目的 比较不同发育行为疾病儿童维生素D水平的差异,分析维生素D水平与核心症状的相关性。方法 收集2018年9月—2022年11月厦门市儿童医院19 119例儿童25(OH) D检测数据、一般人口学资料,以及临床诊断信息,剔除躯体疾病及药物干扰因素,纳入1 311例发育行为疾病儿童作为发育行为疾病组,2 969例典型发育儿童作为典型发育组。采用回顾性病例对照研究设计,使用倾向性评分对年龄和性别两个混淆变量进行1∶1匹配,分析发育行为疾病组和典型发育组之间25(OH) D水平差异,典型发育组与语言发育障碍(LD)、抽动障碍(TD)、全面发育迟缓(GDD)、注意缺陷多动障碍(ADHD)和孤独症谱系障碍(ASD)组之间25(OH) D水平差异。结果 在36~72月龄和72月龄~12岁两个年龄段,发育行为疾病组25(OH) D水平均显著低于典型发育组(t=2.252、5.343,P＜0.05)。发育行为疾病组中,年龄与25(OH) D水平呈中度负相关(r=-0.525,P＜0.001)。ASD组和ADHD组25(OH) D水平显著低于典型发育组,且ASD(OR=0.970)和ADHD(OR=0.960)疾病风险与25(OH) D呈负相关。结论 发育行为疾病儿童与典型发育儿童都呈现年龄越大25(OH) D水平越低的现象,发育行为疾病儿童维生素D水平较典型发育儿童更低,其中以ASD及ADHD儿童维生素D水平降低最为显著。
Abstract
Objective To compare the vitamin D levels among children with different developmental and behavioral disorders, and to analyze the correlation between vitamin D levels and core symptoms. Methods The 25(OH)D test data, general demographic information, and clinical diagnosis information of 19 119 children from September 2018 to November 2022 at Xiamen Children's Hospital were collected. After excluding physical diseases and drug interference factors, 1 311 children with developmental and behavioral disorders were included as the developmental and behavioral disorder group, and 2 969 typically developing children were included as the typical development group. A retrospective case-control study design was adopted, and propensity scores were used to perform a 1∶1 match for the two confounding variables of age and gender. The differences in 25(OH)D levels were analyzed between the developmental and behavioral disorder group and the typical development group, as well as between the typical development group and the groups with language development disorder(LD), tic disorder(TD), global developmental delay(GDD), attention-deficit/hyperactivity disorder(ADHD), and autism spectrum disorder(ASD). Results In both age groups of 36 to 72 months and 72 months to 12 years, the 25(OH)D levels in the developmental and behavioral disorder group were significantly lower than those in the typical development group(t=2.252, 5.343, P<0.05). Within the developmental and behavioral disorder group, age was moderately negatively correlated with 25(OH)D(r=-0.525, P<0.001). The 25(OH)D levels in the ASD and ADHD groups were significantly lower than those in the typical development group, and the risks of ASD(OR=0.970) and ADHD(OR=0.960) were negatively correlated with 25(OH)D. Conclusions Children with developmental and behavioral disorders, similar to typically developing children, exhibit a decreasing trend in 25(OH)D levels as they age. Children with developmental and behavioral disorders have lower vitamin D levels compared to typically developed children, with the most significant decreases observed in those with ASD and ADHD.
关键词
发育行为疾病 /
典型发育儿童 /
25(OH) D /
倾向性评分
Key words
developmental behavioral disorders /
typically developed children /
25(OH) D /
propensity score
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基金
福建省临床重点专科(XE2023-ETBJ-D01);厦门市自然科学基金项目(3502Z20227146);厦门市医疗卫生重点项目(3502Z20234020);上海市公共卫生体系建设三年行动计划优秀学科带头人项目(GWVI-11.2-XD12)
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