目的 调查河南安阳地区住院治疗中新生儿维生素A、D、E水平及相关影响因素,为早期防治维生素A、D、E缺乏提供科学依据。方法 选取2017年5月-2019年2月在安阳市人民医院新生儿科住院治疗的329例新生儿为研究对象。采用高效液相色谱法和液相串联质谱法检测新生儿维生素A、D、E。结果 1)新生儿维生素A水平为(0.17±0.09) mg/L,维生素D水平为(14.21±12.05) ng/ml,维生素E水平为(6.50±3.80) mg/L。2) 足月儿与早产儿的维生素A水平,不同性别新生儿的维生素D水平,高危儿与非高危儿的维生素E水平差异均有统计学意义(P＜0.05)。不同体重组维生素A、D、E水平差异无统计学意义(P＞0.05)。3) 维生素A亚临床缺乏,维生素D及维生素E缺乏比例较高。4) 不同季节出生的新生儿维生素D水平差异有统计学意义(P＜0.05)。孕末期3个月补充维生素D剂量≥400 U/d与＜400 U/d的新生儿维生素D水平差异有统计学意义(P＜0.05)。结论 河南安阳地区住院治疗中新生儿大部分存在维生素A、D、E缺乏,是否足月、是否为高危儿可能分别与维生素A、E水平有关。不同性别、季节及孕末期补充维生素D的剂量与维生素D水平有关。
Abstract
Objective To investigate the levels of vitamin A,D and E of neonates in hospital and the related influencing factors in Anyang,so as to provide scientific evidence for the prevention of vitamin A,D and E deficiency. Methods A total of 329 neonates treated in the Pediatrics Department of the People′s Hospital of Anyang City were enrolled in this study from May 2017 to February 2019.High performance liquid chromatography(HPLC) and liquid chromatography tandem mass spectrometry (MS/MS) were used to test the levels of vitamin A,D,E of neonates.The influencing factors for the levels of vitamin A,D,E were analyzed. Results 1) The levels of vitamin A,D,E in newborns were (0.17±0.09) mg/L,(14.21±12.05)ng/ml and (6.50±3.80)mg/L,respectively.2) Significant differences were found on vitamin A level between preterm infants and full-term infants,vitamin D level between boys and girls,vitamin E level between high-risk and non-high-risk infants (P<0.05).But there were no significant differences on vitamin A、D、E levels among children in different weight groups (P>0.05).3) Vitamin A subclinical deficiency,vitamin D and vitamin E deficiency accounted for a higher proportion.4) There were significant differences on vitamin D levels among neonates born in different seasons and in neonates between vitamin D supplementation ≥400 U/d and ＜ 400 U/d at the end of three months of pregnancy (P<0.05). Conclusionss Most neonates in hospital in Anyang area have vitamin A,D and E deficiency.Preterm and high-risk infants may be related to neonatal vitamin A and E levels,respectively.Different sex,seasons and vitamin D supplementation dose at the end of pregnancy are correlated with vitamin D level in neonates.
关键词
维生素A /
维生素 D /
维生素E /
新生儿
Key words
vitamin A /
vitamin D /
vitamin E /
newborn
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Lima DB,Damiani LP,Fujimori E.Vitamin A deficiency in Brazilian Children and associated variables[J].Rev Paul Pediatr,2018,36(2):176-185.
[2] Song P,Wang J,Wei W,et al.The prevalence of vitamin a deficiency in chinese children:a systematic review and bayesian meta-analysis[J].Nutrients,2017,9(12):1285.
[3] AnandaKesavan TM,Thuruthiyath N,Thomas EP.Subclinical vitamin D deficiency in children from Thrissur,Kerala[J].Indian Pediatr,2018,55(5):434-435.
[4] Carey AN,Duggan C.50 years ago in the journal of pediatrics:vitamin e deficiency:a previously unrecognized cause of hemolytic anemia in the premature infant[J].J Pediatr,2017,181:162.
[5] Sava F,Treszl A,Hajdú J,et al.Plasma vitamin D levels at birth and immune status of preterm infants[J].Immunobiology,2016,221(11):1289-1292.
[6] Haider BA,Sharma R,Bhutta ZA.Neonatal vitamin A supplementation for the prevention of mortality and morbidity in term neonates in low and middle income countries[J].Cochrance Database Syst Rev,2017,2:CD006980.
[7] Dinlen N,Zenciroglu A,Beken S,et al.Association of vitamin D deficiency with acute lower respiratory tract infections in newborns[J].J Matern Fetal Neonatal Med,2016,29(6):928-932.
