不同维生素D预防剂量婴幼儿血清25-羟基维生素D状况研究

目的：了解重庆地区婴幼儿不同维生素D（vitamin D，VD）预防剂量状态下VD营养状况及其影响因素, 为合理补充VD提供参考。方法：选取重庆市不同经济水平地区5所医院健康体检婴幼儿751例（0~3岁），采用问卷调查，并检测其血清25-羟基维生素D 25(OH)D]水平，根据不同VD预防剂量、年龄、季节、喂养方式等分组，了解以上因素对25(OH)D的影响。结果：0~3岁婴幼儿VD补充率74.6%（560/751），VD预防剂量30~1 600 IU/d；25(OH)D水平为（35.29±10.39）ng/mL，并随VD补充量的升高呈现先升高、后保持平稳的趋势；未补充组25(OH)D水平为（30.51±11.03）ng/mL，显著低于补充组；未补充组中VD不足及缺乏率达14.7%，高于补充组（P<0.05）；高剂量补充组（>600 IU/d）较其他组VD缺乏和不足的比率明显下降（P<0.05）；不同季节、年龄、喂养方式、预防剂量可影响25(OH)D水平，以冬春季无食物来源儿童25(OH)D水平最低（18.44±11.91）ng/mL]。结论：重庆地区0~3岁婴幼儿预防性VD补充率高，但补充剂量差异较大。VD预防性补充是维持婴幼儿体内25(OH)D水平的重要措施，季节和喂养方式可显著影响VD营养状态

Serum 25-Hydroxy Vitamin D Level in Children with Different Doses of Vitamin D Supplementation

Objective: To investigate the nutritional status of vitamin D (VD) and its influencing factors under different doses of vitamin D supplementation for infants in Chongqing, so as to provide reference for rational supplementation of VD. Methods: A total of 751 healthy infants and young children (from 0 to 3 years old) from 5 hospitals in different economic levels of Chongqing were selected, and the serum 25-hydroxyvitamin D (25(OH)D) levels were detected by questionnaire survey. According to different doses of vitamin D supplementation, age, season, feeding methods and other groups, the impacts of the above factors on 25(OH)D were investigated. Results: The VD supplement rate of infants aged from 0 to 3 years old was 74.6% (560/751), and the preventive dose of VD was from 30 to 1,600 IU/d. The 25(OH)D level was (35.29±10.39) ng/mL, and increased firstly and then remained stable with the increase of VD supplementation. The 25(OH)D level was (30.51±11.03) ng/mL in children without supplementation, significantly lower than that in children with supplementation. The VD insufficiency and deficiency rate of the no-supplementation group was 14.7%, significantly higher than that in the supplementation group (P<0.05). The VD deficiency and inficiency rate of the high-dose supplementation group (>600 IU/d) was significantly lower than that in other groups (P<0.05). Different preventive dose, season, age and feeding method could affect the 25(OH)D level. Children without supplementation from food in winter and spring had the lowest 25(OH)D level of (18.44±11.91) ng/mL. Conclusion: The VD supplementation rate of children from 0 to 3 years old is relative high in Chongqing, however, there is a great variation in dose of daily supplementation. Preventive VD supplementation is an essential measure to maintain the normal 25(OH)D level. Season and feeding method can significantly affect the nutritional status of VD