目的 观察早期婴儿维生素D营养状况,为合理地补充维生素D提供依据。方法 以我国北方地区冬季出生的72例婴儿为研究对象,自生后15 d起口服维生素D补充剂,满月起逐月询问生活史和体检。于出生及4月龄时分别采集脐血和静脉血,测定血清25-(OH)D、钙、磷和碱性磷酸酶浓度。结果 脐血25-(OH)D平均水平(21.91±5.75)nmol/L,72例(100.0%)维生素D缺乏;婴儿4月龄时血清25-(OH)D平均水平(108.12±45.30)nmol/L,10例(13.9%)维生素D缺乏。血清25-(OH)D平均水平在每日摄入维生素D 200 U~组升至(112.37±37.98)nmol/L,在400 U~组升至(133.97±34.93)nmol/L。但维生素D不足和缺乏者在每日摄入维生素D 200 U~组6例(23.1%),400 U~组仅2例(7.1%)。新生儿及婴儿血钙、磷、碱性磷酸酶水平均正常。结论 北方地区冬季新生儿普遍存在维生素D缺乏,生后尽早补充可以显著改善维生素D营养状况。每日补充200 U维生素D可显著提高早期婴儿血清25-(OH)D水平;若要达到维生素D营养充足,至少补充400 U维生素D。
Abstract
Objective To explore vitamin D status of early infants and provide the evidence for the application. Methods 72 subjects were selected from the infants who were born in winter in northern China.All subjects took vitamin D supplement from the 15th day after birth and accepted history and physical examination during the medication monthly.Umbilical cord blood at birth and the blood of infants at 4 months were collected.The levels of serum 25-(OH)D,calcium,phosphorus and alkaline phosphatase were measured. Results The serum 25-(OH)D level was (21.91±5.75)nmol/L of cord blood and vitamin D status was deficiency in 72 (100.0%) cases.The serum 25-(OH)D level was (108.12±45.30) nmol/L of infants and vitamin D status was deficiency in 10(13.9%) cases.The serum 25-(OH)D levels of vitamin D daily supplement of 200U~,400U~ groups were (112.37±37.98)nmol/L and (133.97±34.93) nmol/L.There were 6(23.1%) cases of the serum 25-(OH)D levels ＜75nmol/L in daily intake of vitamin D 200U~ group and 2 cases (7.1%) in 400U~ group.Calcium,phosphorus,alkaline phosphatase levels of neonates and infants were normal. Conclusions Neonatal vitamin D deficiency is prevalent in the region.Intake sufficient vitamin D as soon as possible after birth could significantly improve neonatal and early infant vitamin D deficiency;vitamin D daily supplement of 200 U could significantly increase serum 25-(OH)D levels.In order to achieve adequate vitamin D nutrition for the general population,400U vitamin D is recommended.
关键词
维生素D /
25-羟维生素D /
脐血 /
婴儿
Key words
vitamin D /
25-hydroxyvitamin D /
cord blood /
infants
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Behrman RE,Kliegman RM,Jenson HB,et al.Nelson Textbook of Pediatrics[M].Philadelphia,PA:Harcourt Brace Jovanovich,2000:184-187.
[2] Holick MF.Vitamin D:importance in the prevention of cancers,type 1 diabetes,heart disease,and osteoporosis[J].The American Joural of Clinical Nutrition,2004,79:362-371.
[3] Camargo CA,Ingham T,Wickens K,et al.Cord-blood 25-hydroxyvitamin d levels and risk of respiratory infection,wheezing,and asthma[J].Pediatrics,2011,127(1):180-187.
[4] 刘湘云,陈荣华,赵正言.儿童保健学[M].4版.江苏:江苏科学技术出版社,2011:296-305.
[5] Holick MF.High prevalence of vitamin D inadequacy and implications for health[J].Mayo Clin Proc,2006,81:353-373.
[6] Bischoff-Ferrari HA,Giovannucci E,Willett WC,et al.Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes[J].Am J Clin Nutr,2006,84:18-28.
[7] Binkley N,Krueger D.Evaluation and correction of low vitamin D status[J].Curr Osteoporos Rep,2008,6(3):95-99.
[8] Holiok MF.Vitamin D deficiency[J].New England J Med,2007,375(3):266-281.
[9] 吴光驰.中国人群维生素D营养状况[J].中国妇幼卫生杂志,2010,1(1):51-54.
[10] Jing WANG,Fan YANG,Meng MAO,et al.High prevalence of vitamin D and calcium defi ciency among pregnant women and their newborns in Chengdu,China[J].World J Pediatr,2010,6(3):265-267.
[11] 李婧,秦锐.脐血维生素D水平测定及相关因素分析[J].中国儿童保健杂志,2010,18(3):216-218.
[12] 吴光驰,陈学存,郭素怡,等.孕妇服维生素D预防佝偻病的剂量探讨[J].中国儿童发展杂志,1992,7(1):14-16.
[13] 郭雪香,付秋月,李同,等.季节对新生儿血清25-羟维生素D及维生素A含量的影响及母、儿的相关性[J].实用儿科临床杂志,1991,6(5):227-230.
[14] 马贤才,于亚梅,李兰菊,等.北方儿童维生素D营养状况.第五届全国佝偻病防治学术会议论文集[C].大连,2002,94-96.
[15] Specker BL,Ho ML,Oestreich A,et al.Prospective study of vitamin D supplementation and rickets in China[J].The Journal of Pediatrics,1992,120(5):733-739.
[16] Kim MJ,Na B,No SJ,et al.Nutritional status of vitamin D and the effect of vitamin D supplementation in Korean breast-fed infants[J].J Korean Med Sci,2010,25:83-89.
[17] Wagner CL,Greer FR,American Academy of Pediatrics Section on Breastfeeding,et al.Prevention of rickets and vitamin D deficiency in infants,children,and adolescents[J].Pediatrics,2008,122:1142-1152.
[18] 顾景范.《2010年美国膳食指南》简介[J].营养学报,2011,33(3):229-233.
[19] 中华医学会儿科学分会儿童保健学组,全国佝偻病防治科研协作组.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.
PDF(545 KB)
