阿拉斯加原住民儿童的佝偻病与维生素D缺乏症
Rickets and vitamin D deficiency in Alaska native children.
作者信息
Singleton Rosalyn, Lescher Rachel, Gessner Bradford D, Benson Matthew, Bulkow Lisa, Rosenfeld John, Thomas Timothy, Holman Robert C, Haberling Dana, Bruce Michael, Bartholomew Michael, Tiesinga James
出版信息
J Pediatr Endocrinol Metab. 2015 Jul;28(7-8):815-23. doi: 10.1515/jpem-2014-0446.
BACKGROUND
Rickets and vitamin D deficiency appeared to increase in Alaskan children starting in the 1990s. We evaluated the epidemiology of rickets and vitamin D deficiency in Alaska native (AN) children in 2001-2010.
METHODS
We analyzed 2001-2010 visits with rickets or vitamin D deficiency diagnosis for AN and American Indian children and the general US population aged <10 years. We conducted a case-control study of AN rickets/vitamin D deficient cases and age- and region-matched controls.
RESULTS
In AN children, annual rickets-associated hospitalization rate (2.23/100,000 children/year) was higher than the general US rate (1.23; 95% CI 1.08-1.39). Rickets incidence increased with latitude. Rickets/vitamin D deficiency cases were more likely to have malnutrition (OR 38.1; 95% CI 4.9-294), had similar breast-feeding prevalence, and were less likely to have received vitamin D supplementation (OR 0.23; 95% CI 0.1-0.87) than controls.
CONCLUSIONS
Our findings highlight the importance of latitude, malnutrition, and lack of vitamin D supplementation as risk factors for rickets.
背景
从20世纪90年代起，阿拉斯加儿童中佝偻病和维生素D缺乏症的发病率似乎有所上升。我们评估了2001年至2010年阿拉斯加原住民（AN）儿童中佝偻病和维生素D缺乏症的流行病学情况。
方法
我们分析了2001年至2010年期间AN儿童、美国印第安儿童以及10岁以下美国普通人群因佝偻病或维生素D缺乏症诊断而进行的就诊情况。我们对AN佝偻病/维生素D缺乏症病例以及年龄和地区匹配的对照进行了病例对照研究。
结果
在AN儿童中，每年与佝偻病相关的住院率（2.23/100,000儿童/年）高于美国总体水平（1.23；95%可信区间1.08 - 1.39）。佝偻病发病率随纬度升高而增加。佝偻病/维生素D缺乏症病例比对照组更易出现营养不良（比值比38.1；95%可信区间4.9 - 294），母乳喂养率相似，且接受维生素D补充剂的可能性较小（比值比0.23；95%可信区间0.1 - 0.87）。
结论
我们的研究结果突出了纬度、营养不良以及缺乏维生素D补充剂作为佝偻病风险因素的重要性。
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