Health Sciences Department, Anna Meyer Children's University Hospital, University of Florence, Viale Pieraccini 24, 50139 Florence, Italy.
Genetics and Molecular Medicine Unit, Anna Meyer Children's University Hospital, Viale Pieraccini 24, 50139 Florence, Italy.
Int J Endocrinol. 2015;2015:896758. doi: 10.1155/2015/896758. Epub 2015 Jan 20.
Background. Poor studies have evaluated 25-hydroxycholecalciferol (25(OH)D) levels in Down syndrome (DS). Objective. To assess in DS subjects serum 25(OH)D value, to identify risk factors for vitamin D deficiency, and to evaluate whether a normal 25(OH)D value can be restored with a 400 I.U. daily supplement of cholecalciferol in respect to controls. Methods. We have longitudinally evaluated 31 DS patients (aged 4.5-18.9 years old) and 99 age- and sex-matched healthy controls. In these subjects, we analysed calcium, phosphate, parathyroid hormone (PTH), 25(OH)D concentrations, and calcium and 25(OH)D dietary intakes, and we quantified outdoor exposure. After 12.3 months (range 8.1-14.7 months) of 25(OH)D supplementation, we reevaluated these subjects. Results. DS subjects showed reduced 25(OH)D levels compared to controls (P < 0.0001), in particular DS subjects with obesity (P < 0.05) and autoimmune diseases history (P < 0.005). PTH levels were significantly higher in DS subjects than controls (P < 0.0001). After cholecalciferol supplementation, 25(OH)D levels were significantly ameliorated (P < 0.05), even if reduced compared to controls (P < 0.0001), in particular in DS subjects with obesity (P < 0.05) and autoimmune diseases (P < 0.001). Conclusions. Hypovitaminosis D is very frequent in DS subjects, in particular in presence of obesity and autoimmune diseases. In these subjects, there could be a need for higher cholecalciferol supplementation.
背景。已有研究对唐氏综合征（Down syndrome，DS）患者的 25-羟维生素 D [25（OH）D] 水平进行了评估，但结果并不理想。目的。评估 DS 患者血清 25（OH）D 水平，识别维生素 D 缺乏的危险因素，并评估与对照组相比，400IU 维生素 D3 日补充剂能否恢复正常的 25（OH）D 水平。方法。我们对 31 名 DS 患者（年龄 4.5-18.9 岁）和 99 名年龄和性别匹配的健康对照者进行了纵向评估。分析了这些受试者的钙、磷、甲状旁腺激素（parathyroid hormone，PTH）、25（OH）D 浓度以及钙和 25（OH）D 的膳食摄入量，并量化了户外活动量。补充 25（OH）D 12.3 个月（8.1-14.7 个月）后，重新评估这些受试者。结果。与对照组相比，DS 患者的 25（OH）D 水平较低（P <0.0001），特别是肥胖（P <0.05）和有自身免疫性疾病史（P <0.005）的 DS 患者。DS 患者的 PTH 水平显著高于对照组（P <0.0001）。补充胆钙化醇后，25（OH）D 水平显著改善（P <0.05），但与对照组相比仍较低（P <0.0001），尤其是肥胖（P <0.05）和自身免疫性疾病（P <0.001）的 DS 患者。结论。DS 患者普遍存在维生素 D 缺乏，尤其是肥胖和自身免疫性疾病患者。这些患者可能需要更高剂量的胆钙化醇补充。
