Akkermans Marjolijn D, van der Horst-Graat Judith M, Eussen Simone R B M, van Goudoever Johannes B, Brus Frank
*Department of Paediatrics, Juliana Children's Hospital/Haga Teaching Hospital, The Hague †Danone Nutricia Research, Utrecht ‡Department of Paediatrics, Emma Children's Hospital - Academic Medical Center, Amsterdam, The Netherlands.
J Pediatr Gastroenterol Nutr. 2016 Apr;62(4):635-42. doi: 10.1097/MPG.0000000000001015.
Iron deficiency (ID) and vitamin D deficiency (VDD) are the 2 most common micronutrient deficiencies in young children worldwide and may lead to impaired neurodevelopment and rickets, respectively. Risk factors for ID and VDD differ between populations. The objective of this study was to determine the prevalence of and risk factors for ID and VDD in 12- to 36-month-old children in Western Europe.
This study took place in Germany, the Netherlands, and the United Kingdom from 2012 to 2014. A venous blood sample was taken to establish iron and vitamin D status. ID was defined as serum ferritin <12 μg/L in the absence of infection (high sensitivity C-reactive protein <10 mg/L). VDD was defined as serum 25-hydroxyvitamin D <50 nmol/L (20 ng/mL). Furthermore, parents were asked to fill out a questionnaire regarding their child's demographic- and socioeconomic characteristics, food intake, sun exposure, and medical history.
In 325 children (white race 95%, boys 56%, mean age 20.7 months) the overall prevalence of ID and VDD was 11.8% and 22.8%, respectively. The use of primarily cow's milk as major type of milk was associated with ID (odds ratio [OR] 3.20, 95% confidence interval [CI] 1.12-8.53) and VDD (OR 7.17, 95% CI 3.10-16.57). The use of vitamin D supplements (OR 0.20, 95% CI 0.07-0.56) was associated with a lower prevalence of VDD.
Despite current nutritional recommendations, ID and VDD are common in healthy young white children. Health programs focusing on adequate iron and vitamin D intake at an early age should be implemented to prevent deficiencies.
缺铁（ID）和维生素D缺乏（VDD）是全球幼儿中最常见的两种微量营养素缺乏症，分别可能导致神经发育受损和佝偻病。ID和VDD的风险因素因人群而异。本研究的目的是确定西欧12至36个月大儿童中ID和VDD的患病率及风险因素。
本研究于2012年至2014年在德国、荷兰和英国进行。采集静脉血样以确定铁和维生素D状态。ID定义为在无感染（高敏C反应蛋白<10mg/L）情况下血清铁蛋白<12μg/L。VDD定义为血清25-羟基维生素D<50nmol/L（20ng/mL）。此外，还要求家长填写一份关于其孩子的人口统计学和社会经济特征、食物摄入、日照情况及病史的问卷。
在325名儿童（白人占95%，男孩占56%，平均年龄20.7个月）中，ID和VDD的总体患病率分别为11.8%和22.8%。主要将牛奶作为主要奶类使用与ID（比值比[OR]3.20，95%置信区间[CI]1.12 - 8.53）和VDD（OR 7.17，95%CI 3.10 - 16.57）相关。使用维生素D补充剂（OR 0.20，95%CI 0.07 - 0.56）与较低的VDD患病率相关。
尽管有当前的营养建议，但ID和VDD在健康的白人幼儿中很常见。应实施关注幼儿充足铁和维生素D摄入的健康计划以预防缺乏症。
