢＭＣ与血浆ＰＴＨ浓度呈反向关系，但其它部位ＢＭＣ以及老年男性所有部位ＢＭＣ均与血浆ＰＴＨ浓度无关。     

激光作业人员血脂调查

本文调查１３０名激光科研工作者的血脂。调查结果，激光作业人员各项血脂均值与标准差为：ＨＤＬ－Ｃ，男１．２３８±０．２４３ｍｍｏｌ／Ｌ，女１．２８８±０．２０７ｍｍｏｌ／Ｌ；ＨＤＬ－ｃ／ＴＣ，男０．３３±０．０８，女０．３４９±０．０８６；ＴＧ，男１．２２２±０．３７１ｍｍｏｌ／Ｌ，女１．２８４±０．６０２ｍｍｏｌ／Ｌ·ＨＤＬ－ｃ均值与ＨＤＬ－ｃ／ＴＣ比值明显低于对照组（Ｐ＜０．０１），ＴＧ均值明显高于对照组（Ｐ＜０．０１）。各指标异常率比较，激光组男性ＨＤＬ－ｃ、ＨＴＬ－／ＴＣ、ＴＣ与ＴＧ的异常率分别高于对照组（Ｐ＜０．０１），女性ＴＧ增高的异常率亦明显高于对照组（Ｐ＜０．０１）。结果提示激光工作者患冠心病的危险性增高。     

儿童血铅水平对智商的影响分析

对无锡市４３８名１～５岁儿童进行双盲法血铅及智商测定,血铅检测采用石墨炉原子吸收法,１～２岁及 ４～５岁儿童分别采用ＣＥＣＣ及ＷＰＰＳＩ 进行智商测定。以智商＞１２０分及＜７０分为高智商组和低智商组,血铅≥１００ ｕｇ／Ｌ和＜１００ｕｇ／Ｌ分为高血铅组和低血铅组。结果４３８名１～５岁儿童血铅均值为８６．０７±３１．５３ｕｇ／Ｌ,智商均值为 ９５．８３±１１．２２分。儿童铅中毒（血铅值≥１００ ｕｇ／Ｌ）发生率为２８．５４％,血铅水平的高低与智商呈负相关。高血铅组智商 均值为９２．０６±１５．５８分,低血铅组智商均值为９８．６２±１５．７２分;高智商组血铅均值为７６．２２±２４．１８ ｕｇ／Ｌ,低智商组血 铅均值为９９．４２±３３． ５３ ｕｇ／Ｌ。经统计学分析,血铅水平与智商之间有显著性差别,高、低血铅组智商相差达６． ５６分。提 出高血铅对儿童智能发育起着阻碍作用,应引起重视。     

孕期补充维生素D对先天性佝偻病的防治作用

将妊娠２８周的受试 妇随机分为４组，分别１次性口服维生素Ｄ（ＶＤ）１０万ＩＵ或肌注ＶＤ１０万ＩＵ或２０万ＩＵ，对照组口服空白胶囊。结果３个补充组产妇血和脐血２５－（ＯＨ）Ｄ水平以及产妇血钙水平显著高于垦，而产妇血和脐血２５－（ＯＨ）Ｄ小于２７．３ｎｍｏｌ／Ｌ（１１ｎｇ／ｍｌ）的发生率以及孕后期腿抽筋的发生率显著低于对照组，补充组产妇血２５－（ＯＨ）Ｄ水平高于其妊娠２８周时的水平。补充组发现先天性佝     

Higher concentrations of vitamin D in Canadian children with juvenile idiopathic arthritis compared to healthy controls are associated with more frequent use of vitamin D supplements and season of birth

A number of studies have demonstrated that patients with autoimmune disease have lower levels of vitamin D prompting speculation that vitamin D might suppress inflammation and immune responses in children with juvenile idiopathic arthritis (JIA).  The objective of this study was to compare vitamin D levels in children with JIA at disease onset with healthy children. We hypothesized that children and adolescents with JIA have lower vitamin D levels than healthy children and adolescents. Data from a Canadian cohort of children with new-onset JIA (n= 164, data collection 2007-2012) were compared to Canadian Health Measures Survey (CHMS) data (n=4027, data collection 2007-2011). We compared 25-hydroxy vitamin D (25(OH)D) concentrations with measures of inflammation, vitamin D supplement use, milk intake, and season of birth. Mean 25(OH)D level was significantly higher in patients with JIA (79 ± 3.1 nmol/L) than in healthy controls (68 ± 1.8 nmol/L P <.05). Patients with JIA more often used vitamin D containing supplements (50% vs. 7%; P <.05). The prevalence of 25(OH)D deficiency (<30 nmol/L) was 6% for both groups. Children with JIA with 25(OH)D deficiency or insufficiency (<50 nmol/L) had higher C-reactive protein levels. Children with JIA were more often born in the fall and winter compared to healthy children. In contrast to earlier studies, we found vitamin D levels in Canadian children with JIA were higher compared to healthy children and associated with more frequent use of vitamin D supplements. Among children with JIA, low vitamin D levels were associated with indicators of greater inflammation.     

