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对德黑兰健康儿童和青少年维生素D状况的评估及其与甲状旁腺激素、性别、体重和身高的关系。

Assessment of vitamin D status in healthy children and adolescents living in Tehran and its relation to iPTH, gender, weight and height.

作者信息

Razzaghy-Azar Maryam, Shakiba Marjan

机构信息

Pediatric Endocrinology Department, H. Aliasghar Hospital, Iran University of Medical Sciences, East Dastgerdi Avenue, Modarres Express Way, Tehran, Iran.

出版信息

Ann Hum Biol. 2010 Sep-Oct;37(5):692-701. doi: 10.3109/03014460903527348.

Abstract

This study was conducted to determine the frequency of vitamin D deficiency and its correlation with different factors. Three hundred and thirteen healthy children and adolescents (192 females and 121 males aged 8-18 years, mean +/- SD, 12.7 +/- 2.3 years) were enrolled, and measurements of serum 25-hydroxyvitamin D [25(OH)D] (using EIA) and intact parathyroid hormone (iPTH) (using immunoradiometric assay (IRMA)) were conducted. The grades of vitamin D status were defined according to blood level of 25(OH)D as follows: severely deficient < 12.5; deficient, > or = 12.5 and < 25; insufficient, > or = 25 and < 50; normal > or = 50 and < 250 nmol/L. Severe deficiency was detected in 25% of subjects (males 8%; females 92%), deficiency in 27% (males 34%; females 66%) and insufficiency in 26% (males 58%; females 42%). The mean 25(OH)D level in males was significantly greater than that in females (p < 0.001), and this level was significantly higher in prepubertal compared to pubertal subjects (p < 0.001). 25(OH)D had a negative correlation with iPTH (p < 0.001). The curve of iPTH began to rise when 25(OH)D reached 75 nmol/L. The level of 25(OH)D had a negative correlation with BMI-SDS and height-SDS in females (p-value, 0.01 and 0.039, respectively). The subjects did not have any signs or symptoms of rickets. Frequency of vitamin D deficiency did not have any significant seasonal variation. Furthermore, vitamin D deficiency was not found to be related to the type or location of the subjects' homes. In this study, subclinical vitamin D deficiency was significantly more prevalent in females, particularly those undergoing puberty. Children who were obese and taller than average, had lower levels of 25(OH)D, and level of 25(OH)D should be maintained > 75 nmol/L in order to prevent PTH rising.

摘要

本研究旨在确定维生素D缺乏的发生率及其与不同因素的相关性。纳入了313名健康儿童和青少年(192名女性和121名男性,年龄8 - 18岁,平均±标准差,12.7±2.3岁),并进行了血清25 - 羟基维生素D [25(OH)D](采用酶免疫分析(EIA))和完整甲状旁腺激素(iPTH)(采用免疫放射分析(IRMA))的检测。维生素D状态分级根据25(OH)D血水平定义如下:严重缺乏<12.5;缺乏,≥12.5且<25;不足,≥25且<50;正常≥50且<250 nmol/L。25%的受试者检测出严重缺乏(男性8%;女性92%),27%的受试者缺乏(男性34%;女性66%),26%的受试者不足(男性58%;女性42%)。男性的平均25(OH)D水平显著高于女性(p<0.001),且该水平在青春期前受试者中显著高于青春期受试者(p<0.001)。25(OH)D与iPTH呈负相关(p<0.001)。当25(OH)D达到75 nmol/L时,iPTH曲线开始上升。女性中25(OH)D水平与BMI - SDS和身高 - SDS呈负相关(p值分别为0.01和0.039)。受试者无任何佝偻病的体征或症状。维生素D缺乏的发生率无显著季节性变化。此外,未发现维生素D缺乏与受试者家庭类型或位置有关。在本研究中,亚临床维生素D缺乏在女性中更为普遍,尤其是青春期女性。肥胖且高于平均身高的儿童25(OH)D水平较低,为防止PTH升高,25(OH)D水平应维持>75 nmol/L。

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