婴幼儿血清25-羟维生素D与骨密度的相关性分析
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摘要
目的:探讨婴幼儿血清25-羟维生素D[25-(OH)D]与骨密度(BMD)的相关性。方法:选取2015年6月-2016年6月就诊于本院儿童保健科并存在"身材矮小、营养不良、夜惊、出汗多、烦躁"等相关症状的婴幼儿354例作为研究对象,对其进行血清25-(OH)D及骨密度水平检测。比较不同月龄段婴幼儿的25-(OH)D与骨密度水平及构成比情况,并分析25-(OH)D及骨密度的相关性。结果:354例婴幼儿的25-(OH)D和骨密度平均水平分别为(28.32±9.15)ng/mL和(-1.33±0.49)。随着月龄的增加,25-(OH)D和骨密度水平均呈逐渐降低趋势,且不同月龄段比较,差异均有统计学意义(P<0.05)。不同月龄段婴幼儿的25-(OH)D及骨密度水平在男女性别中比较,差异均无统计学意义(P>0.05)。不同月龄段间婴幼儿的25-(OH)D构成比比较,差异有统计学意义(X~2=51.653,P<0.001),月龄越高,严重不足率也越高;不同月龄段间骨密度构成比比较,差异有统计学意义(X~2=33.964,P<0.001),月龄越高,重度不足率也越高。骨密度轻、中、重度不足总水平的25-(OH)D不足比例均明显高于正常比例,差异均有统计学意义(P<0.05)。婴幼儿25-(OH)D水平与骨密度Z值呈正相关(r=0.819,P<0.001)。结论:25-(OH)D与骨密度有一定的相关性,临床上可根据25-(OH)D及骨密度的水平来指导维生素D及钙剂的补充。早期干预维生素D的缺乏对婴幼儿的骨骼发育,预防佝偻病有着重要意义,值得临床进一步研究。
Objective:To discuss the correlation between serum 25-hydroxyvitamin D [25-(OH)D]and bone mineral density(BMD)in infants and young children.Method:A total of 354 infants and young children with clinical symptoms of short stature,malnutrition,night terror,profuse sweating and agitation treated in Children's Rehabilitation Department of our hospital from June 2015 to June 2016 were selected as the study objects.Serum 25-(OH)D and bone mineral density of infants and young children were measured.The 25-(OH)D and bone mineral density in infants and young children at different age groups were compared and correlation of 25-(OH)D and bone mineral density was analyzed.Result:The average levels of 25-(OH)D and bone mineral density of 354 infants and young children were(28.32±9.15)ng/mL and(-1.33±0.49)respectively.With the increase of month age,the levels of 25-(OH)D and bone mineral density decreased gradually,and there were significant differences among different age groups(P<0.05).There were no significant differences in 25-(OH)D and bone mineral density levels of different age groups between male and female infants(P>0.05).There were significant differences in the ratio of 25-(OH)D among different age groups( X~2 =51.653,P<0.001).The higher the age,the higher the rate of serious insufficiency.There were significant differences in the ratio of bone mineral density among different age groups( X~2=33.964,P<0.001).The higher the age,the higher the rate of severe insufficiency.The proportion of 25-(OH)D deficiency in the total level of slight,moderate and severe bone mineral density deficiency were significantly higher than those in the normal proportion,the differences were statistically significant(P<0.05).There was a positive correlation between 25-(OH)D level and Z value of bone mineral density in infants and young children(r=0.819,P<0.001).Conclusion:25-(OH)D has a certain correlation with bone mineral density,which can guide the supplementation of vitamin D and calcium according to the levels of 25-(OH)D and bone mineral density.The early intervention of vitamin D deficiency is of great significance to the skeletal development of infants and children and the prevention of rickets.It is worthy of further clinical study.
