687例儿童血清25羟维生素D检测与影响因素分析

目的 了解神木市儿童血清25羟维生素D[25-(OH)D]水平,寻找影响因素并评价危险程度,为防治该地区维生素D(VD)缺乏提供理论依据。方法 选取2016年1月-2017年12月在神木市医院儿童保健科健康查体儿童共687例。采用化学发光免疫法测定血清25-(OH)D水平并分析影响因素。结果 共收集687例健康儿童血清VD,最高值为96.9 ng/ml,最低值为2 ng/ml,平均水平为(32.59±13.14)ng/ml,其中VD缺乏120例(17.5%),VD不足169例(24.6%),VD适宜398例(57.9%),无VD过量及中毒。单因素分析结果显示,VD水平与年龄、季节、每天户外活动时间、曾添加过VD、持续服用VD时间、近三月是否添加VD相关(P<0.05)。进一步Logistic回归分析显示,户外活动时间[在30 min与2 h之间(OR=0.43,95%CI:0.22~0.84,P=0.03)、持续服用VD时间在3月~1年之间(OR=0.12,95%CI:0.05~0.28,P<0.001)是影响VD水平的因素。结论 户外活动时间、持续服用VD时间是VD缺乏的保护性因素。VD缺乏重在预防,应加强健康宣教。

Analysis of the status and influencing factors of serum 25-hydroxy vitamin D in 687 children

Objective To understand the serum level of 25-hydroxy vitamin D [25-(OH)D] in children from Shenmu,to evaluate the risk degree and to find out the influencing factors,thereby providing theoretical basis for the prevention and treatment of vitamin D deficiency in this area. Methods A total of 687 children were selected for health examination in child health clinic from January 2016 to December 2017.Serum 25-(OH)D₃ concentrations of children was tested by chemiluminescence immunoassay,and the influencing factors were analyzed. Results The maximum value of 25-(OH)D in 687 children was 96.9 ng/ml,and the minimum value was 2 ng/ml,with the average level of (32.59±13.14) ng/ml.The number of children with vitamin D deficiency,insufficiency,appropriate level of vitamin D was 120(17.5%),169(24.6%) and 398(57.9%),respectively.No children existed excessive vitamin D level or vitamin D intoxication.Single factor analysis indicated that vitamin D level was related to age,season,daily time for outdoor activity,previous supplementation of vitamin D,duration of vitamin D supplementation,vitamin D supplementation over the past three months(P＜0.05).Logistic regression analysis showed that daily outdoor activity time for 30 min to 2 hours (OR=0.43,95%CI:0.22-0.84,P=0.03) and vitamin D supplementation for 3 months to one year (OR=0.12,95%CI:0.05-0.28,P<0.001) were protective factors for vitamin D deficiency. Conclusion The protective factor of vitamin D deficiency is the duration of outdoor activities and vitamin D supplementation.The key to reduce vitamin D deficiency is prevention,and health education is supposed to be strengthened.