苏州地区0～6岁儿童维生素D营养状况调查分析
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摘要
目的了解苏州地区儿童血清25(OH)D_3的水平状态,为0～6岁儿童合理补充维生素D提供科学依据。方法选取苏州市立医院儿童保健门诊2015年9月至2016年9月常规体检的15 010例儿童,其中男7 905例,女7 105例,通过采集其指尖血进行血清25(OH)D_3检测。结果 (1)苏州地区15 010例0～6岁儿童血清25(OH)D_3均值为(35.83±13.23)μg/L,男、女童血清25(OH)D_3均值分别为(36.48±13.25)、(35.11±13.16)μg/L,差异有统计学意义(P<0.01)。(2)0～<3、3～<6、6～<12、12～<36、36～<48、≥48个月年龄段儿童血清25(OH)D_3均值分别为(34.49±11.53)、(41.15±13.86)、(48.03±17.25)、(46.12±17.69)、(28.49±16.55)和(42.28±17.59)μg/L,除3～<6个月年龄段儿童与≥48个月比较差异无统计学意义外,其余各年龄段两两比较差异均有统计学意义(P<0.05)。(3)1～12月检测的血清25(OH)D_3中除1、2、3月与11月,7月与8月两两比较差异无统计学意义外,其余各月份之间比较差异均有统计学意义(P<0.01)。按维生素D水平判断标准分级,各月份血清25(OH)D_3分级构成比差异有统计学意义(P<0.01)。25(OH)D_3>30μg/L比例低于50%的月份为1、3、11月,比例在50%～60%为2、6、12月,比例在60%～70%为7、8、9月,比例>70%的月份为4、5和10月。结论苏州地区学龄儿童血清25(OH)D_3水平下降明显,应加强宣教,关注该年龄段儿童维生素D的摄入情况。
Objective To study the level of serum 25(OH)D3 in children in suzhou area,and to provide scientific basis for the rational supplement of vitamin D for children aged 0-6 years.Methods From September2015 to September 2016,15 010 children underwent routine physical examination in the Children′s Health Clinic of Suzhou Municipal Hospital were selected,of whom 7 905 were male and 7 105 were female.The serum 25(OH)D3 was detected by collecting their fingerling blood.Results(1)The mean serum 25(OH)D3 of15 010 children aged 0 to 6 in Suzhou was(35.83±13.23)μg/L,and the mean serum 25(OH)D3 of male and female were(36.48±13.25)and(35.11±13.16)μg/L respectively,and the differences were statistically significant(P<0.01).(2)The mean level of serum 25(OH)D3 of 0-<3,3-<6,6-<12,12-<36,36-<48 and≥48 months old children were(34.49±11.53),(41.15±13.86),(48.03±17.25),(46.12±17.69),(28.49±16.55)and(42.28±17.59)μg/L.The detection levels of serum 25(OH)D3 between the age groups were statistically significant(P<0.05)except the children 3-<6 months and≥48 months.(3)From January to December,the detection levels of serum 25(OH)D3 were statistically significant between different months(P<0.01)except in January,February,March and November,as well as July and August.The serum25(OH)D3 in each month was graded according to the vitamin D level,and the detection levels of serum 25(OH)D3 between different months were statistically significant(P<0.01).The proportion of serum 25(OH)D3 over 30μg/L was less than 50%in January,March and November.The ratio ranged from 50%to 60%in February,June and December.The ratio ranged from 60%to 70%in the July,August and September,while the proportion was over 70%in April,May and October.Conclusion The level of serum 25(OH)D3 in children in Suzhou area was decreased obviously,and health education should be strengthened,and attention should be paid to intaking of vitamin D in children.
Objective To study the level of serum 25(OH)D3 in children in suzhou area,and to provide scientific basis for the rational supplement of vitamin D for children aged 0-6 years.Methods From September2015 to September 2016,15 010 children underwent routine physical examination in the Children′s Health Clinic of Suzhou Municipal Hospital were selected,of whom 7 905 were male and 7 105 were female.The serum 25(OH)D3 was detected by collecting their fingerling blood.Results(1)The mean serum 25(OH)D3 of15 010 children aged 0 to 6 in Suzhou was(35.83±13.23)μg/L,and the mean serum 25(OH)D3 of male and female were(36.48±13.25)and(35.11±13.16)μg/L respectively,and the differences were statistically significant(P<0.01).(2)The mean level of serum 25(OH)D3 of 0-<3,3-<6,6-<12,12-<36,36-<48 and≥48 months old children were(34.49±11.53),(41.15±13.86),(48.03±17.25),(46.12±17.69),(28.49±16.55)and(42.28±17.59)μg/L.The detection levels of serum 25(OH)D3 between the age groups were statistically significant(P<0.05)except the children 3-<6 months and≥48 months.(3)From January to December,the detection levels of serum 25(OH)D3 were statistically significant between different months(P<0.01)except in January,February,March and November,as well as July and August.The serum25(OH)D3 in each month was graded according to the vitamin D level,and the detection levels of serum 25(OH)D3 between different months were statistically significant(P<0.01).The proportion of serum 25(OH)D3 over 30μg/L was less than 50%in January,March and November.The ratio ranged from 50%to 60%in February,June and December.The ratio ranged from 60%to 70%in the July,August and September,while the proportion was over 70%in April,May and October.Conclusion The level of serum 25(OH)D3 in children in Suzhou area was decreased obviously,and health education should be strengthened,and attention should be paid to intaking of vitamin D in children.
