603名青春期儿童维生素D水平状况相关研究

目的 了解青春期儿童维生素D(VD)水平状况及其影响因素,分析导致VD不足的原因,为后续研究和防治提供科学依据。方法 2015-2016年随机抽取哈尔滨市某城区某中学603名6~8年级11~17岁青春期儿童进行体格检查、问卷调查及实验室检测血清25(OH)D、甲状旁腺素(PTH)、钙(Ca)、磷(P)和碱性磷酸酶(ALP)的水平。结果 603名青春期儿童血清25(OH)D的中位数和四分间距位数为14.16 (10.68, 18.46)ng/ml,VD不足和缺乏占81.1%。血清PTH、Ca、P、ALP水平分别为42.7(31.90, 60.70)pg/ml、(2.47±0.13) mmol/L、(1.57±0.21) mmol/L、(275.23±127.60) U/L。血清25(OH)D与PTH水平和ALP水平之间呈负相关(r=-0.039、-0.141,P<0.001),与Ca呈正相关(r=0.312,P<0.001),与P无明显相关性。PTH和25(OH)D为对数关系,当PTH达到最大抑制状态时无25(OH)D拐点值。户外活动时间、补充VD制剂与血清25(OH)D水平呈正相关(P_趋势<0.001),户外活动时间、VD制剂的补充是青春期儿童VD水平的重要影响因素。结论 11~17岁青春期儿童VD缺乏情况普遍存在。血清PTH、ALP和Ca,这些指标的测定有助于评价青春期儿童VD水平状况,建议通过鼓励青春期儿童增加户外活动,补充VD制剂等手段,可以提高血清25(OH)D水平。

Study on vitamin D level of 603 adolescent children in Harbin

Objective To know about serum vitamin D (VD) level of the adolescence children and the its influencing factors, and to analyze the causes of VD insufficiency, so as to provide scientific reference for further research. Methods A total of 603 healthy adolescence children aged 11 to 17 years were enrolled in this study, and were taken physical examination, questionnaire survey from 2015 to 2016. Serum levels of 25(OH)D, parathyroid hormone (PTH), calcium (Ca), phosphorus (P) and alkaline phosphatase (ALP) of the participants were tested. Results Serum 25(OH)D level of 603 adolescence children were 14.16 (10.68, 18.46) ng/ml, and 81.1% adolescent children had VD deficiency and insufficiency. Serum levels of PTH, Ca, P and ALP were 42.7(31.90, 60.70) pg/ml, (2.47±0.13) nmol/L, (1.57±0.21) nmol/ L and (275.23±127.60) U/L. Serum 25(OH)D level was negatively correlated with PTH level and ALP level(r＝-0.039,-0.141,P<0.01), positively related to serum Ca level(r=0.312,P＜0.001). There was a logarithmic correlation between PTH and 25(OH)D, and no 25(OH)D inflection point appeared when PTH reached the maximum inhibition state.Outdoor activities time, VD supplementation was positively related to serum 25(OH)D level(P _trend＜0.01). Conclusions Vitamin D deficiency and insufficiency among adolescents is common. Indicators like serum PTH,ALP and Ca levels would help to assessing VD level of children. So it is suggested to encourage outdoor activities, take VD supplementation to improve 25(OH)D level of children.