Siafarikas Aris, Deichl Alfons, Jahreis Gerhard, Pieplow Angela, Vogel Hartmut, Kauf Eberhard, Kapuhs Anna-Elisabeth, Badeke Elke, Berger Günter, Kändler Hans, Hesse Volker
Princess Margaret Hospital for Children, Department of Endocrinology and Diabetes, Roberts Road, Subiaco, Perth, WA 6020.
Paediatric Practice, Burglengenfeld.
J Pediatr Endocrinol Metab. 2017 Apr 1;30(4):395-404. doi: 10.1515/jpem-2016-0310.
Universal vitamin D supplementation is controversial. Preventative examinations and public health initiatives in former East Germany that included vitamin D prophylaxis for children were regulated by official recommendations and guidelines. The aim of this study is to analyse the impact of a standardised nationwide guideline for universal supplementation with 400 International Units (IU) vitamin D3/day during the first year of life on clinical and biochemical parameters and the influence of surrounding factors.
This is a cross-sectional analysis looking at data from a field study of 3481 term-born children during their first year of life that was conducted in 1989.
There were no significant clinical signs of rickets. 25 hydroxyvitamin D (25(OH)D) (mean and SEM, total analyses n=572) after birth (n=28) was 36(7) nmol/L, at 1 month 64(4) nmol/L (n=70, p<0.0001), 91(5) nmol/L at 3 months (n=95, p<0.0001), 65(8) nmol/L at 8 months (n=21, p=0.005) and ranged between 33 and 109 nmol/L until 12 months. Less than 0.2% of analyses revealed pathological levels for calcium or phosphate. Alkaline phosphatase (ALP) levels (n=690) were >1500 U/L (95th percentile) in 3.6%. Participants were on breastmilk or vitamin D-free formula, with solids added from 6 months of age. There were seasonal variations in 25(OH)D levels with a rise during spring and autumn. Thus this analysis is unique as sun exposure and supplementation can be considered as the only vitamin D sources.
We conclude that universal supplementation with 400 IU of vitamin D3 during the first year of life is safe and provides sufficient 25(OH)D levels in Germany.
普遍补充维生素D存在争议。前东德的预防性检查和公共卫生举措包括对儿童进行维生素D预防，这些举措受官方建议和指南的规范。本研究的目的是分析在生命的第一年每天补充400国际单位（IU）维生素D3的标准化全国性指南对临床和生化参数的影响以及周围因素的作用。
这是一项横断面分析，研究的数据来自1989年对3481名足月儿出生后第一年进行的一项现场研究。
无明显的佝偻病临床体征。出生时（n = 28）25羟维生素D（25(OH)D）（均值和标准误，总计分析n = 572）为36(7) nmol/L，1个月时为64(4) nmol/L（n = 70，p < 0.0001），3个月时为91(5) nmol/L（n = 95，p < 0.0001），8个月时为65(8) nmol/L（n = 21，p = 0.005），直至12个月时在33至109 nmol/L之间。不到0.2%的分析显示钙或磷水平异常。碱性磷酸酶（ALP）水平（n = 690）在3.6%的参与者中>1500 U/L（第95百分位数）。参与者食用母乳或不含维生素D的配方奶，6个月龄开始添加固体食物。25(OH)D水平存在季节性变化，春季和秋季升高。因此，由于可将日照和补充剂视为唯一的维生素D来源，该分析具有独特性。
我们得出结论，在德国，生命的第一年普遍补充400 IU维生素D3是安全的，并能提供足够的25(OH)D水平。
