Grossman Zachi, Hadjipanayis Adamos, Stiris Tom, Del Torso Stefano, Mercier Jean-Christophe, Valiulis Arunas, Shamir Raanan
Pediatric Clinic, Maccabi Health Services, Tel Aviv, Israel.
Department of Paediatrics, Larnaca General Hospital, Larnaca, Cyprus.
Eur J Pediatr. 2017 Jun;176(6):829-831. doi: 10.1007/s00431-017-2903-2. Epub 2017 Apr 12.
Vitamin D is synthesized in human skin upon sun exposure and is also a nutrient. It regulates calcium and phosphate metabolism and is essential for the maintenance of bone health. Vitamin D supplementation during infancy, in order to prevent rickets, is universally accepted. Many human cell types carry vitamin D receptor, this being a drive for conducting studies on the possible association between vitamin D status and other diseases. Studies have affirmed that a considerable number of healthy European children may be vitamin D deficient, especially in high-risk groups (darker pigmented skin, living in areas with reduced sun exposure and other disorders). However, the definition of deficiency is unclear due to inter assay differences and due to a lack of consensus as to what is an "adequate" 25(OH)D level. Therefore, there is no justification for routine screening for vitamin D deficiency in healthy children. An evaluation of vitamin D status is justified in children belonging to high-risk groups. All infants up to 1 year of age should receive an oral supplementation of 400 IU/day of vitamin D. Beyond this age, seasonal variation of sunlight should be taken into account when considering a national policy of supplementation or fortification.
维生素D在人体皮肤暴露于阳光下时合成,它也是一种营养素。它调节钙和磷的代谢,对维持骨骼健康至关重要。婴儿期补充维生素D以预防佝偻病已被普遍接受。许多人类细胞类型都携带维生素D受体,这推动了关于维生素D状态与其他疾病之间可能关联的研究。研究证实,相当数量的健康欧洲儿童可能维生素D缺乏,尤其是在高危人群中(皮肤色素沉着较深、生活在阳光照射减少地区以及患有其他疾病的人群)。然而,由于检测方法之间的差异以及对于什么是“充足”的25(OH)D水平缺乏共识,缺乏的定义并不明确。因此,对健康儿童进行维生素D缺乏的常规筛查没有依据。对高危人群中的儿童评估维生素D状态是合理的。所有1岁以下婴儿应每天口服补充400国际单位的维生素D。超过这个年龄,在考虑国家补充或强化政策时应考虑阳光的季节性变化。