Department of Pediatrics, The Ministry of Health Tepecik Teaching and Research Hospital, 119/1 sk. No: 5 Basinkent site B blok/6, 35050 Bornova- Izmir, Turkey.
Pediatrics. 2012 Oct;130(4):e921-7. doi: 10.1542/peds.2012-0017. Epub 2012 Sep 24.
OBJECTIVE: To examine the vitamin D status of 4-month-old exclusively breastfed infants supplemented with 400 IU daily of vitamin D and to determine whether there was any seasonal variation in serum 25-hydroxyvitamin D (25(OH)D) levels of infants. METHODS: In this cross-sectional study, serum calcium, phosphorus, alkaline phosphatase, parathyroid hormone, and 25(OH)D levels of 143 exclusively breastfed 4-month-old infants supplemented daily with 400 IU of vitamin D were measured in a temperate latitude, Izmir, Turkey, between May 2008 and April 2009. A questionnaire on demographic characteristics of infants and mothers, vitamin D supplementation of infants after birth, mothers' multivitamin supplementation, dressing habits, and consumption of dairy products during pregnancy was used. RESULTS: Vitamin D deficiency (≤ 50 nmol/L) and insufficiency (51-74 nmol/L) were determined in 40 (28%) and 55 (38.5%) infants, respectively. During winter days, serum 25(OH)D levels were <20 ng/mL in 45.4% of infants and <10 ng/mL in 10.6% of infants. Season of blood sampling, compliance of vitamin D supplementation, maternal education level, and consumption of dairy products were highly predictive of serum 25(OH)D levels in multiple linear regression analysis (P < .05). The use of the Pearson correlation test found a statistically significant negative correlation between 25(OH)D and parathyroid hormone levels (r = -0.419, P < .001). CONCLUSIONS: Despite supplementation with 400 IU of vitamin D daily, the rate of vitamin D deficiency was worryingly high in 4-month-old exclusively breastfed infants living in Izmir, Turkey. So, additional studies are needed to clarify optimal amount of vitamin D supplementation to the infants, especially during winter days.
目的:检测每日补充 400IU 维生素 D 的 4 月龄纯母乳喂养婴儿的维生素 D 状况,并确定婴儿血清 25-羟维生素 D(25(OH)D)水平是否存在季节性变化。
方法:在这项横断面研究中,于 2008 年 5 月至 2009 年 4 月在土耳其伊兹密尔的温带地区测量了 143 名每日补充 400IU 维生素 D 的纯母乳喂养 4 月龄婴儿的血清钙、磷、碱性磷酸酶、甲状旁腺激素和 25(OH)D 水平。使用了一份关于婴儿和母亲人口统计学特征、婴儿出生后维生素 D 补充、母亲多种维生素补充、穿衣习惯以及怀孕期间乳制品消费的问卷。
结果:40 名(28%)和 55 名(38.5%)婴儿分别被诊断为维生素 D 缺乏(≤50nmol/L)和不足(51-74nmol/L)。在冬季,45.4%的婴儿血清 25(OH)D 水平<20ng/mL,10.6%的婴儿血清 25(OH)D 水平<10ng/mL。在多元线性回归分析中,采血季节、维生素 D 补充的依从性、母亲教育水平和乳制品消费是血清 25(OH)D 水平的高度预测因素(P<0.05)。通过皮尔逊相关检验发现,25(OH)D 与甲状旁腺激素水平之间存在显著的负相关(r=-0.419,P<0.001)。
结论:尽管每日补充 400IU 维生素 D,但居住在土耳其伊兹密尔的 4 月龄纯母乳喂养婴儿的维生素 D 缺乏率令人担忧。因此,需要进一步研究以明确婴儿补充维生素 D 的最佳剂量,特别是在冬季。
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