Weiler Hope, Fitzpatrick-Wong Shirley, Veitch Rebecca, Kovacs Heather, Schellenberg Jeannine, McCloy Ursula, Yuen Chui Kin
Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, Man.
CMAJ. 2005 Mar 15;172(6):757-61. doi: 10.1503/cmaj.1040508.
Vitamin D is required for normal bone growth and mineralization. We sought to determine whether vitamin D deficiency at birth is associated with bone mineral content (BMC) of Canadian infants.
We measured plasma 25-hydroxyvitamin D [25(OH)D] as an indicator of vitamin D status in 50 healthy mothers and their newborn term infants. In the infants, anthropometry and lumbar, femur and whole-body BMC were measured within 15 days of delivery. Mothers completed a 24-hour recall and 3-day food and supplement record. We categorized the vitamin D status of mothers and infants as deficient or adequate and then compared infant bone mass in these groups using nonpaired t tests. Maternal and infant variables known to be related to bone mass were tested for their relation to BMC using backward stepwise regression analysis.
Twenty-three (46%) of the mothers and 18 (36%) of the infants had a plasma 25(OH)D concentration consistent with deficiency. Infants who were vitamin D deficient were larger at birth and follow-up. Absolute lumbar spine, femur and whole-body BMC were not different between infants with adequate vitamin D and those who were deficient, despite larger body size in the latter group. In the regression analysis, higher whole-body BMC was associated with greater gestational age and weight at birth as well as higher infant plasma 25(OH)D.
A high rate of vitamin D deficiency was observed among women and their newborn infants. Among infants, vitamin D deficiency was associated with greater weight and length but lower bone mass relative to body weight. Whether a return to normal vitamin D status, achieved through supplements or fortified infant formula, can reset the trajectory for acquisition of BMC requires investigation.
正常的骨骼生长和矿化需要维生素D。我们试图确定出生时维生素D缺乏是否与加拿大婴儿的骨矿物质含量(BMC)相关。
我们测量了50名健康母亲及其足月新生儿的血浆25-羟基维生素D [25(OH)D],作为维生素D状态的指标。在婴儿出生后15天内测量其人体测量数据以及腰椎、股骨和全身的BMC。母亲们完成了一份24小时饮食回顾以及3天的食物和补充剂记录。我们将母亲和婴儿的维生素D状态分为缺乏或充足两类,然后使用非配对t检验比较这些组中的婴儿骨量。使用向后逐步回归分析测试已知与骨量相关的母婴变量与BMC的关系。
23名(46%)母亲和18名(36%)婴儿的血浆25(OH)D浓度符合缺乏标准。维生素D缺乏的婴儿在出生时和随访时体型更大。尽管维生素D缺乏组的婴儿体型较大,但维生素D充足的婴儿与缺乏的婴儿相比,其腰椎、股骨和全身的绝对BMC并无差异。在回归分析中,较高的全身BMC与更大的胎龄、出生体重以及较高的婴儿血浆25(OH)D相关。
在女性及其新生儿中观察到较高的维生素D缺乏率。在婴儿中,维生素D缺乏与更大的体重和身长相关,但相对于体重而言骨量较低。通过补充剂或强化婴儿配方奶粉恢复到正常维生素D状态是否能够重置BMC的获取轨迹,仍有待研究。