昆明地区儿童血清 25羟基维生素 D水平检测及维生素 D营养状态分析

目的　了解昆明地区儿童血清 25羟基维生素 D 25（OH）D]水平及维生素 D营养状态，为儿童合理补充维生素 D提供科学依据。方法　选取昆明市第一人民医院 2016年 11月 ~2019年 10月体检儿童 0～ 14岁 600例为研究对象，采用液相色谱串联质谱（ LC-MS/MS）法检测血清 25（OH）D水平，分析不同性别、年龄及季节儿童血清 25（OH）D水平及营养状态。结果　600例 0～ 14岁儿童血清 25（OH）D水平为 27.44±8.82 ng/ml。血清 25（OH）D缺乏率为 19.33%（116/600），不足率为 47.67%（286/600），充足率为 33.00%（198/600）。女童的缺乏率（ 24.83%）高于男童（ 14.33%），儿童血清 25（OH）D的缺乏、不足和充足率在不同性别间差异有统计学意义（ χ2=11.784，P<0.01）。6～ 14岁儿童血清 25（OH）D缺乏率高于 0～ 1岁、1～ 3岁和３～６岁儿童（ 46.81% vs 5.88%，5.86%和 19.53%），血清 25（OH）D的缺乏、不足和充足率在不同年龄段上差异有统计学意义（ χ2=188.515，P<0.01）。夏、冬季的儿童血清 25（OH）D缺乏率高于春、秋季（ 22.00%，27.50% vs 12.80%，11.43%），不同季节血清 25（OH）D的缺乏、不足和充足率差异有统计学意义（ χ2=14.492，P<0.05）。结论　昆明地区 0～ 14岁儿童血清 25（OH）D营养状况欠佳，应加强维生素 D健康宣传工作，提高儿童血清 25（OH）D的监测，特别关注 3～ 14岁阶段儿童维生素 D的补充。

Detection of Serum 25-Hydroxyvitamin D Level and Analysis of Vitamin D Status in Children in Kunming

Objective To study the levels and status of serum 25-hydroxyvitamin D25(OH)D]in children in Kunming City and provide scientific basis for the rational supplement of vitamin D for children.Methods A total of 600 children aged 0~14 years from November 2016 to October 2019 in the First People’s Hospital of Kunming for physical examination were selected as subjects.The serum 25(OH)D levels were measured by liquid chromatography tandem mass spectrometry(LC-MS/MS).The relationship between the levels and nutritional status of serum 25(OH)D and sexs,ages,seasons were analyzed.Results The serum 25(OH)D levels of 600 children aged 0~14 years was 27.44±8.82 ng/ml.The serum 25(OH)D deficiency rate was 19.33%(116/600),insufficiency rate was 47.67%(286/600)and adequacy rate was 33.00%(198/600).The rate of serum 25(OH)D deficiencyin girls(24.83%)was higher than that in boys(14.33%).There was significant differences in the rate of serum 25(OH)-D deficiency,insufficiency and adequacy between boys and girls(χ^2=11.784,P<0.01).The rate of serum 25(OH)D deficiency in children aged 6~14 years was higher than that in children aged 0~1,1~3 and 3~6 years(46.81%vs 5.88%,5.86%and 19.53%),the rate of serum 25(OH)D deficiency,insufficiency and adequacy was significant differences in different ages(χ^2=188.515,P<0.01),and the rate of serum 25(OH)D deficiency in summer and winter was higher than that in spring and autumn(22.00%,27.50%vs 12.80%,11.43%).There was also significant differences in the rate of serum 25(OH)D deficiency,insufficiency and adequacy in different seasons(χ^2=14.492,P<0.05).Conclusion The nutritional status of serum 25(OH)D in children aged 0~14 years in Kunming City is not optimistic.The healtheducation of vitamin D shouldbe strengthened.It is necessary to improve the monitoring of serum 25(OH)D,especially should pay attention to vitamin D supplementation for children aged 3~14 years.