Anderson Laura N, Heong Sze Wing, Chen Yang, Thorpe Kevin E, Adeli Khosrow, Howard Andrew, Sochett Etienne, Birken Catherine S, Parkin Patricia C, Maguire Jonathon L
Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Child Health Evaluative Sciences Program, The Hospital for Sick Children, Toronto, Ontario, Canada.
Am J Epidemiol. 2017 Jun 15;185(12):1255-1262. doi: 10.1093/aje/kww204.
The objective of this study was to evaluate the association of vitamin D intake and serum levels with fracture risk in children under 6 years of age. A case-control study was conducted in Toronto, Ontario, Canada. Cases were recruited from the fracture clinic at the Hospital for Sick Children, and matched controls were obtained from the TARGet Kids! primary-care research network. Controls were matched to cases on age, sex, height, and season. Fracture risk was estimated from conditional logistic regression, with adjustment for skin type, fracture history, waist circumference, outdoor free play, neighborhood income, soda consumption, and child's birth weight. A total of 206 cases were recruited during May 2009-April 2013 and matched to 343 controls. Serum 25-hydroxyvitamin D concentration (per 10-nmol/L increment: adjusted odds ratio (aOR) = 0.95, 95% confidence interval (CI): 0.88, 1.03) and intake of cow's milk (<2 cups/day vs. 2 cups/day: aOR = 0.95 (95% CI: 0.60, 1.52); >2 cups/day vs. 2 cups/day: aOR = 1.39 (95% CI: 0.85, 2.23)) were not significantly associated with reduced odds of fracture. A statistically significant association was observed between child use of vitamin D supplements and decreased odds of fracture (yes vs. no: aOR = 0.42, 95% CI: 0.25, 0.69). Vitamin D supplementation, but not serum 25-hydroxyvitamin D level or milk intake, was associated with reduced fracture risk among these healthy young children.
本研究的目的是评估6岁以下儿童维生素D摄入量和血清水平与骨折风险之间的关联。在加拿大安大略省多伦多市进行了一项病例对照研究。病例从病童医院的骨折诊所招募，匹配的对照从TARGet Kids!初级保健研究网络获得。对照在年龄、性别、身高和季节方面与病例进行匹配。通过条件逻辑回归估计骨折风险，并对皮肤类型、骨折史、腰围、户外自由活动、邻里收入、汽水摄入量和儿童出生体重进行调整。2009年5月至2013年4月期间共招募了206例病例，并与343例对照进行匹配。血清25-羟维生素D浓度（每增加10 nmol/L：调整后的优势比（aOR）=0.95，95%置信区间（CI）：0.88，1.03）和牛奶摄入量（<2杯/天与2杯/天：aOR=0.95（95%CI：0.60，1.52）；>2杯/天与2杯/天：aOR=1.39（95%CI：0.85，2.23））与骨折几率降低无显著关联。观察到儿童使用维生素D补充剂与骨折几率降低之间存在统计学显著关联（是与否：aOR=0.42，95%CI：0.25，0.69）。在这些健康幼儿中，维生素D补充剂而非血清25-羟维生素D水平或牛奶摄入量与骨折风险降低相关。
