目的 探讨儿童骨骼发育与维生素K的关联性,为日后临床及时干预儿童时期异常骨骼发育提供理论依据。方法 以2020年1月—2022年4月到四川省内数家妇幼保健机构儿童保健门诊进行健康体检的6 335名0～14岁儿童为研究对象,采用液相串联质谱法检测维生素K1、K2的水平,同时记录其骨骼发育情况。以是否存在骨骼发育异常分为正常组(n=5 040例)和异常组(n=1 295例),对两组指标进行差异性分析,并通过Logistic回归分析儿童骨骼发育的影响因素,尤其是维生素K与儿童骨骼发育异常的关联性。结果 骨骼发育正常组和异常组儿童性别、年龄、身高、体质量、血清维生素D、K1、K2比较差异有统计学意义(χ2=6.03,Z=14.32、16.35、16.70、8.26、5.70,χ2=13.88,P＜0.05)。不同年龄组儿童骨骼发育异常检出率比较,差异有统计学意义(χ2=158.66,P＜0.05);异常组各年龄段维生素K2＜0.10ng/mL占比情况比较,差异无统计学意义(P＞0.05),维生素K1水平比较,差异有统计学意义(Z=36.5,P＜0.05);正常组中各年龄段儿童维生素K2、K1水平比较,差异有统计学意义(χ2=47.58、Z=582.65,P＜0.05)。多因素Logistic回归分析结果提示:女性(OR=0.857, 95%CI:0.755～0.973,P＜0.05)、体质量(OR=0.949, 95%CI:0.931～0.968)是儿童骨骼发育异常的保护因素(P＜0.05),身高(OR=1.044, 95%CI:1.034～1.054)、维生素K2＜0.1ng/mL(OR=1.153, 95%CI:1.006～1.320)均是儿童骨骼发育异常的危险因素(P＜0.05)。结论 儿童骨骼发育受多种因素影响;在维生素K中,主要是维生素K2影响儿童骨骼发育,且维生素K2＜0.1ng/mL儿童较维生素K2≥0.1ng/mL儿童更易出现骨骼发育异常,监测及干预儿童维生素K2水平,对骨骼发育异常疾病早期预防,有一定临床意义。
Abstract
Objective To explore the association between bone development and vitamin K in 6 335 children aged 0 to 14 years, in order to provide a theoretical basis for future clinical intervention of abnormal bone development in children. Methods From January 2020 to April 2022, 6 335 children aged 0 to 14 years who took physical examination in the child health department of several maternal and child health hospitals in Sichuan Province were selected in this study. Serum levels of vitaminK1 and K2 were tested by liquid tandem mass spectrometry, meanwhile, the conditions of bone development was recorded. The children were divided into normal group (n=5 040) and abnormal group (n=1 295) according to the bone development result. Then the differences between the two groups were analyzed, andthe influencing factors of bone development in children,especillythe relationship between abnormal bone development and vitamin K was analyzed by Logistic regression. Results There were significant differences in gender(χ2=6.03), age(Z=14.32), height(Z=16.35), weight(Z=16.70), serum vitamin D(Z=8.26),K1(Z=5.70) and K2(χ2=13.88) between normal bone development group and abnormal bone development (P＜0.05). The detection rate of skeletal dysplasia in children at different age groups was statistically significant (χ2=158.66, P<0.05). There was no significant difference in the proportion of vitamin K2<0.10ng/mL among different age groups (P>0.05), but the level of vitamin K1 among different age groups was statistically significant (Z=36.5, P<0.05). The levels of vitamin K2 and K1 in children among different ages in the normal group were compared, and the difference was statistically significant (χ2=47.58, Z=582.65, P<0.05).Logistic regression analysis showed that female(OR=0.857,95%CI:0.755-0.973) and weight (OR=0.949,95%CI:0.931-0.968) were protective factors of bone development in children (P<0.05) , height (OR=1.044,95%CI:1.034-1.054) , and vitamin K2<0.1ng/mL(OR=1.153,95%CI:1.006-1.320) were risk factors for bone development in children(P<0.05). Conclusions The development of children's bones is influenced by various factors.Among vitamin K, it is mainly vitamin K2 that affects children′s bone development, and children with vitamin K2< 0.1ng/mL are more likely to have abnormal bone development than children with vitamin K2≥0.1ng/mL. Monitoring and intervening vitamin K2 level in children is of certain clinical significance for the early prevention of abnormal bone development diseases.
关键词
骨骼发育 /
维生素K /
儿童
Key words
bone development /
vitamin K /
children
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基金
国家卫生健康委医药卫生科技发展研究中心(WA2020HK01)
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