柳州市城区1～6岁儿童血清25-羟基维生素D水平调查分析
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摘要
目的了解柳州市城区儿童血25-(OH)D水平,为合理补充维生素D(VD)提供科学依据。方法以2016年7月15日-2017年7月14日在柳州市妇幼保健院儿保科门诊体检的1岁半～6岁4 560名入托儿童为研究对象。采用化学发光法检测血清25-(OH)D水平。结果 4 560名学龄前儿童血25-(OH)D平均水平为(101.57±31.56) nmol/L,VD缺乏及不足率为19.91%。1岁组儿童VD水平最高,随年龄增长而降低(F=208.962,P<0.001)。4～6岁组儿童的VD缺乏及不足率明显高于1～3岁组(χ~2=360.878,P<0.001)。冬春季节的缺乏及不足率明显高于夏秋季节(χ~2=82.739,P<0.001)。2岁后儿童VD补充剂使用率明显降低,超过50%的3岁及以上儿童不服用VD补充剂。结论柳州市城区学龄前儿童冬春季节儿童VD水平较低,以4～6岁儿童VD缺乏及不足率较严重,建议长期合理补充VD制剂。
Objective To investigate the level of 25-hydroxyl vitamin D [25-(OH)D] in children aged 1 to 6 years in Liuzhou area,in order to provide the scientific basis for rational supplement of vitamin D(VD). Method Totally 4 560 preschool children undergoing the physical examination in the Pediatric Health Care Department of Maternal and Child Health Hospital of Liuzhou were enrolled in this study from 15 th July,2016 to 14 th July,2017.Serum level of 25-(OH)D was tested by the electrochemiluminescence immunoassay. Results The average level of 25-(OH)D in 4 560 children was(101.57±31.56) nmol/L,and 908 children(19.91%) were found with 25-(OH)D insufficiency and deficiency.The 25-(OH)D level in one-year-old children was much higher than that in other age groups and the serum 25-(OH) D level decreased with age in children over 2 years old(F=208.962,P<0.001).The rates of VitD insufficiency and deficiency among children aged 4 to 6 years were much higher than those in children aged 1 to 3 years(χ~2=360.878,P<0.001).The rates of VD insufficiency and deficiency in winter and spring were significantly higher than those in summer and autumn(χ~2=82.739,P<0.001).VD supplements decreased obviously in children over 2 years old,and over 50% of 3-year-old children did not take VD supplements. Conclusions VD insufficiency and deficiency is common in children aged 4 to 6 years in Liuzhou,especially in winter and spring.So it is recommended that VD supplements should be taken in a long-term and reasonable manner.
Objective To investigate the level of 25-hydroxyl vitamin D [25-(OH)D] in children aged 1 to 6 years in Liuzhou area,in order to provide the scientific basis for rational supplement of vitamin D(VD). Method Totally 4 560 preschool children undergoing the physical examination in the Pediatric Health Care Department of Maternal and Child Health Hospital of Liuzhou were enrolled in this study from 15 th July,2016 to 14 th July,2017.Serum level of 25-(OH)D was tested by the electrochemiluminescence immunoassay. Results The average level of 25-(OH)D in 4 560 children was(101.57±31.56) nmol/L,and 908 children(19.91%) were found with 25-(OH)D insufficiency and deficiency.The 25-(OH)D level in one-year-old children was much higher than that in other age groups and the serum 25-(OH) D level decreased with age in children over 2 years old(F=208.962,P<0.001).The rates of VitD insufficiency and deficiency among children aged 4 to 6 years were much higher than those in children aged 1 to 3 years(χ~2=360.878,P<0.001).The rates of VD insufficiency and deficiency in winter and spring were significantly higher than those in summer and autumn(χ~2=82.739,P<0.001).VD supplements decreased obviously in children over 2 years old,and over 50% of 3-year-old children did not take VD supplements. Conclusions VD insufficiency and deficiency is common in children aged 4 to 6 years in Liuzhou,especially in winter and spring.So it is recommended that VD supplements should be taken in a long-term and reasonable manner.
引文
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[9] Lichtenstein A,FerreiraJúnior M,Sales MM,et al.Vitamin D:non-skeletal actions and rational use[J].Rev Assoc Med Bras,2013,59(5):495-506.
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[11] Saraff V,Shaw N.Sunshine and Vitamin D[J].Archives of disease in childhood,2016,101(2):190-192.
[12] Terushkin V,Bender A,Psaty EL,et al.Estimated equivalency of vitamin D production from natural sun exposure versus oral vitamin D supplementation across seasons at two US latitudes[J].J Am Acad Dermatol,2010,62(6):929.
[2] 姚碧容,成婧,钟昊,等.2014年长沙地区16395例儿童维生素D水平分析[J].临床与病理杂志,2015,35(10):1783-1787.
[3] 邵小飞,郑娟,刘杰.1309例0～7岁儿童25-羟基维生素D水平分析[J].中国妇幼卫生杂志,2015,6(3):26-29.
[4] 刘金荣,留佩宁.温州地区0～6岁婴幼儿25-羟维生素D水平调查[J].现代实用医学,2016,28(12):1618-1619.
[5] 《中华儿科杂志》编辑委员会.维生素D缺乏性佝偻病防治建议[J].中华儿科杂志,2008,46(3):190-191.
[6] 毛萌,金星明.儿童保健与发育行为诊疗规范[M].北京:人民卫生出版社,2015.
[7] 中华人民共和国国家卫生健康委员会,WS/T 578.4-2018.中国居民膳食营养素参考摄入量第4部分:脂溶性维生素[S].北京.2018-04-27.
[8] 钟龙青,柯江维.维生素D与儿童相关疾病研究进展[J].实验与检验医学,2018,36(1):1-2.
[9] Lichtenstein A,FerreiraJúnior M,Sales MM,et al.Vitamin D:non-skeletal actions and rational use[J].Rev Assoc Med Bras,2013,59(5):495-506.
[10] 刘珍,王晓明.维生素D 与哮喘、过敏和呼吸道感染相关性的研究进展[J].中外医疗,2017,37(2):191-195.
[11] Saraff V,Shaw N.Sunshine and Vitamin D[J].Archives of disease in childhood,2016,101(2):190-192.
[12] Terushkin V,Bender A,Psaty EL,et al.Estimated equivalency of vitamin D production from natural sun exposure versus oral vitamin D supplementation across seasons at two US latitudes[J].J Am Acad Dermatol,2010,62(6):929.
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