目的 分析儿童血清维生素K2的临床特征及其与骨密度的相关性,为预防儿童骨强度不足提供参考依据。方法 回顾性选取2020年1月—2023年3月期间,在重庆市数家市、县级医院儿科门诊体检行血清维生素K2检测的4 145名儿童为研究对象,进行血清维生素K2相关分析。进一步筛选出完成血清25-(OH)D和腰椎骨密度测定的学龄期儿童844例,分析维生素K2水平与骨密度的相关性。 结果 血清维生素K2缺乏的总体检出率为61.6%(2 553/4 145),不同年龄段间血清维生素K2缺乏检出率差异有统计学意义(χ2=39.364,P<0.05),婴儿期和学龄期检出率较高。儿童维生素K2水平受季节和母亲文化水平影响,差异有统计学意义(χ2=45.310,9.990,P<0.05)。骨量发育正常组和不足组儿童年龄(Z=3.416)、性别(χ2=9.218)和血清维生素K2水平(χ2=5.826)比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果提示:维生素K2缺乏是学龄期儿童骨量发育不足的独立危险因素(OR=1.37,95%CI:1.03~1.83,P=0.030)。结论 儿童群体中维生素K2缺乏率较高,应重点关注婴儿期和学龄期儿童;学龄期儿童骨量发育不足与血清维生素K2缺乏有关。
Abstract
Objective To analyze the clinical characteristics of serum vitamin K2 in children and its correlation with bone mineral density, so as to provide reference for the prevention of insufficient bone strength in children. Methods A total of 4 145 children who underwent serum vitamin K2 testing and physical examination at pediatric outpatient clinics of several municipal and county hospitals in Chongqing from January 2020 to March 2023 were retrospectively selected into this study for serum vitamin K2-related analysis.Further 844 school-age children who completed serum 25-(OH)D and lumbar bone densitometry measurements were screened to analyze the correlation between vitamin K2 level and bone mineral density. Results The overall serum vitamin K2 deficiency rate was 61.6% (2 553/4 145), and the difference in serum vitamin K2 deficiency rate between different age groups was statistically significant (χ2=39.364, P<0.05).The vitamin K2 level of children was significantly influenced by season and maternal education level (χ2=45.310,9.990, P<0.05).There were significant differences in age (Z=3.416), gender (χ2=9.218) and serum vitamin K2 deficiency rate (χ2=5.826) between normal bone mass development group and insufficient bone mass development group (P<0.05).Multivariate Logistic regression analysis suggested that vitamin K2 deficiency was an independent risk factor for insufficient bone mass development in school-age children (OR=1.37,95%CI:1.03 - 1.83, P=0.030). Conclusions There is a higher serum vitamin K2 deficiency rate among children, especially infants and school-age children.Decreased bone mineral density in school-age children may be associated with serum vitamin K2 deficiency.
关键词
维生素K2 /
骨密度 /
骨量发育不足 /
儿童
Key words
vitamin K2 /
bone mineral density /
insufficient bone mass development /
children
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基金
国家卫生健康委员会一般项目(WA2022HK02)