目的 了解江苏省0~6岁儿童维生素D(VitD)营养状况,探讨户外活动时间及体质指数与VitD水平的关系。方法 采用分层随机整群抽样的方法,抽取江苏省12个地区0~6岁健康儿童5 289名,常规体检,测量体重、身长/高,计算体质指数(BMI),检测血清25-羟维生素D[25(OH)D]浓度,并进行相关问卷调查。结果 1)江苏省0~6岁儿童血清25(OH)D平均水平为(66.59±30.27)nmol/L,以25-(OH)D<75 nmol/L作为VitD 缺乏和不足的标准[1],VitD缺乏和不足者3 471例(65.6%);2岁以上儿童VitD水平[(61.65±27.57) nom/L]明显低于2岁以下婴幼儿[(70.25±32.55) nom/L]。2)在校正年龄、性别等影响因素后,多因素回归分析显示:户外活动时间、BMI与VitD水平相关,每日户外活动时间达4 h以上者VitD水平最佳,随BMI增加,VitD水平呈上升趋势(F=4.168,P<0.05);以BMI>P 97th为肥胖标准,本研究中肥胖儿童409例(7.73%),肥胖儿童血清VitD水平[(65.94±29.56)nmol/L]低于正常儿童[(66.65±30.34)nmol/L],但差异无统计学意义(t=0.454,P=0.650)。结论 江苏省儿童VitD营养状况处于相对缺乏状态,2周岁以上儿童VitD水平显著低于2岁以下儿童;足够的户外活动时间有利于维持较好的VitD营养状况;在未达到肥胖标准时,儿童BMI与VitD水平呈正相关。
Abstract
Objective To evaluate the vitamin D (VitD) nutritional status,and to investigate the interaction of 25-hydroxy-vitamin D [25(OH)D] and outdoor activities time and the body mass index in 0~6 years old children. Methods Utilizing a stratified random cluster sampling design,a total of 5 289 healthy children aged 0~6 years old were recruited from 12 regions of Jiangsu province.Anthropometric indices:weight,height,VitD levels were estimated by ELISA,and the related questionnaire investigation was carried. Results 1)The means and standard deviations of serum 25-(OH)D levels was (66.59±30.27)nmol/L,65.6% had VitD deficiency,VitD overdose and poisoning cases were not found.The level of 25-(OH)D was significantly higher in 0~2 years old group.2)When children's age,gender and other variables were adjusted,outdoor activities time and the BMI were correlated with the serum 25-(OH)D levels (P<0.01),Daily time for outdoor activities up to 4 hours had best VitD level (F=11.45,P<0.05).The research objects receiving physical examination were screened by BMI(BMI>P 97th was the standard for obesity).In the study with 409 cases of obese children,the 25-(OH)D concentration increased with BMI(F=4.168,P<0.05).In addition,the serum 25-(OH)D levels in obesity and normal group were (65.94±29.56)nmol/L and (66.65±30.34) nmol/L,and this difference was not significant(t=0.454,P=0.650). Conclusions There is a high prevalence of VitD deficiency in 0 to 6 year olds in Jiangsu province,especially for children over 2 years of age.The average VitD levels among children more exposed to sunlight is sufficient.When it is not up to the obesity standard,there is a positive correlation between 25-(OH)D levels and BMI.
关键词
户外活动时间 /
体质指数 /
儿童 /
维生素D
Key words
outdoor physical inactivity /
body mass index /
children /
vitamin D
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Misra M,Pacaud D,Petryk A,et al.Vitamin D deficiency in children and its management:review of current knowledge and recommendations[J].Pediatrics,2008,122:398-417.
[2] Wolpowitz,Beon,Gichrest,et al.The Vitamin D questions:How much do you need and how should you get it?[J].Journal of the American Academy of Dermatology,2006,54(2):301-317.
[3] 林涛,陈焕辉,陈翎,等.2012年广州地区25295名儿童维生素D营养状况分析[J].中国儿童保健杂志,2013,21(8):836-839.
[4] Kensarah OA,Jazar AS,Azzeh FS.Hypovitaminosis D in healthy toddlers and preschool children from Western Saudi Arabia[J].Int J Vitam Nutr Res,2015,85(12):50-60.
[5] Jari M,Qorbani M,Moafi M,et al.Association of 25-hydroxy vitamin D levels with indexes of general and abdominal obesity in Iranian adolescents:The CASPIAN-III study[J].J Res Med Sci,2015,20(2):122-126.
[6] 蒋玉艳,唐振柱,苏冰.512名6～13岁儿童维生素D营养状况与体质指数的关系[J].应用预防医学,2013,19(3):135-141.
[7] 古桂熊,戴耀华.儿童保健学[M].江苏:清华大学出版社,2011.
[8] 《中华儿科杂志》编辑委员会,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(2):190-191.
[9] 《中华儿科杂志》编辑委员会,中华医学会儿科学分会儿童保健学组.儿童微量营养素缺乏防治建议[J].中华儿科杂志,2010,48(4):502-509.
[10] 莫丽亚,黄彩芝,邓永超,等.湖南地区少年儿童维生素D营养状况分析[J].中国妇幼保健杂志,2012,31(27):4926-4928.
[11] 霍亭竹,杨尧,吴康敏,等.西昌市城区0~4岁儿童佝偻病现况调查[J].中国儿童保健杂志,2011,19(7): 613-615.
[12] 张倩,胡小琪,马冠生,等.我国藏族和汉族儿童少年维生素D营养状况[J].现代预防医学,2010,37(3):465-467.
[13] 梁培培,秦锐,梁冠禹,等.婴幼儿维生素D缺乏调查及维生素D补充对血清25-羟维生素D水平的影响[J].江苏医药,2013,48(4):502-509.
[14] 王迪,谭春秋,仰曙芬.学龄前儿童维生素D的营养状况以及25(OH)D与骨代谢的研究[C].中华医学会第十七次全国儿科学术大会论文汇编,2012,1417.
[15] 《中国儿童保健杂志》编辑委员会,全国佝偻病防治科研协作组,中国优生科学协会小儿营养专业委员会,维生素D缺乏及维生素D缺乏性佝偻病防治建议[J].中国儿童保健杂志,2015,23(7):781-782.
[16] Pavandeep G,Sunil K.Assessment of the feasibility of using sunlight exposure to obtain the recommended level of vitamin D in Canada[J].CMAJ Open,2015,3(3):E258-E263.
[17] Zhang RH,He DH,Zhou B,et al.Analysis of vitamin D status in Men highly exposed to sunlight[J].Biomed Environ Sci,2015,28(12):913-916.
[18] 杨芳,吕学云,张军生,等.肥胖干预对肥胖儿童血清维生素D、甲状旁腺激素和胰岛素抵抗指数的影响[J].中国妇幼保健杂志,2011,25(8):3417-3419.
[19] Jari M,Qorbani M,Moafi M,et al.Association of 25-hydroxy Vitamin D levels with indexes of general and abdominal obesity in Iranian adolescents:The CASPIAN-III study[J].J Res Med Sci,2015,20(2):122-126.
[20] Sakineh M,Reyhaneh M,Hossein Z,et al.Relationship between 25-hydroxy vitamin-D and obesity in 2~7 years old children referred to a paediatric hospital in Iran[J].J Cli and Dia Res,2014,8(9):PC06-PC08.
基金
江苏省妇幼保健重点学科项目(FXK201203);中国疾病预防控制中心妇幼保健中心-合生元母婴营养与健康研究项目(2015FYH020)
PDF(564 KB)
