Rajakumar Kumaravel, Holick Michael F, Moore Charity G, Cohen Elan, Olabopo Flora, Haralam Mary Ann, Bogusz Jaimee, Nucci Anita, Greenspan Susan L
Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Pediatr Int. 2014 Feb;56(1):35-42. doi: 10.1111/ped.12210.
Seasonal fluxes in 25-hydroxyvitamin D (25(OH)D) in children can affect bone turnover, and in turn potentially affect bone accrual and peak bone mass. The aim of this study was to examine the effect of seasonal flux on the association among 25(OH)D, parathyroid hormone (PTH) and markers of bone turnover in pre- and early pubertal black children and white children.
Data were collected during summer (June-September) and winter (December-March) in 6-12-year-old children. Measurements included serum 25(OH)D, PTH, osteocalcin (OC), collagen type 1 cross-linked C-telopeptide (CTx), dietary intake of vitamin D and calcium, skin color, sunlight exposure, and body mass index (BMI).
A total of 138 children (mean age, 9.1 ± 1.7 years; black, n = 94; male, n = 81) were studied. 25(OH)D was higher (41.2 ± 13 vs 34.5 ± 11.1 ng/mL; P < 0.001) and CTx was lower (0.8 ± 0.3 vs 0.9 ± 0.5 ng/mL; P < 0.001) in all participants during summer when compared to winter. Furthermore, seasonal differences in CTx were more pronounced in black children (summer, 0.7 ± 0.3 vs winter, 1.0 ± 0.5 ng/mL; P < 0.001). PTH was a significant predictor of serum CTx and OC after adjusting for race, season, Tanner stage, dietary calcium, skin color and BMI.
25(OH)D declined significantly in both black children and white children during winter. CTx significantly increased during winter in black children compared to white children, suggesting increased rates of resorption in black children during winter. Benefits of enhancement of wintertime vitamin D status on bone health need further exploration.
儿童体内25-羟基维生素D(25(OH)D)的季节性变化会影响骨转换,进而可能影响骨质积累和峰值骨量。本研究的目的是探讨季节性变化对青春期前和青春期早期黑人儿童及白人儿童体内25(OH)D、甲状旁腺激素(PTH)和骨转换标志物之间关联的影响。
收集6至12岁儿童在夏季(6月至9月)和冬季(12月至3月)的数据。测量指标包括血清25(OH)D、PTH、骨钙素(OC)、1型胶原交联C末端肽(CTx)、维生素D和钙的饮食摄入量、肤色、阳光暴露量以及体重指数(BMI)。
共研究了138名儿童(平均年龄9.1±1.7岁;黑人94名;男性81名)。与冬季相比,所有参与者在夏季时25(OH)D水平更高(41.2±13 vs 34.5±11.1 ng/mL;P<0.001),CTx水平更低(0.8±0.3 vs 0.9±0.5 ng/mL;P<0.001)。此外,黑人儿童CTx的季节性差异更为明显(夏季,0.7±0.3 vs冬季,1.0±0.5 ng/mL;P<0.001)。在校正种族、季节、坦纳分期、饮食钙、肤色和BMI后,PTH是血清CTx和OC的显著预测指标。
黑人儿童和白人儿童在冬季时25(OH)D均显著下降。与白人儿童相比,黑人儿童在冬季时CTx显著升高,提示冬季黑人儿童的骨吸收速率增加。冬季提高维生素D水平对骨骼健康的益处有待进一步探索。