Singh Jasmine, Merrill Eric Dean, Sandesara Pratik B, Schoeneberg Laura, Dai Hongying, Raghuveer Geetha
University of Missouri-Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO, 64108, USA.
Children's Mercy Hospital, 2401 Gillham Rd, Kansas City, MO, 64108, USA.
Pediatr Cardiol. 2015 Oct;36(7):1338-43. doi: 10.1007/s00246-015-1162-0. Epub 2015 Apr 3.
Vitamin D has anti-inflammatory properties, and deficiency is prevalent in children. There is a paucity of data regarding vitamin D status and its correlation with low-grade inflammation and vasculature. We prospectively enrolled 25 children, 9-11 years old (13 male); 21 obese. Eight atherosclerosis-promoting risk factors were scored as categorical variables with the following thresholds defining abnormality: body mass index Z score ≥ 1.5; systolic blood pressure ≥ 95th percentile (for age, sex, and height); triglyceride ≥ 100 mg/dL; low-density lipoprotein cholesterol (LDL-C) ≥ 110 mg/dL; high-density lipoprotein cholesterol ≤ 45 mg/dL; hemoglobin A1C (HBA1C) ≥ 5.5; 25-hydroxyvitamin D [25(OH) D] ≤ 30 ng/mL, and tobacco smoke exposure. High-sensitivity C-reactive protein (hsCRP) was measured to assess low-grade inflammation and classified as low- (<1 mg/L), average- (1-3 mg/L), and high-risk (>3 to <10 mg/L) groups. The proportion of children within each hsCRP group who had above threshold risk factors was calculated. Carotid artery ultrasound was performed to measure carotid artery intima-media thickness (CIMT). Median (range) for 25(OH) D was 24 (17-45) ng/mL. Eighteen were either 25 (OH) D deficient (<20 ng/mL) or insufficient (20-30 ng/mL), and seven were sufficient (>30 ng/mL). hsCRP was 1.7 (0.2-9.1) mg/L, with 11 being <1.0 mg/L, 8 between 1.0-3.0 and 6 > 3.0 to < 10.0 mg/L. Risk factor score was 3.9 ± 1.7 out of eight. 25(OH) D levels did not correlate with hsCRP or CIMT. While vitamin D deficiency, inflammation, and risk factors coexist at a very young age, causative mechanisms remain unclear.
维生素D具有抗炎特性，且儿童中维生素D缺乏情况普遍。关于维生素D状态及其与低度炎症和脉管系统的相关性的数据较少。我们前瞻性地招募了25名9至11岁的儿童（13名男性）；其中21名肥胖。对八个促进动脉粥样硬化的危险因素进行分类变量评分，以下阈值定义异常情况：体重指数Z评分≥1.5；收缩压≥第95百分位数（根据年龄、性别和身高）；甘油三酯≥100mg/dL；低密度脂蛋白胆固醇（LDL-C）≥110mg/dL；高密度脂蛋白胆固醇≤45mg/dL；糖化血红蛋白（HBA1C）≥5.5；25-羟基维生素D[25(OH)D]≤30ng/mL，以及接触烟草烟雾。测量高敏C反应蛋白（hsCRP）以评估低度炎症，并将其分为低风险（<1mg/L）、中度风险（1-3mg/L）和高风险（>3至<10mg/L）组。计算每个hsCRP组中具有高于阈值危险因素的儿童比例。进行颈动脉超声检查以测量颈动脉内膜中层厚度（CIMT）。25(OH)D的中位数（范围）为24（17-45）ng/mL。18名儿童25(OH)D缺乏（<20ng/mL）或不足（20-30ng/mL），7名儿童充足（>30ng/mL）。hsCRP为1.7（0.2-9.1）mg/L，其中11名<1.0mg/L，8名在1.0-3.0之间，6名>3.0至<10.0mg/L。危险因素评分为8项中的3.9±1.7。25(OH)D水平与hsCRP或CIMT无相关性。虽然维生素D缺乏、炎症和危险因素在非常小的年龄就同时存在，但其致病机制仍不清楚。