引文
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[15]王丽敏,张雪玲,王文娟,等.佳木斯地区6岁以下儿童血清维生素A、25-羟基维生素D、维生素E水平分析[J].检验医学,2017,32(4):276-279.
[16]冯慧敏,姚梅,郑义婷.皖北地区0~14岁儿童维生素D营养状况分析[J].中国学校卫生,2017,38(4):594-595.
[17]陈国微.丽水市区儿童保健门诊0~6岁儿童血清25-羟维生素D水平调查[J].中国农村卫生事业管理,2016,36(2):231-233.
[18]高改兰,李杰,汤淑斌,等.宝鸡地区1 874例0~7岁儿童维生素D水平调查研究[J].中国儿童保健杂志,2016,24(1):33-36.
[2] LEOPARDI N M,FELDMAN-WINTER L.Vitamin D status&nutritional status among urban versus suburban adolescents[J].J Pediatr Adolesc Gynecol,2011,24(2):e51.
[3] RAJAKUMAR K,HOLICK M F,JEONG K,et al.Impact of season and diet on vitamin D status of African American and Caucasian children[J].Clin Pediatr(Phila),2011,50(6):493-502.
[4] ZHU Z,ZHAN J,SHAO J,et al.High prevalence of vitamin D deficiency among children aged 1month to 16years in Hangzhou,China[J].BMC Public Health,2012,12(1):126.
[5] AZAB S F,SALEH S H,ELSAEED W F,et al.Vitamin D status in diabetic Egyptian children and adolescents:a case-control study[J].Ital J Pediatr,2013,39(1):73.
[6] EMMERSON A J B,DOCKERY K E,MUGHAL M Z,et al.Vitamin D status of white pregnant women and infants at birth and 4months in North West England:a cohort study[J].Matern Child Nutr,2017,14(1):12453.
[7]刘华清,张增利.人群维生素D水平检测的必要性[J].中国骨质疏松杂志,2012,18(4):371-374.
[8] PALACIOS C,GONZALEZ L.Is vitamin D deficiency a major global public health problem[J].J Steroid Biochem Mol Biol,2014,144Pt A:138-145.
[9] MANSBACH J M,GINDE A A,CAMARGO C A J R.Serum 25-hydroxyvitamin D levels among US children aged 1to 11years:do children need more vitamin D[J].Pediatrics,2009,124(5):1404-1410.
[10]MAGUIRE J L,BIRKEN C S,KHOVRATOVICH M,et al.Modifiable determinants of serum 25-hydroxyvitamin D status in early childhood:opportunities for prevention[J].JAMA Pediatr,2013,167(3):230-235.
[11]VIETH R.Vitamin D supplementation,25-hydroxyvitamin D concentrations,and safety[J].Am J Clin Nutr,1999,69(5):842-856.
[12]HOLICK M F.Resurrection of vitamin D deficiency and rickets[J].J Clin Invest,2006,116(8):2062-2072.
[13]BOUILLON R,NORMAN A W,LIPS P.Vitamin D deficiency[J].N Engl J Med,2007,357(19):1980-1981.
[14]VIERUCCI F,DEL PISTOIA M,FANOS M,et al.Vitamin D status and predictors of hypovitaminosis D in Italian children and adolescents:a cross-sectional study[J].Eur J Pediatr,2013,172(12):1607-1617.
[15]王丽敏,张雪玲,王文娟,等.佳木斯地区6岁以下儿童血清维生素A、25-羟基维生素D、维生素E水平分析[J].检验医学,2017,32(4):276-279.
[16]冯慧敏,姚梅,郑义婷.皖北地区0~14岁儿童维生素D营养状况分析[J].中国学校卫生,2017,38(4):594-595.
[17]陈国微.丽水市区儿童保健门诊0~6岁儿童血清25-羟维生素D水平调查[J].中国农村卫生事业管理,2016,36(2):231-233.
[18]高改兰,李杰,汤淑斌,等.宝鸡地区1 874例0~7岁儿童维生素D水平调查研究[J].中国儿童保健杂志,2016,24(1):33-36.