Rovner Alisha J, Stallings Virginia A, Kawchak Deborah A, Schall Joan I, Ohene-Frempong Kwaku, Zemel Babette S
Division of Epidemiology, Statistics and Prevention, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD, USA.
J Am Diet Assoc. 2008 Sep;108(9):1512-6. doi: 10.1016/j.jada.2008.06.433.
Vitamin D is a particularly concerning nutrient for children with homozygous SS sickle cell disease (SCD-SS) due to their increased skin melanin concentrations, reduced levels of physical activity, and poor vitamin D intake. The goal of this study was to compare the vitamin D status of children with SCD-SS to healthy African-American children living in the same geographic area. Growth, dietary intake, serum 25-hydroxyvitamin D [25(OH)D], and intact parathyroid hormone (iPTH) concentrations were measured in 61 African-American subjects with SCD-SS and 89 healthy African-American control subjects age 5 to 18 years from the Philadelphia, PA, region (latitude 39.95 degrees N). Median serum 25(OH)D concentrations were 15 ng/mL (95% confidence interval [CI]: 13, 17) in subjects with SCD-SS and 21 ng/mL (95% CI: 18, 22) in healthy control subjects (P<0.0002). Vitamin D deficiency [25(OH)D<11 mg/mL] was found in 33% of subjects with SCD-SS and 9% of healthy control subjects (P<0.001); 25% of subjects with SCD-SS and 17% of healthy control subjects had elevated iPTH [(>59 rhog/mL), P<0.05]. Ninety-three percent of subjects with SCD-SS and 90% of healthy subjects had vitamin D insufficiency [25(OH)D<30 mg/mL]. The risk of vitamin D deficiency among subjects with SCD-SS was 5.3 (95% CI: 2.5, 8.2) times greater than control subjects, adjusted for season and age. Poor vitamin D status was prevalent in children with SCD-SS and healthy African-American children living in the same geographic area. However, children with SCD-SS were at greater risk for vitamin D deficiency than healthy African-American children.
由于纯合子SS型镰状细胞病（SCD - SS）患儿皮肤黑色素浓度增加、身体活动水平降低以及维生素D摄入量低，维生素D是这类患儿尤其需要关注的营养素。本研究的目的是比较SCD - SS患儿与生活在同一地理区域的健康非裔美国儿童的维生素D状况。对来自宾夕法尼亚州费城地区（北纬39.95度）的61名5至18岁的患有SCD - SS的非裔美国受试者和89名健康非裔美国对照受试者测量了生长指标、饮食摄入量、血清25 - 羟基维生素D [25(OH)D]和完整甲状旁腺激素（iPTH）浓度。SCD - SS受试者的血清25(OH)D浓度中位数为15 ng/mL（95%置信区间[CI]：13，17），健康对照受试者为21 ng/mL（95% CI：18，22）（P<0.0002）。在SCD - SS受试者中33%发现维生素D缺乏[25(OH)D<11 mg/mL]，健康对照受试者中为9%（P<0.001）；25%的SCD - SS受试者和17%的健康对照受试者iPTH升高[（>59 rhog/mL），P<0.05]。93%的SCD - SS受试者和90%的健康受试者存在维生素D不足[25(OH)D<30 mg/mL]。经季节和年龄调整后，SCD - SS受试者中维生素D缺乏的风险比对照受试者高5.3倍（95% CI：2.5，8.2）。SCD - SS患儿和生活在同一地理区域的健康非裔美国儿童普遍存在维生素D状况不佳的情况。然而，SCD - SS患儿比健康非裔美国儿童患维生素D缺乏的风险更高。
