3024名1～6岁儿童骨密度与骨代谢相关因素的临床研究

doi:10.11852/zgetbjzz2024-1103

中国儿童保健杂志 ›› 2025, Vol. 33 ›› Issue (12): 1372-1375.DOI: 10.11852/zgetbjzz2024-1103

3024名1～6岁儿童骨密度与骨代谢相关因素的临床研究

徐燕芬, 董文红, 卢韦, 沈盈

浙江大学医学院附属儿童医院儿保科/国家儿童健康与疾病临床医学研究中心,浙江杭州 310003

收稿日期:2024-09-11 修回日期:2025-03-18 发布日期:2025-12-02 出版日期:2025-12-10
通讯作者: 沈盈,E-mail:93234451@qq.com
作者简介:徐燕芬(1981—),本科学历,主管护师,主要研究方向为儿童健康管理,婴幼儿营养。
基金资助:
浙江省教育厅一般科研项目(自然科学类)(Y202249557)

Clinical study of bone mineral density and related factors of bone metabolism in 3 024 children aged 1 to 6 years

XU Yanfen, DONG Wenhong, LU Wei, SHEN Ying

Department of Child Care,Children′s Hospital Affiliated to Zhejiang University School of Medicine/National Clinical Research Center of Child Health and Disease, Hangzhou, Zhejiang 310003, China

Received:2024-09-11 Revised:2025-03-18 Online:2025-12-10 Published:2025-12-02
Contact: SHEN Ying,E-mail:93234451@qq.com

摘要/Abstract

摘要： 目的分析儿童骨密度与性别、年龄、体质量指数(BMI)、血钙、血磷、血清碱性磷酸酶(ALP)和血清25-羟维生素D[25-(OH)D]的关系,为促进儿童骨骼健康提供科学依据。方法选取2018年6月—2022年9月在浙江大学附属儿童医院儿童保健科健康管理中心体检的3 024名1~6岁儿童为研究对象,检测儿童的BMI、血清ALP、钙、磷与25-(OH)D水平,并采用超声骨密度仪检测骨密度指标。结果纳入3 024例儿童中骨密度偏低578例,检出率为19.11%;男童骨密度Z值高于女童(t=3.132,P＜0.01);不同年龄组儿童间骨密度Z值比较差异均有统计学意义(F=54.493,P＜0.001);骨密度正常组BMI低于骨密度偏低组(t=7.083,P＜0.001);骨密度偏低组血清钙、磷和25-(OH)D水平均低于骨密度正常组(t=8.659、3.479、16.440,P＜0.01)。相关分析显示,骨密度Z值与血清钙、磷、25-(OH)D水平呈正相关(r=0.146、0.051、0.240,P＜0.05);与BMI呈负相关(r=-0.128,P<0.05);与ALP无相关性(P=0.684)。Logistic多元回归分析显示BMI(OR=1.259)、血清钙(OR=0.025)、磷(OR=0.426)和25-(OH)D(OR=0.954)水平均为儿童骨密度的影响因素(P＜0.05)。结论儿童骨密度与性别、年龄、血清钙、磷、BMI和25-(OH)D有关,与血清ALP无关。维持相对较高的血清钙、磷和25-(OH)D对维持正常骨密度有重要意义。

关键词: 骨密度, 骨代谢, 25-羟维生素D, 儿童

Abstract: Objective To analyze the relationship between bone mineral density (BMD) in children and factors including sex, age, body mass index (BMI), blood calcium, blood phosphorus, serum alkaline phosphatase (ALP), and serum 25-hydroxyvitamin D[25-(OH)D], in order to provide a scientific basis for promoting pediatric bone health. Methods A total of 3 024 children aged 1 - 6 years who underwent health examinations at the Child Health Care Center of the Children′s Hospital Affiliated to Zhejiang University School of Medicine from June 2018 to September 2022 were included.BMI, serum ALP, calcium, phosphorus, and 25-(OH)D levels were measured, and BMD was assessed using ultrasound bone densitometry. Results Among the3 024 participants, 578 children (19.11%) had low BMD.Male children exhibited higher BMD Z-scores than females (t=3.132, P<0.01).Significant differences in BMD Z-scores were observed across age groups (F=54.493, P<0.001).The normal BMD group had lower BMI than the low BMD group (t=7.083, P<0.001).Children with low BMD showed lower serum calcium, phosphorus, and 25-(OH)D levels compared to those with normal BMD (t=8.659, 3.479, 16.440, P<0.01).Correlation analysis revealed that BMD Z-scores were positively associated with serum calcium, phosphorus, and 25-(OH)D levels (r=0.146, 0.051, 0.240, P<0.05), negatively correlated with BMI (r=-0.128, P<0.05), and not correlated with ALP (P=0.684).Multivariate logistic regression identified BMI (OR=1.259), calcium (OR=0.025), phosphorus (OR=0.426), and 25-(OH)D (OR=0.954) levels as significant influencing factors of BMD (P<0.05). Conclusions Pediatric BMD is associated with sex, age, serum calcium, phosphorus, BMI, and 25-(OH)D, but not with serum ALP.Maintaining relatively high levels of serum calcium, phosphorus, and 25-(OH)D is crucial for sustaining normal BMD in children.

Key words: bone mineral density, bone metabolism, 25-(OH)D, preschool children

中图分类号:

R179

徐燕芬, 董文红, 卢韦, 沈盈. 3024名1～6岁儿童骨密度与骨代谢相关因素的临床研究[J]. 中国儿童保健杂志, 2025, 33(12): 1372-1375.

