Objective To know about serum vitamin D (VD) level of the adolescence children and the its influencing factors, and to analyze the causes of VD insufficiency, so as to provide scientific reference for further research. Methods A total of 603 healthy adolescence children aged 11 to 17 years were enrolled in this study, and were taken physical examination, questionnaire survey from 2015 to 2016. Serum levels of 25(OH)D, parathyroid hormone (PTH), calcium (Ca), phosphorus (P) and alkaline phosphatase (ALP) of the participants were tested. Results Serum 25(OH)D level of 603 adolescence children were 14.16 (10.68, 18.46) ng/ml, and 81.1% adolescent children had VD deficiency and insufficiency. Serum levels of PTH, Ca, P and ALP were 42.7(31.90, 60.70) pg/ml, (2.47±0.13) nmol/L, (1.57±0.21) nmol/ L and (275.23±127.60) U/L. Serum 25(OH)D level was negatively correlated with PTH level and ALP level(r＝-0.039,-0.141,P<0.01), positively related to serum Ca level(r=0.312,P＜0.001). There was a logarithmic correlation between PTH and 25(OH)D, and no 25(OH)D inflection point appeared when PTH reached the maximum inhibition state.Outdoor activities time, VD supplementation was positively related to serum 25(OH)D level(P trend＜0.01). Conclusions Vitamin D deficiency and insufficiency among adolescents is common. Indicators like serum PTH,ALP and Ca levels would help to assessing VD level of children. So it is suggested to encourage outdoor activities, take VD supplementation to improve 25(OH)D level of children.
Key words
vitamin D /
adolescence children /
parathyroid hormone /
calcium /
phosphorus /
alkaline phosphatase /
outdoor activity time
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
[1] Chang SW, Lee HC. Vitamin D and health-the missing vitamin in humans[J]. Pediatr Neonatol, 2019,60(3):237-244.
[2] Bizzaro G, Shoenfeld Y. Vitamin D and autoimmune thyroid diseases: facts and unresolved questions[J]. Immunol Res, 2015,61:46-52.
[3] Sarafin K,Durazo-Arvizu R,Tian L,et al.Standardizing 25-hydroxyvitamin D values from the Canadian Health Measures Survey [J]. Am J Clin Nutr, 2015, 102(5):1044-1050.
[4] Joshua G,Kerry SF, Sheila G, et al.Vitamin D status in infancy and cardiometabolic health in adolescence[J]. Am J Clin Nutr, 2020. doi: 10.1093/ajcn/nqaa273.
[5] Laing EM, Lewis RD. New concepts in vitamin D requirements for children and adolescents:a controversy revisited[J].Front Horm Res, 2018, 50:42-65.
[6] Kumar J, Munter P, Kaskel FJ, et al. Prevalence and associations of 25 hydroxy vitamin D deficiency in US children: NHANES 2001-2004[J]. Pediatrics,2009,124:e362-e370.
[7] Cashman KD, Dowling KG,Škrabáková Z, et al. Vitamin D deficiency in Europe: pandemic?[J]. Am J Clin Nutr,2016,103(4):1033-1044.
[8] Science M, Maguire JL, Russell ML,et al. Prevalence and predictors of low serum 25-hydroxyvitamin D levels in rural Canadian children[J]. Paediatr Child Health, 2017,22(3):125-129.
[9] Shin YH, Shin HJ, Lee YJ. Vitamin D status and childhood health[J]. Korean J Pediatr,2013,56:417-423.
[10] Souberbielle JC, Maruani G, Courbebaisse M. Metabolism and main effects of vitamin D[J]. Presse Med, 2013,42:1343-1350.
[11] Musson P, Collin J. Management of vitamin D deficiency in childhood and adolescence[J]. Nurs Child Young People, 2015,27:27-35.
[12] Khadilkar A, Kadam N, Chiplonkar S, et al. School-based calcium-vitamin D with micronutrient supplementation enhances bone mass in underprivileged Indian premenarchal girls[J]. Bone, 2012,51:1-7.
[13] Logan VF, Gray AR, Peddie MC, et al. Long-term vitamin D3 supplementation is more effective than vitamin D2 in maintaining serum 25-hydroxy vitamin D status over the winter months[J]. Br J Nutr, 2013,109:1082-1088.
[14] 仰曙芬,吴光驰.VD缺乏及VD缺乏性佝偻病防治建议[J].中国儿童保健杂志,2015,23(7):781-782.
[15] Bose S, Breysse PN, McCormack MC, et al. Outdoor exposure and vitamin D levels in urban children with asthma[J]. Nutr J, 2013,12:81.
[16] Weishaar T, Rajan S. Importance of body weight and skin color in determining appropriate vitamin D3 supplement doses for children and adolescents[J]. Pediatr Res, 2015,77:370-375.
[17] Kang JI, Lee YS, Han YJ, et al. The serum level of 25-hydroxy vitamin D for maximal suppression of parathyroid hormone in children: the relationship between 25-hydroxy vitamin D and parathyroid hormone[J]. Korean J Pediatr,2017, 60(2):45-49.
[18] Arabi A, Baddoura R, Awada H, et al. Hypovitaminosis D osteopathy: is it mediated through PTH, lean mass, or is it a direct effect?[J]. Bone, 2006,39:268-275.
[19] Abrams SA, Griffin IJ, Hawthorne KM,et al. Relationships among vitamin D levels, parathyroid hormone, and calcium absorption in young adolescents[J]. J Clin Endocrinol Metab 2005,90:5576-5581.
[20] John FA,Sonia AT,Simcha P,et al. Optimal vitamin D status and serum parathyroid hormone concentrations in African American women[J]. Am J Clin Nutr, 2006, 84(3) : 602-609.
[21] Aloanzi ZH, Tuck SP, Raj N, et al. Assessment of vitamin D status in male osteoporosis[J]. Clin Chem ,2006,52:248-254.
PDF(1087 KB)