Objective:To discuss the correlation between serum 25-hydroxyvitamin D [25-(OH)D]and bone mineral density(BMD)in infants and young children.Method:A total of 354 infants and young children with clinical symptoms of short stature,malnutrition,night terror,profuse sweating and agitation treated in Children's Rehabilitation Department of our hospital from June 2015 to June 2016 were selected as the study objects.Serum 25-(OH)D and bone mineral density of infants and young children were measured.The 25-(OH)D and bone mineral density in infants and young children at different age groups were compared and correlation of 25-(OH)D and bone mineral density was analyzed.Result:The average levels of 25-(OH)D and bone mineral density of 354 infants and young children were(28.32±9.15)ng/mL and(-1.33±0.49)respectively.With the increase of month age,the levels of 25-(OH)D and bone mineral density decreased gradually,and there were significant differences among different age groups(P<0.05).There were no significant differences in 25-(OH)D and bone mineral density levels of different age groups between male and female infants(P>0.05).There were significant differences in the ratio of 25-(OH)D among different age groups( X~2 =51.653,P<0.001).The higher the age,the higher the rate of serious insufficiency.There were significant differences in the ratio of bone mineral density among different age groups( X~2=33.964,P<0.001).The higher the age,the higher the rate of severe insufficiency.The proportion of 25-(OH)D deficiency in the total level of slight,moderate and severe bone mineral density deficiency were significantly higher than those in the normal proportion,the differences were statistically significant(P<0.05).There was a positive correlation between 25-(OH)D level and Z value of bone mineral density in infants and young children(r=0.819,P<0.001).Conclusion:25-(OH)D has a certain correlation with bone mineral density,which can guide the supplementation of vitamin D and calcium according to the levels of 25-(OH)D and bone mineral density.The early intervention of vitamin D deficiency is of great significance to the skeletal development of infants and children and the prevention of rickets.It is worthy of further clinical study.
引文
[1]赵爱利,龙俊青.0~3岁儿童血清25-羟维生素D、血清总钙与骨密度的关系研究[J/OL].中国医学前沿杂志(电子版),2017,9(8):74-77.
[2]蔡闫闫,刘永春,朱玲玲,等.扬州城区婴幼儿血清25-羟维生素D与骨密度检测分析[J].实用临床医药杂志,2015,19(7):161-163.
[3]孟庆军,华青,戴婷婷.儿童血清25(OH)VitD与骨代谢标志物水平的相关性研究[J].海南医学院学报,2015,21(10):1390-1392.
[4]赵光耀,查洪.早产儿25羟维生素D含量测定及相关因素分析[J].南京医科大学学报(自然科学版),2015,35(11):1643-1648.
[5]刘燕,钱红艳.婴幼儿25-羟基维生素D与骨密度的相关性研究[J].世界临床医学杂志,2017,11(16):143-144.
[6]李孔英,余灵英,翁利红.龙泉市2~6岁儿童维生素D营养状况调查[J].浙江预防医学,2016,28(2):196-197.
[7]黄飞燕,罗雪.儿童血清25-羟维生素D水平与超声骨密度关系研究[J].西南军医,2016,18(1):9-12.
[8]侯江婷,邓红岩,邹秋艳,等.张家港市18月龄幼儿维生素D水平及影响因素探讨[J].江苏预防医学,2016,27(3):365-366.
[9]李朦,袁耿彪.血清25-羟维生素D和雌激素水平与骨密度相关性的临床研究[J].国际检验医学杂志,2013,34(22):3043-3045,3054.
[10]孔德策,杨铁毅,邵进,等.50~60岁绝经后骨折女性25(OH)D3和骨密度、骨代谢指标的关系研究[J].中国骨质疏松杂志,2017,23(2):191-196.
[11]吴远桥,蒋旭峰,李毅沛,等.婴幼儿血清25-羟维生素D水平与骨密度关系观察[J].浙江预防医学,2009,21(2):56,58.
[12]欧丽黎,李吉华.骨碱性磷酸酶、血25-羟维生素D3联合骨密度对小儿维生素D缺乏性佝偻病的诊断价值[J].医学综述,2018,24(7):1449-1452.
[13]魏秋实,陈镇秋,谭新,等.中国男性和女性血清25羟维生素D水平与年龄、性别和骨密度之间的关系[J].实用骨科杂志,2016,22(5):480.
[14]唐毅,杨靖,曹洪义,等.成都地区不同年龄城乡妇女维生素D和骨代谢指标及骨密度的状况分析[J].中国骨质疏松杂志,2016,22(6):756-760.
[15]叶侃,宋媛,陆艳红,等.苏州地区儿童维生素D受体基因多态性与25-羟维生素D水平的关系[J].江苏医药,2017,43(8):552-554.
[16]李源斌,陆妹.早产儿血清25羟基维生素D3水平与超声骨密度的相关性研究[J].中国当代医药,2017,24(13):106-108,126.
