Division of Pediatric Hematology and Oncology, Department of Pediatrics Medicine, Hospital General Universitario Gregorio Marañón, Maiquez 9, 28007 Madrid, Spain.
Eur J Pediatr. 2012 Dec;171(12):1793-8. doi: 10.1007/s00431-012-1817-2. Epub 2012 Sep 5.
Patients with sickle cell disease have vitamin D deficiency and poor bone health which makes them prone to have an increased risk of fractures and osteoporosis in adulthood. We performed a prospective, cross-sectional study in children diagnosed with sickle cell disease living in Madrid, Spain. The purpose of this study was to evaluate the status of vitamin D of these children. Patients 0-16 years old were enrolled between 2008 and 2011. We studied demographics, calcium metabolism, and bone health, especially by measuring levels of 25-hydroxyvitamin D (25(OH)D), during different seasons of the year, and bone densitometry (beyond 4 years of age). Seventy-eight children were included in the study. Mean age was 4.8 ± 4.3 years, and mean serum 25(OH)D level was 21.50 ± 13.14 ng/ml, with no differences in 25(OH)D levels within different seasons. Fifty-six percent of children had levels of 25(OH) vitamin D of <20 ng/ml, whereas 79 and 18 % of them had levels of <30 and <11 ng/ml, respectively. Secondary hyperparathyroidism was observed in 25 % of children. Densitometry was performed in 33 children, and an abnormal z-score was seen in 15.2 % of them with no correlation with levels of 25(OH)D.
Vitamin D deficiency is highly prevalent in children with sickle cell disease, who are residing in Madrid, Spain, and it is detected at a young age. We propose that early intervention may increase the possibility of an adequate bone density later in life.
评估这些儿童的维生素 D 状况。
纳入 2008 年至 2011 年间居住在西班牙马德里的诊断为镰状细胞病的 0-16 岁儿童。我们研究了人口统计学、钙代谢和骨骼健康,特别是通过测量 25-羟维生素 D(25(OH)D)水平来评估。在不同季节进行了研究,并在 4 岁以上进行了骨密度测定。
78 名儿童纳入研究。平均年龄为 4.8±4.3 岁,平均血清 25(OH)D 水平为 21.50±13.14ng/ml,不同季节 25(OH)D 水平无差异。56%的儿童 25(OH)维生素 D 水平<20ng/ml,79%和 18%的儿童<30ng/ml 和<11ng/ml。25%的儿童存在继发性甲状旁腺功能亢进。33 名儿童进行了骨密度测定,其中 15.2%的儿童骨密度 z 评分异常,与 25(OH)D 水平无相关性。
西班牙马德里居住的镰状细胞病儿童维生素 D 缺乏非常普遍,且在儿童早期即可发现。我们建议早期干预可能会增加日后获得足够骨密度的可能性。