Serum 25-hydroxyvitamin D levels among Mexican children ages 2 y to 12 y: A national survey

ObjectiveThe aim of this study was to assess the vitamin D status in preschool and school-age children in Mexico.Methods25-hydroxyvitamin D (25-OH-D) serum concentrations were measured using a direct enzyme-linked immunosorbent assay commercial kit in a nationally representative sample of 1025 Mexican children ages 2 y to 12 y who participated in the 2006 Mexican National Health and Nutrition Survey.ResultsMean serum 25-OH-D concentration was 94.6 ± 47 nmol/L. Concentrations were lower in preschool children (2–5 y; 78.3 ± 37 nmol/L) than in school-aged children (6–12 y; 105.8 ± 51 nmol/L; P < 0.001). Children living in urban areas had lower levels (89.8 ± 36 nmol/L) than children from rural areas (108.1 ± 75 nmol/L; P < 0.05). Twenty-four percent of preschool children had vitamin D deficiency (25-OH-D < 50 nmol/L) compared with 10% of school-aged children (P < 0.05). Thirty percent of preschool children had vitamin D insufficiency (25-OH-D 50–74.9 nmol/L) compared with 18% of school-aged children (P < 0.05). In urban areas, 18% of children had vitamin D deficiency and 25% had insufficiency compared with 10% and 16% of children in rural areas, respectively (P < 0.05). Prevalence of severe vitamin D deficiency (25-OH-D < 20 nmol/L) was extremely low (0.3%).ConclusionsVitamin D deficiency and insufficiency are important public health problems in Mexican children.     

广州地区儿童维生素D营养状况及其与超重肥胖关系的研究

目的 了解广州地区儿童维生素D(Vit D)营养状况,分析儿童超重肥胖与Vit D营养状况的关系,为儿童Vit D的合理补充、预防Vit D缺乏性疾病提供科学依据。方法 采用横断面研究,收集广东省妇幼保健院健康体检儿童的年龄、性别,测量身高、体重,计算体质指数(BMI),采集空腹静脉血,用化学发光法检测血清中25-羟维生素D[25-(OH)D]水平。结果 共收集7 578名儿童,血清25-(OH)D平均水平为(98.57±39.96)nmol/L,其中男童为(98.58±39.64)nmol/L,女童为(98.56±40.38)nmol/L,差异无统计学意义(P>0.05);658名儿童Vit D缺乏 (8.68%)、1 602名儿童Vit D不足 (21.14%),不同性别儿童Vit D缺乏率及不足率差异无统计学意义(P>0.05)。不同年龄儿童血清25-(OH)D水平差异有统计学意义(P<0.05),血清25-(OH)D水平随年龄增加逐渐下降;不同年龄儿童Vit D营养状况差异有统计学意义(P<0.05),Vit D缺乏率及不足率随年龄增加而升高(χ²_趋势=275.266,P<0.05)。超重、肥胖儿童血清25-(OH)D水平低于正常儿童,差异有统计学意义(P<0.05);超重、肥胖儿童Vit D缺乏率及不足率均高于正常儿童,差异有统计学意义(P<0.05)。血清25-(OH)D水平与BMI呈负相关(P<0.001)。结论 广州地区学龄儿童和超重肥胖儿童Vit D营养状况均较差,应重视儿童尤其是学龄儿童、超重、肥胖儿童Vit D的合理补充。     

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.     

2012年广州地区25 295名儿童维生素D营养状况分析

目的 分析广州地区25 295名儿童维生素D营养状况与年龄、季节的关系。 方法 采用酶联免疫法检测25-羟基维生素D[25-(OH)D]水平,收集2012年全年广州市妇女儿童医疗中心25 295例0~16周岁健康儿童25-(OH)D结果,维生素D营养状况以血清水平判断:维生素D严重缺乏(<12.5 nmol/L)、维生素D缺乏(12.5~37.5 nmol/L)、维生素D不足(37.5~50.0 nmol/L),分别各年龄组及各月份应用SPSS 17.0统计软件进行分析。结果 2012年广州地区25 295例儿童25-(OH)D平均水平72.41 nmol/L,无性别差异;无维生素D严重缺乏病例;25-(OH)D<50 nmol/L的比例为13.22%。儿童25-(OH)D水平随年龄的增长而降低,维生素D的缺乏和不足与年龄呈正比;2012年1月份为全年最低水平,1~7月份25-(OH)D水平逐月上升, 8、9月份达到全年峰值,10~12月份逐月下降;各月份维生素D缺乏和不足的比例在1月份为全年最高,全年最低值在9月份。 结论广州地区在冬春季节儿童维生素D营养水平较低,3周岁以上的儿童维生素D营养缺乏较严重。     

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。     

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.     

