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肥胖与非肥胖非裔美国儿童的维生素D状态及对维生素D(3)的反应

Vitamin D status and response to Vitamin D(3) in obese vs. non-obese African American children.

作者信息

Rajakumar Kumaravel, Fernstrom John D, Holick Michael F, Janosky Janine E, Greenspan Susan L

机构信息

Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

出版信息

Obesity (Silver Spring). 2008 Jan;16(1):90-5. doi: 10.1038/oby.2007.23.

Abstract

BACKGROUND

Serum 25-hydroxyvitamin D (25(OH)D) is low in obese adults.

OBJECTIVE

To examine serum 25(OH)D in obese (BMI >95th percentile for age) vs. non-obese (BMI = 5th-75th percentile for age) 6-10-year-old African American children and compare their differences in therapeutic response to vitamin D supplementation.

METHODS AND PROCEDURES

In an open label non-randomized pre-post comparison 21 obese (OB) and 20 non-obese (non-OB) subjects matched for age, sex, skin color, and pubertal maturation were treated with 400 IU of vitamin D(3) daily for 1 month. Serum 25(OH)D, 1,25-dihydroxyvitamin D (1,25(OH)(2)D), parathyroid hormone (PTH), leptin, and markers of bone turnover (serum bone-specific alkaline phosphatase (BSAP), osteocalcin (OC), and urine n -telopeptide cross-links of type 1 collagen (urine NTX)) were measured. Vitamin D deficiency was defined as serum 25(OH)D < or =20 ng/ml and insufficiency as 21-29 ng/ml respectively.

RESULTS

Vitamin D deficiency occurred in 12/21 (57%) OB vs. 8/20 (40%) non-OB at baseline (P = 0.35) and persisted in 5/21 (24%) OB vs. 2/18 (11%) non-OB (P = 0.42) after treatment. When the cohort was stratified by the baseline levels of 25(OH)D, there were differences in the response to treatment in the obese and non-obese cohorts.

DISCUSSION

Vitamin D deficiency was common among OB and non-OB preadolescent African American children, and 400 IU of vitamin D(3) (2x the recommended adequate intake) daily for 1 month was inadequate to raise their blood levels of 25(OH)D to > or =30 ng/ml.

摘要

背景

肥胖成年人的血清25-羟维生素D(25(OH)D)水平较低。

目的

检测肥胖(BMI高于年龄别第95百分位数)与非肥胖(BMI处于年龄别第5至75百分位数)的6至10岁非裔美国儿童的血清25(OH)D,并比较他们对维生素D补充治疗反应的差异。

方法与步骤

在一项开放标签、非随机的前后对照研究中,21名肥胖(OB)和20名非肥胖(非OB)受试者,根据年龄、性别、肤色和青春期成熟度进行匹配,每天接受400 IU维生素D(3)治疗,为期1个月。检测血清25(OH)D、1,25-二羟维生素D(1,25(OH)(2)D)、甲状旁腺激素(PTH)、瘦素以及骨转换标志物(血清骨特异性碱性磷酸酶(BSAP)、骨钙素(OC)和尿Ⅰ型胶原N-端肽交联物(尿NTX))。维生素D缺乏定义为血清25(OH)D≤20 ng/ml,不足定义为21 - 29 ng/ml。

结果

基线时,12/21(57%)的肥胖儿童与8/20(40%)的非肥胖儿童存在维生素D缺乏(P = 0.35),治疗后,5/21(24%)的肥胖儿童与2/18(11%)的非肥胖儿童仍存在维生素D缺乏(P = 0.42)。当根据25(OH)D的基线水平对队列进行分层时,肥胖和非肥胖队列对治疗的反应存在差异。

讨论

维生素D缺乏在肥胖和非肥胖的青春期前非裔美国儿童中普遍存在,每天400 IU维生素D(3)(推荐充足摄入量的2倍),持续1个月,不足以将他们的血液25(OH)D水平提高至≥30 ng/ml。

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