阿尔及利亚北部学童的维生素D状况、季节变化及维生素D缺乏的决定因素
Vitamin D status of schoolchildren in Northern Algeria, seasonal variations and determinants of vitamin D deficiency.
作者信息
Djennane M, Lebbah S, Roux C, Djoudi H, Cavalier E, Souberbielle J-C
机构信息
Rheumatology Department, University Hospital, Tizi-Ouzou, Algeria.
出版信息
Osteoporos Int. 2014 May;25(5):1493-502. doi: 10.1007/s00198-014-2623-7. Epub 2014 Feb 25.
UNLABELLED
There are no published data on the vitamin D status of children living in North Africa. In 435 healthy Algerian children 5-15 years old, we found that vitamin D insufficiency (serum 25-hydroxyvitamin D (25OHD) <50 nmol/L) was frequent, especially in winter. Low vitamin D status was associated with increased parathyroid hormone (PTH) and leg deformation
INTRODUCTION
As there are no published data on the vitamin D status of children living in North Africa, we evaluated the 25OHD concentration of healthy Algerian children at the end of summer and at the end of winter. As secondary objectives, we studied the various determinants of vitamin D status and the PTH-25OHD relationship in these subjects.
METHODS
Four hundred thirty-five children 5-15 years old were examined and had a blood sample in September 2010. Of them, 408 were sampled again in March 2011.
RESULTS
Median 25OHD concentration in the whole group was 71.4 nmol/L in September and 52.9 nmol/L in March. In September, 58.4, 29.9, and 8.1% had a 25OHD concentration below 75, 50, and 30 nmol/L respectively. In March, these percentages increased to 65.2, 41.4, and 17.4% for the 75, 50, and 30 nmol/L threshold, respectively. In multivariate analysis, older age, darker skin phototype, low daily vitamin D and calcium intake, poor socioeconomic status, and short daily sun exposure remained significantly associated with a 25OHD <50 nmol/L at both visits. In 72 (16.6%) children, genu varum/valgum was present. Compared to the 363 children without leg deformation, they presented more frequently with the risk factors of vitamin D insufficiency. They also had lower 25OHD concentrations and higher PTH and tALP. Serum PTH and 25OHD concentrations were negatively and significantly correlated (r = -0.43; p < 0.001) without a 25OHD threshold above which PTH does not decrease anymore.
CONCLUSION
Despite a sunny environment, vitamin D insufficiency is frequent in healthy Algerian children.
未标注
目前尚无关于北非儿童维生素D状况的公开数据。在435名5至15岁的健康阿尔及利亚儿童中，我们发现维生素D不足（血清25-羟基维生素D（25OHD）<50 nmol/L）很常见，尤其是在冬季。维生素D水平低与甲状旁腺激素（PTH）升高和腿部畸形有关。
引言
由于尚无关于北非儿童维生素D状况的公开数据，我们评估了健康阿尔及利亚儿童在夏末和冬末的25OHD浓度。作为次要目标，我们研究了这些受试者维生素D状况的各种决定因素以及PTH-25OHD关系。
方法
对435名5至15岁的儿童进行了检查，并于2010年9月采集了血样。其中，408名儿童于2011年3月再次采样。
结果
整个组的25OHD浓度中位数在9月为71.4 nmol/L，在3月为52.9 nmol/L。9月，25OHD浓度低于75、50和30 nmol/L的儿童分别占58.4%、29.9%和8.1%。3月，对于75、50和30 nmol/L的阈值，这些百分比分别增至65.2%、41.4%和17.4%。多因素分析显示，年龄较大、皮肤光型较深、每日维生素D和钙摄入量低、社会经济地位差以及每日日照时间短在两次就诊时均与25OHD<50 nmol/L显著相关。72名（16.6%）儿童存在膝内翻/膝外翻。与363名无腿部畸形的儿童相比，他们更频繁地出现维生素D不足的危险因素。他们的25OHD浓度也更低，PTH和总碱性磷酸酶（tALP）更高。血清PTH和25OHD浓度呈显著负相关（r = -0.43；p < 0.001），且不存在一个使PTH不再下降的25OHD阈值。
结论
尽管环境阳光充足，但健康的阿尔及利亚儿童中维生素D不足仍很常见。
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