Perinatal Vitamin D and Calcium Status of Northern Canadian Mothers and Their Newborn Infants

Objective: This study was undertaken to examine the vitamin D and calcium status of mothers and their newborns.

Methods: The intakes of vitamin D and calcium were determined prenatally in 121 women including 33 Caucasians, 51 Inuits, and 37 Native Indians, living in the Inuvik zone of the Northwest Territories. Plasma concentrations of 25-(OH)-D and calcium were also measured in mothers as well as in their offspring at delivery.

Results: The daily mean vitamin D intake of native mothers, including Inuits and Indians, with (8.1±5.5 μg) and without supplements (3.4±2.5 μg) was significantly lower than that of non-native mothers (13.2±5.9 μg and 5.8±4.3 μg, respectively). According to the predicted prevalence of low vitamin D intake, there existed a higher risk of vitamin D deficiency without supplementation in both native (88.6% vs 48.4%) and non-native (63.5% vs. 15.1%) mothers. The trend for calcium intakes with and without supplementation was similar to vitamin D intake. At the point of delivery, the plasma levels of 25-(OH)-D were lower in native mothers (50.1±19.3 nmol/L) and their offspring (34.2±13.1 nmol/L) than their counterparts (59.8±29.4 nmol/L and 41.4±23.5 nmol/L, respectively). Its plasma levels in newborn infants averaged only 67% of their mothers. None of these infants showed clinical evidence of vitamin D deficiency. In fact, their plasma calcium levels were significantly higher than their mothers.

Conclusions: Plasma 25-(OH)-D concentrations of 60 to 70% of maternal levels may represent a “normal” range for newborn infants. However, a supplementation in native northern Canadian mothers during pregnancy and in their neonates during infancy may have a role to play in the prevention of vitamin D deficiency.     

成都市0～6岁儿童25-羟维生素D水平调查

目的:了解成都市儿童维生素D的营养状况。方法:对来医院儿童保健科门诊进行常规体检的0～6岁701例儿童采用酶联免疫法进行血清25-(OH)D检测。结果:25-(OH)D的平均测定值为(68.60±1.29)nmol/L,25-(OH)D缺乏及严重缺乏的为226例,占32.24%;25-(OH)D水平不足的为237例,占33.811%;水平充足(合适水平)的为238例,占33.95%,前两者占总人数的66.05%。男性和女性血清25-(OH)D水平差异无统计学意义(P>0.05),但25-(OH)D水平随着年龄增高而呈下降(P<0.01)。血清25-(OH)D水平夏秋季显著高于春冬季节(P<0.05)。结论:成都市0～6岁儿童25-(OH)D水平低下,应增加该地区儿童的维生素D摄入量及加强户外活动,尤需重视3～6岁的儿童及冬春季节维生素D的补充。     

肥胖儿童血清25羟维生素D水平及其临床意义

目的 观察学龄期肥胖与体重正常儿童血清25羟维生素D[25(OH)D]水平及其与儿童肥胖程度及糖脂代谢的关系。方法 按照《中国0~18岁儿童青少年体块指数的生长曲线》标准,从学龄期儿童中筛选出超重和肥胖儿童作为肥胖组,并设置同年龄、体重正常儿童为对照组。采用ELSIA测定血清25羟维生素D[25(OH)D]、甲状旁腺素(parathyroid hormone,PTH),全自动生化分析仪测定血生化指标。结果 肥胖儿童59人(男童45人,女童14人),平均年龄(9.58±2.39)岁,BMI 为25.14±4.02;对照组35人(男童23人,女童12人),平均年龄(8.92±1.56)岁,BMI为15.56±1.51。肥胖组儿童血清25(OH)D(45.40±11.86)nmol/L明显低于对照组儿童(59.56±16.08)nmol/L,差异有高度统计学意义(P<0.001),骨密度低于正常组儿童(P<0.001);血清25(OH)D浓度与BMI SDS、腰围、腰臀比及血甘油三脂呈显著负相关(P<0.05);25(OH)D低于50 nmol的肥胖儿童的甘油三脂水平[(2.08±0.26) mmol/L]明显高于25(OH)D大于50 nmol的肥胖儿童[(1.41±0.14) mmol/L]。 结论 肥胖儿童血清25(OH)D浓度明显低于体重正常儿童,血清25(OH)D浓度与儿童BMI SDS、腰围、甘油三脂呈负相关提示维生素D缺乏可能是儿童中心性肥胖和代谢综合症的危险因素。