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[智利蓬塔阿雷纳斯儿童严重维生素D缺乏:营养状况对补充剂反应的影响]

[Severe vitamin D deficiency in children from Punta Arenas, Chile: Influence of nutritional status on the response to supplementation].

作者信息

Brinkmann Karin, Le Roy Catalina, Iñiguez Germán, Borzutzky Arturo

机构信息

Hospital Clínico Magallanes Dr. Lautaro Navarro Avaria, Punta Arenas, Chile.

Departamento de Gastroenterología y Nutrición Pediátrica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

出版信息

Rev Chil Pediatr. 2015 May-Jun;86(3):182-8. doi: 10.1016/j.rchipe.2015.03.001. Epub 2015 Jul 9.

Abstract

UNLABELLED

There is a high risk of vitamin D (VD) deficiency in the population of southern Chile that can be treated with VD supplements. Weight excess (WE) can influence the response to supplements.

OBJECTIVES

To study the prevalence of VD deficiency and the effect of cholecalciferol (VD3) supplements in healthy children from Punta Arenas, Chile, and evaluate a possible association with nutritional status.

METHODOLOGY

Demographic and anthropometric data, as well as laboratory assessment of serum 25-hidroxyvitamin D (25OHD) and other bone metabolism parameters were evaluated. After baseline evaluation, children were supplemented with VD3 1600 IU/day for one month, after which 25OHD was retested.

RESULTS

Of the 108 children studied, 50% were boys, and had a mean age of 9.6±0.5 years. Nutritional assessment showed that 39% had normal weight, 46% were overweight, and 15% were obese. Median 25OHD was 10.9ng/ml: 96.3% had deficiency (<20ng/ml) and 3.7% insufficiency (20-29ng/ml). Severe deficiency was found in 62% (<12ng/ml). Baseline 25OHD was not affected by nutritional status. After supplementation, median 25OHD was 17.5ng/ml: 62% had deficiency, 36% insufficiency, and 2% sufficiency (>30ng/ml). Children with WE had a significantly lower increase in 25OHD than children with normal weight (5±5.5 vs. 7.7±4.9, p=03). Children with WE may require 32% higher VD dose than normal weight children to attain the same 25OHD concentration.

CONCLUSIONS

Chilean schoolchildren from Punta Arenas have high prevalence of WE and VD deficiency, with a majority in the range of severe VD deficiency. WE interferes in the response to VD supplementation, leading to a lower increase in 25OHD.

摘要

未标注

智利南部人群中维生素D(VD)缺乏风险较高,可通过补充VD进行治疗。体重超标(WE)会影响对补充剂的反应。

目的

研究智利蓬塔阿雷纳斯健康儿童中VD缺乏的患病率以及胆钙化醇(VD3)补充剂的效果,并评估其与营养状况的可能关联。

方法

评估人口统计学和人体测量数据,以及血清25-羟基维生素D(25OHD)和其他骨代谢参数的实验室评估。在基线评估后,儿童每天补充1600国际单位的VD3,持续一个月,之后重新检测25OHD。

结果

在研究的108名儿童中,50%为男孩,平均年龄为9.6±0.5岁。营养评估显示,39%体重正常,46%超重,15%肥胖。25OHD中位数为10.9纳克/毫升:96.3%缺乏(<20纳克/毫升),3.7%不足(20 - 29纳克/毫升)。62%存在严重缺乏(<12纳克/毫升)。基线25OHD不受营养状况影响。补充后,25OHD中位数为17.5纳克/毫升:62%缺乏,36%不足,2%充足(>30纳克/毫升)。体重超标的儿童25OHD的升高明显低于体重正常的儿童(5±5.5对7.7±4.9,p = 0.03)。体重超标的儿童可能需要比体重正常的儿童高32%的VD剂量才能达到相同的25OHD浓度。

结论

智利蓬塔阿雷纳斯的学童中体重超标和VD缺乏患病率较高,大多数处于严重VD缺乏范围内。体重超标会干扰对VD补充剂的反应,导致25OHD升高较低。

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