Ozcan Alper, Kendirci Mustafa, Kondolot Meda, Kardas Fatih, Akın Leyla
J Pediatr Endocrinol Metab. 2017 May 1;30(5):543-549. doi: 10.1515/jpem-2016-0223.
Vitamin D (VD) deficiency (VDD) is still a population-based health problem that affects people at different ages. The aim of this study was to evaluate VD prophylaxis for the prevention of VDD in (3-36)-month-old infants and children.
Infants and children aged between 3 and 36 months, with different etiologies, admitted to outpatient and inpatient clinics from October 2010 to October 2011 at the Children's Hospital of Erciyes University, were enrolled for the study. Their VD intake (if used; time of initiation, dosage and compliance) and nutritional status (breast-fed, formula or complementary fed) were noted. In order to study seasonal VD changes, the levels of serum calcium, phosphorus and magnesium, alkaline phosphatase activity (PLA), plasma parathyroid hormone (PTH) and 25 hydroxyvitamin 25(OH)D levels were measured at the beginning of VD supplementation during the four seasons.
A total of 316 subjects were enrolled in the study, consisting of 202 (63.9%) outpatient and 114 (26.1%) inpatient groups. From these subjects, 304 (96.2%) were supplemented with VD; whereas 12 (3.8%) were not. Out of the subjects supplemented with VD, 237 (75%) initiated VD after the second week of life, 267 (87.8%) were given three drops of VD daily and 209 (66.1%) had taken VD regularly. The plasma 25(OH)D levels were found to be lower in the inpatient group than the outpatient group (29.35 ng/mL and 34.35 ng/mL, respectively). The plasma 25(OH)D levels were lower during the spring and winter. VDD and VD insufficiency (VDI) was found in 31 (9.8%) and 30 (9.5%) subjects, respectively.
The plasma 25(OH)D levels were lower in inpatient and breast-fed only subjects and in winter and spring. The national VD augmentation program seems to be beneficial for the prevention of VDD, but VDD/VDI seems to still be an important health problem.
维生素D（VD）缺乏（VDD）仍是一个影响不同年龄段人群的基于人群的健康问题。本研究的目的是评估VD预防措施对预防3至36个月大婴幼儿VDD的效果。
选取2010年10月至2011年10月在埃尔西耶斯大学儿童医院门诊和住院部就诊的3至36个月大、病因各异的婴幼儿纳入研究。记录他们的VD摄入量（若使用；开始时间、剂量和依从性）以及营养状况（母乳喂养、配方奶喂养或辅食喂养）。为研究VD的季节性变化，在四季VD补充开始时测量血清钙、磷、镁水平、碱性磷酸酶活性（PLA）、血浆甲状旁腺激素（PTH）和25羟维生素25(OH)D水平。
共316名受试者纳入研究，其中门诊组202名（63.9%），住院组114名（26.1%）。这些受试者中，304名（96.2%）补充了VD，12名（3.8%）未补充。在补充VD的受试者中，237名（75%）在出生后第二周后开始补充VD，267名（87.8%）每天服用三滴VD，209名（66.1%）规律服用VD。发现住院组血浆25(OH)D水平低于门诊组（分别为29.35 ng/mL和34.35 ng/mL）。春季和冬季血浆25(OH)D水平较低。分别有31名（9.8%）和30名（9.5%）受试者存在VDD和VD不足（VDI）。
住院患者、仅母乳喂养的受试者以及冬季和春季时血浆25(OH)D水平较低。全国性的VD强化计划似乎对预防VDD有益，但VDD/VDI似乎仍是一个重要的健康问题。