[17]王全光.25羟维生素D3胰岛素样生长因子-Ⅰ及超声骨密度在佝偻病患儿中的意义[J].河北医学,2017,23(5):867-869.
[18]陈小香,谭新,邓伟民.骨质疏松症患者骨密度与血清25羟维生素D的相关性研究[J].中国骨质疏松杂志,2017,23(7):851-855.
[19]刘丹丹,常虹,谈敏.男性2型糖尿病患者25羟维生素D3及骨代谢指标的变化分析[J].安徽医药,2015,19(2):288-291.
[20]李文忠,陆耀宇,田永波,等.黔南州3~6岁农村布依族与苗族儿童维生素D营养状况及骨密度的比较研究[J].中国妇幼保健,2013,28(19):3117-3120,3134.
[2]蔡闫闫,刘永春,朱玲玲,等.扬州城区婴幼儿血清25-羟维生素D与骨密度检测分析[J].实用临床医药杂志,2015,19(7):161-163.
[3]孟庆军,华青,戴婷婷.儿童血清25(OH)VitD与骨代谢标志物水平的相关性研究[J].海南医学院学报,2015,21(10):1390-1392.
[4]赵光耀,查洪.早产儿25羟维生素D含量测定及相关因素分析[J].南京医科大学学报(自然科学版),2015,35(11):1643-1648.
[5]刘燕,钱红艳.婴幼儿25-羟基维生素D与骨密度的相关性研究[J].世界临床医学杂志,2017,11(16):143-144.
[6]李孔英,余灵英,翁利红.龙泉市2~6岁儿童维生素D营养状况调查[J].浙江预防医学,2016,28(2):196-197.
[7]黄飞燕,罗雪.儿童血清25-羟维生素D水平与超声骨密度关系研究[J].西南军医,2016,18(1):9-12.
[8]侯江婷,邓红岩,邹秋艳,等.张家港市18月龄幼儿维生素D水平及影响因素探讨[J].江苏预防医学,2016,27(3):365-366.
[9]李朦,袁耿彪.血清25-羟维生素D和雌激素水平与骨密度相关性的临床研究[J].国际检验医学杂志,2013,34(22):3043-3045,3054.
[10]孔德策,杨铁毅,邵进,等.50~60岁绝经后骨折女性25(OH)D3和骨密度、骨代谢指标的关系研究[J].中国骨质疏松杂志,2017,23(2):191-196.
[11]吴远桥,蒋旭峰,李毅沛,等.婴幼儿血清25-羟维生素D水平与骨密度关系观察[J].浙江预防医学,2009,21(2):56,58.
[12]欧丽黎,李吉华.骨碱性磷酸酶、血25-羟维生素D3联合骨密度对小儿维生素D缺乏性佝偻病的诊断价值[J].医学综述,2018,24(7):1449-1452.
[13]魏秋实,陈镇秋,谭新,等.中国男性和女性血清25羟维生素D水平与年龄、性别和骨密度之间的关系[J].实用骨科杂志,2016,22(5):480.
[14]唐毅,杨靖,曹洪义,等.成都地区不同年龄城乡妇女维生素D和骨代谢指标及骨密度的状况分析[J].中国骨质疏松杂志,2016,22(6):756-760.
[15]叶侃,宋媛,陆艳红,等.苏州地区儿童维生素D受体基因多态性与25-羟维生素D水平的关系[J].江苏医药,2017,43(8):552-554.
[16]李源斌,陆妹.早产儿血清25羟基维生素D3水平与超声骨密度的相关性研究[J].中国当代医药,2017,24(13):106-108,126.
[17]王全光.25羟维生素D3胰岛素样生长因子-Ⅰ及超声骨密度在佝偻病患儿中的意义[J].河北医学,2017,23(5):867-869.
[18]陈小香,谭新,邓伟民.骨质疏松症患者骨密度与血清25羟维生素D的相关性研究[J].中国骨质疏松杂志,2017,23(7):851-855.
[19]刘丹丹,常虹,谈敏.男性2型糖尿病患者25羟维生素D3及骨代谢指标的变化分析[J].安徽医药,2015,19(2):288-291.
[20]李文忠,陆耀宇,田永波,等.黔南州3~6岁农村布依族与苗族儿童维生素D营养状况及骨密度的比较研究[J].中国妇幼保健,2013,28(19):3117-3120,3134.