Pediatric Endocrinology Unit, Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Ramat-Gan, Israel.
Pediatr Res. 2012 Dec;72(6):620-4. doi: 10.1038/pr.2012.131. Epub 2012 Oct 4.
Multiple studies associate low vitamin D levels with cancer morbidity and mortality. However, few studies have measured vitamin D in pediatric patients with malignancy. Our aim was to assess vitamin D status in a large cohort of pediatric patients with cancer and to define risk factors for deficiency.
Circulating 25-hydroxyvitamin D (25OHD) levels were measured in 211 patients. Calcium intake and sun exposure habits were assessed in 142 patients (age 12.1 ± 5.8 y; number of male patients, 69; mean time from diagnosis, 4.4 ± 3.8 y).
Daily calcium intake was 66.2 ± 39.3% of the recommended daily allowance. Mean 25OHD levels were 20.6 ± 7.9 ng/ml. Vitamin D deficiency (<15 ng/ml) was found in 24.6% of the patients and insufficiency (15-20 ng/ml) in 23.2%. Younger age and amount of sun exposure were associated with higher serum 25OHD. No association was found with calcium intake, disease type, gender, BMI SD score, years since diagnosis, or stem cell transplantation. The 25OHD levels during winter were significantly lower than the summer levels.
The prevalence of vitamin D deficiency and insufficiency in pediatric patients with a history of malignancy was high, whereas calcium intake was low. These findings are concerning, given the risk for osteoporosis in this population and the possible role of vitamin D in the context of malignancy.
多项研究表明维生素 D 水平低与癌症发病率和死亡率有关。然而，很少有研究测量过患有恶性肿瘤的儿科患者的维生素 D 水平。我们的目的是评估大量患有癌症的儿科患者的维生素 D 状况，并确定其缺乏的危险因素。
测量了 211 例患者的循环 25-羟维生素 D（25OHD）水平。在 142 例患者（年龄 12.1±5.8 岁；男性患者 69 例；从诊断到现在的平均时间为 4.4±3.8 年）中评估了钙摄入量和阳光暴露习惯。
每日钙摄入量为建议日摄入量的 66.2±39.3%。平均 25OHD 水平为 20.6±7.9ng/ml。24.6%的患者存在维生素 D 缺乏症（<15ng/ml），23.2%的患者存在不足症（15-20ng/ml）。年龄较小和阳光暴露量与血清 25OHD 水平较高相关。与钙摄入量、疾病类型、性别、BMI SD 评分、从诊断到现在的时间或干细胞移植均无关联。冬季的 25OHD 水平明显低于夏季。
患有恶性肿瘤病史的儿科患者中维生素 D 缺乏和不足的患病率很高，而钙摄入量却很低。鉴于该人群骨质疏松的风险以及维生素 D 在恶性肿瘤方面的可能作用，这些发现令人担忧。