[8] Hollis BW.Short-term and long-term consequences and concerns regarding valid assessment of vitamin D deficiency:comparison of recent food supplementation and clinical guidance reports[J] .Curr Opin Clin Nutr Metab Care,2011,14(6):598-604.
[9] Holick,MF.Sunlight and vitamin D for bone health and prevention of autoimmune diseases,cancers,and cardiovascular disease[J].Am J Cli Nutr,2004,80(Suppl 6):1678-1688.
[10] 中华医学会儿科学分会儿童保健组,《中华儿科杂志》编辑委员会.儿童微量营养素缺乏及防治建议[J].中华儿科杂志,2010,48:502-509.
[11] 江载芳,申昆玲,申颖.诸福棠实用儿科学[M].8版.北京:人民卫生出版社,2014:423,556-572.
[12] West KP.Extent of vitamin A deficiency among preschool children and women of reproductive age [J].J Nutr,2002,132(Suppl 9):2857-2866.
[13] 董西慧,朴梅花,韩彤妍,等.早产儿维生素A水平及其相关因素[J].中华围产医学杂志,2017,20(12):874-881.
[14] 陈君,王斌.维生素D缺乏与新生儿肺发育[J].国际儿科杂志,2016,43(12):942-944.
[15] Hibbs AM,Ross K,Kerns LA,et al.Effect of vitamin D supplementation on recurrent wheezing in black infants who were born preterm:the D-wheeze randomized clinical trial[J].JAMA,2018,319(20):2086-2094.
[16] Händel MN,Frederiksen P,Cohen A,et al.Neonatal vitamin D status from archived dried blood spots and future risk of fractures in childhood:results from the dtect study,a population-based case-cohort study[J].Am J Clin Nutr,2017,106(1):155-161.
[17] Uday S,Fratzl-Zelman N,Roschger P,et al.Cardiac,bone and growth plate manifestation in hypocalcemic infants:revealing the hidden body of the vitamin D deficiency iceberg[J].BMC Pediatr,2018,18(1):183.
[18] Bunyavanich S,Rifas-Shiman SL,Platts-Mills TA,et al.Pr-enatal,perinatal,and childhood vitamin D exposure and their association with childhood allergic rhinitis and allergic sensitization [J].J Allergy Clin Immunol,2016,137(4):1063-1070.e2
[19] Morris SK,Pell LG,Rahman MZ,et al.Maternal vitamin D supplementation during pregnancy and lactation to prevent acute respiratory infections in infancy in Dhaka,Bangladesh(MDARI trial):protocol for a prospective cohort study nested within a randomize dcontrolledtrial[J].BMC Pregnancy Child Birth,2016,16(1):309.
[20] Tergestina M,Jose A,Sridhar S,et al.Vitamin D status and adequacy of standard supplementation in preterm neonates from Sounth India[J].J Pediatr Gastroenterol Nutr,2014,58(5):661-665.
[21] Onwuneme C,Martin F,McCarthy R,et al.The association of vitamin d status with acute respiratory morbidity in preterm infants[J].J Pediatr,2015,166(5):1175-1180.
[22] Fouda MA,Turkestani IZ,Almusharraf S,et al.Extremely high prevalence of maternal and neonatal vitamin d deficiency in the arab population[J].Neonatology,2017,112(3):225-230.
[23] 章晓英,李宇宁,安彩霞.新生儿维生素D营养状况调查[J].中国新生儿科杂志,2013,28(6):384-387.
[24] Størdal K,Mårild K,Tapia G,et al.Fetal and maternal genetic variants influencing neonatal vitamin d status[J].J Clin Endocrinol Metab,2017,102(11):4072-4079.
[25] Loudyi FM,Kassouati J,Kabiri M,et al.Vitamin D status in Moroccan pregnant women and newborns:reports of 102 caases[J].Pan Afr Med J,2016,24:170.
[26] 王晨,禹松林,王丹华.新生儿维生素D水平及其相关因素[J].中国新生儿科杂志,2015,30(4):241-245.
[27] Silva ALCD,Ribeiro KDDS,Melo LRM,et al.Vitamin E in human milk and its relation to the nutritional requirement of the term newborn[J].Rev Paul Pediatr,2017,35(2):158-164.
[28] 刘登礼,何必子.不同胎龄和不同出生体重新生儿出生时血清维生素A水平测定[J].中国新生儿科杂志,2015,30(5):358-360.
基金
国家卫生计生委医药卫生科技发展研究中心专项课题(W2016EWHNB07)。
PDF(883 KB)