XU Yanfen, DONG Wenhong, LU Wei, SHEN Ying. Clinical study of bone mineral density and related factors of bone metabolism in 3 024 children aged 1 to 6 years[J]. Chinese Journal of Child Health Care, 2025, 33(12): 1372-1375.

参考文献

[1] 费燕.学龄前儿童超声骨密度检测的研究进展[J].医疗装备, 2020, 44(8):200-201.
Fei Y.Research progress of ultrasound bone mineral density detection in preschool children[J].Medical Equipment, 2020, 44(8):200-201.(in Chinese)
[2] Kanis JA.Assessment of fracture risk and its application to screening for postmenopausal osteoporosis:Synopsis of a WHO report.WHO Study Group[J].Osteoporos Int,1994,4(6):368-381.
[3] 沈朝霞,潘圆圆,黄荣,等.儿童骨密度与骨代谢相关因素的临床研究[J].中国儿童保健杂志, 2020, 28(2):144-147.
Shen ZX, Pan YY, Huang R, et al.Clinical study of bone mineral density and bone metabolism in children[J].Chin J Child Health Care, 2020, 28(2):144-147.(in Chinese)
[4] 陈小娜,陈玉翠,房飞晓.骨密度与婴幼儿生长发育速度关系的队列研究[J].中国卫生标准管理,2022, 13(21):30-34.
Chen XN, Chen YC, Fang FX.Cohort study on the relationship between bone mineral density and infant growth and development rate[J].Chinese Journal of Health Standards Management, 2022, 13(21):30-34.(in Chinese)
[5] Proia P, Amato A, Drid P, et al.The impact of diet and physical activity on bone health in children and adolescents[J].Front Endocrinol (Lausanne), 2021, 12(1080):1-12.
[6] Hofmann C, Girschick H, Lapa C, et al.Frakturen und knochendichte im kindesalter fractures and bone mineral density in childhood[J].Z Rheumatol, 2019, 78(7):636-644.
[7] 马金凤,张翻弟,邱振涛,等.银川市0~6岁儿童骨密度检测及其影响因素分析[J].宁夏医学杂志, 2022, 44(11):1020-1023.
Ma JF, Zhang FD, Qiu ZT, et al.Analysis of bone mineral density and its influencing factors in children aged 0-6 years in Yinchuan City[J].Ningxia Medical Journal, 2022, 44(11):1020-1023.(in Chinese)
[8] 覃蔓瑛,洪梅.婴幼儿骨密度影响因素的临床研究进展[J/OL].世界最新医学信息文摘(连续型电子期刊),2020, 20(2):39-40.
Qin MY, Hong M.Progress of clinical research on influencing factors of infant bone mineral density[J/OL].World Latest Medical Information Digest (Continuous Electronic Journal), 2020, 20(2):39-40.(in Chinese)
[9] Ferrer FS, Castell EC, Marco FC, et al.Influence of weight status on bone mineral content measured by DXA in children[J].BMC Pediatr, 2021, 21(1):1-8.
[10] 王倩,赵莉,武艳梅,等.盘锦市0～6岁儿童骨密度调查及其与血清维生素K的关系研究[J].中国实用医药, 2020, 15(25):164-165.
Wang Q, Zhao L, Wu YM, et al.Investigation of bone mineral density and its relationship with serum vitamin K in children aged 0~6 years in Panjin City[J].Chinese Journal of Practical Medicine, 2020, 15(25):164-165.(in Chinese)
[11] 卢婷婷.定期监测学龄前儿童的体质指数和骨密度在儿童保健中的应用价值[J].保健文汇, 2022, 23(10):179-181.
Lu TT.Application value of regular monitoring of body mass index and bone mineral density of preschool children in children′s health care[J].Journal of Health Sciences, 2022, 23(10):179-181.(in Chinese)
[12] 郑琦玮.儿童血清25羟基维生素D与骨密度关系的研究[D].石家庄:河北医科大学,2022.
Zheng QW.Study on the relationship between serum 25-hydroxyvitamin D and bone mineral density in children[D].Shijiazhuang: Hebei Medical University, 2022.(in Chinese)
[13] 李海波, 赵小元, 洪伟,等.学龄儿童维生素D营养状况与跟骨骨密度关系的前瞻性队列研究[J].中华流行病学杂志, 2021, 42(3):462-468.
Li HB, Zhao XY, Hong W, et al.A prospective cohort study on the relationship between vitamin D nutritional status and calcaneal bone mineral density in school-age children[J].Chin J Epidemiol, 2021, 42(3): 462-468.(in Chinese)
[14] Pan K, Tu R, Yao X, et al.Associations between serum calcium, 25(OH)D level and bone mineral density in adolescents[J].Adv Rheumatol, 2021,61(1):1-9.
[15] 孙慧, 郭俊霞, 留佩宁, 等.儿童维生素D营养状况与骨密度关系的研究[J].浙江预防医学, 2015, 27(7):682-685.
Sun H, Guo JX, Liu PN, et al.Study on the relationship between vitamin D nutrition and bone mineral density in children[J].Zhejiang Preventive Medicine, 2015, 27(7):682-685.(in Chinese)
[16] 王旭辉,陈江林,杨庆贤,等.517例6～12岁儿童血钙浓度及超声骨密度水平影响因素分析[J].我和宝贝, 2020,10(4):89-92.
Wang XH, Chen JL, Yang QX, et al.Analysis of influencing factors of blood calcium concentration and ultrasound bone mineral density in 517 children aged 6 to 12 years[J].Me and Baby, 2020,10(4):89-92.(in Chinese)

3024名1～6岁儿童骨密度与骨代谢相关因素的临床研究

Clinical study of bone mineral density and related factors of bone metabolism in 3 024 children aged 1 to 6 years

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