Narchi H, Kochiyil J, Zayed R, Abdulrazzak W, Agarwal M
Department of Pediatrics, Faculty of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
Ann Trop Paediatr. 2011;31(3):225-30. doi: 10.1179/1465328111Y.0000000017.
Although hypovitaminosis D has been reported in the neonatal period and infancy, there is currently little information on the longitudinal changes in vitamin D status throughout early infancy.
To estimate, in Al Ain, UAE, the prevalence of vitamin D deficiency and longitudinal changes and risk factors in infants between birth and 6 months of age.
Serum 25-OH-vitamin-D levels were measured after birth and 6 months later in 27 infants of mothers of Middle Eastern or Asian origin who were pregnant between the months of September and November 2007.
At delivery, mean (SD) maternal serum 25-OH-vitamin-D level was 35.5 nmol/L (24.7); five mothers (22%, 95% CI 0.7-43) had adequate serum levels (>50 mmol/L), 11 (48%, 95% CI 27-70) insufficient levels (25-50 nmol/L) and seven (30%, 95% CI 13-53) deficient (<25 nmol/L) levels. Serum 25-OH-vitamin-D levels were adequate in eight infants (30%, CI 14-50%), insufficient in 13 (48%, CI 28-60%) and deficient in six (22%, CI 8.5-42%). Despite recommendations, none had received any vitamin D supplementation since birth. Despite the high prevalence of hypovitaminosis D at birth and the lack of pharmacological supplementation, the number of infants with adequate levels at 6 months of age rose to 20 (87%, CI 66-97%). No infant had deficiency (CI 0-21%) and three (13%, CI 27-33%) had insufficiency. Adequate levels were detected in four infants who were partially breastfed [mean (SD) 108.5 (20.7) nmol/L] and in only 84% of the 19 exclusively breastfed infants [mean (SD) 96.2 (44.5) nmol/L] but the difference was not statistically significant. Although serum levels improved at 6 months, it occurred more slowly in exclusively breastfed infants.
In the absence of vitamin D supplementation, guidelines for vitamin D supplementation in infancy still need to be followed because the mechanisms for normalisation are not clearly understood.
虽然新生儿期和婴儿期已有维生素D缺乏症的报道，但目前关于整个婴儿早期维生素D状态的纵向变化信息很少。
在阿联酋艾因市，评估出生至6个月婴儿维生素D缺乏症的患病率、纵向变化及危险因素。
对2007年9月至11月期间怀孕的27名中东或亚洲裔母亲的婴儿，在出生时和6个月后测量血清25-羟基维生素D水平。
分娩时，母亲血清25-羟基维生素D水平的均值（标准差）为35.5 nmol/L（24.7）；5名母亲（22%，95%可信区间0.7 - 43）血清水平充足（>50 mmol/L），11名（48%，95%可信区间27 - 70）不足（25 - 50 nmol/L），7名（30%，95%可信区间13 - 53）缺乏（<25 nmol/L）。8名婴儿（30%，可信区间14 - 50%）血清25-羟基维生素D水平充足，13名（48%，可信区间28 - 60%）不足，6名（22%，可信区间8.5 - 42%）缺乏。尽管有相关建议，但无一名婴儿自出生后接受过任何维生素D补充。尽管出生时维生素D缺乏症患病率很高且缺乏药物补充，但6个月大时血清水平充足的婴儿数量增至20名（87%，可信区间66 - 97%）。无婴儿缺乏（可信区间0 - 21%），3名（13%，可信区间27 - 33%）不足。4名部分母乳喂养的婴儿血清水平充足[均值（标准差）108.5（20.7）nmol/L]，19名纯母乳喂养婴儿中只有84%血清水平充足[均值（标准差）96.2（44.5）nmol/L]，但差异无统计学意义。尽管6个月时血清水平有所改善，但纯母乳喂养婴儿改善得更慢。
在未补充维生素D的情况下，婴儿期维生素D补充指南仍需遵循，因为正常化机制尚不清楚。
