Fraser David R
Faculty of Veterinary Science, University of Sydney, Sydney, NSW 2006, Australia.
J Steroid Biochem Mol Biol. 2004 May;89-90(1-5):491-5. doi: 10.1016/j.jsbmb.2004.03.057.
Vitamin D-deficiency rickets is an important disease of childhood in China. It occurs in all regions (20-53 degrees N) but is more prevalent in the north. A survey in Beijing indicated that Vitamin D-deficiency (plasma 25(OH)D concentration <12.5 nmol/l) occurred in more than 40% of adolescent girls in winter. Dietary calcium was often as low as 350 mg per day and a positive correlation was found between this and both bone mineral density (BMD) and Vitamin D status. In a subsequent intervention study with 757 Beijing schoolgirls, a daily supplement of milk, fortified with calcium, was provided on school days for 24 months. From anthropometric and bone density data, it is evident that the increased calcium intake from milk, had significant effects on bone and that deficiencies of both calcium and of Vitamin D had been affecting bone growth and development. In neighboring Mongolia (42 degrees -50 degrees N), rickets is also common, but its prevalence has increased since 1990. A 2-year survey (2000-2002) in Mongolia indicated that, as in China, a low intake of calcium and limited exposure to solar ultraviolet (UV) light in summer were associated with Vitamin D-deficiency. However, over the last decade, malnutrition has become widespread. It now appears that malnutrition impairs the efficiency of the utilization of Vitamin D obtained in summer. Hence, a number of factors need to be addressed to prevent Vitamin D-deficiency during growth.
维生素D缺乏性佝偻病在中国是一种重要的儿童疾病。该病在所有地区（北纬20 - 53度）均有发生，但在北方更为普遍。北京的一项调查表明，冬季超过40%的青春期女孩存在维生素D缺乏（血浆25(OH)D浓度<12.5 nmol/l）。膳食钙摄入量常常低至每日350毫克，且发现这与骨矿物质密度（BMD）和维生素D状态均呈正相关。在随后对757名北京女学生进行的干预研究中，在上学日每天提供添加钙的强化牛奶，持续24个月。从人体测量和骨密度数据来看，很明显牛奶中增加的钙摄入量对骨骼有显著影响，而且钙和维生素D的缺乏一直在影响骨骼生长发育。在邻国蒙古（北纬42度 - 50度），佝偻病也很常见，但自1990年以来其患病率有所上升。蒙古一项为期两年（2000 - 2002年）的调查表明，与中国情况一样，夏季钙摄入量低以及太阳紫外线（UV）照射有限与维生素D缺乏有关。然而，在过去十年中，营养不良已变得普遍。现在看来，营养不良会损害夏季获得的维生素D的利用效率。因此，为预防生长期间的维生素D缺乏，需要解决多个因素。
