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维生素D缺乏与坦桑尼亚婴儿的生长或常见疾病发病率无关。

Vitamin D Deficiency Is Not Associated With Growth or the Incidence of Common Morbidities Among Tanzanian Infants.

作者信息

Sudfeld Christopher R, Manji Karim P, Smith Emily R, Aboud Said, Kisenge Rodrick, Fawzi Wafaie W, Duggan Christopher P

机构信息

*Department of Global Health and Population †Department of Nutrition ‡Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA §Department of Paediatrics and Child Health ||Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania ¶Department of Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital and Harvard Medical School, Boston, MA.

出版信息

J Pediatr Gastroenterol Nutr. 2017 Oct;65(4):467-474. doi: 10.1097/MPG.0000000000001658.

Abstract

OBJECTIVE

The objective of this study was to examine risk factors for vitamin D deficiency and determine the association of vitamin D status with child growth and incidence of common morbidities among Tanzanian infants.

METHODS

A prospective cohort of 581 Tanzanian infants born to human immunodeficiency virus (HIV)-uninfected mothers had serum 25-hydroxyvitamin D assessed at 6 weeks and 6 months of age. Infants were seen at monthly clinic visits for growth monitoring until 18 months of age. Physicians examined infants every 3 months or when an illness was noted to document morbidities.

RESULTS

The prevalence of vitamin D deficiency (<20 ng/mL) declined from 76.4% at 6 weeks of age to 21.2% at 6 months. Infants who were exclusively breastfed at 6 weeks of age had 2.05 (95% confidence interval 1.11-3.79; P = 0.02) times the risk of vitamin D deficiency as compared formula-fed infants. After multivariate adjustment, there was no association of vitamin D status at 6 weeks or 6 months with the incidence of stunting, wasting, or underweight. There was also no association of low vitamin D with the incidence of diarrhea, upper respiratory infection, acute lower respiratory tract infection, or malaria.

CONCLUSIONS

Vitamin D deficiency is common during early infancy, particularly among exclusively breastfed infants; however, these observational data suggest it may not be an important contributor to morbidity and growth among the general population of Tanzanian infants. Future studies of vitamin D among high-risk infants, including those with low birthweight and exposed to HIV, may be warranted.

摘要

目的

本研究的目的是检查维生素D缺乏的风险因素,并确定坦桑尼亚婴儿的维生素D状态与儿童生长及常见疾病发病率之间的关联。

方法

对581名出生于未感染人类免疫缺陷病毒(HIV)母亲的坦桑尼亚婴儿进行前瞻性队列研究,在其6周龄和6月龄时评估血清25-羟基维生素D水平。婴儿每月到诊所进行生长监测,直至18月龄。医生每3个月或在发现疾病时对婴儿进行检查,以记录疾病情况。

结果

维生素D缺乏(<20 ng/mL)的患病率从6周龄时的76.4%降至6月龄时的21.2%。6周龄时纯母乳喂养的婴儿维生素D缺乏风险是配方奶喂养婴儿的2.05倍(95%置信区间1.11 - 3.79;P = 0.02)。多因素调整后,6周龄或6月龄时的维生素D状态与发育迟缓、消瘦或体重不足的发病率无关联。低维生素D水平与腹泻、上呼吸道感染、急性下呼吸道感染或疟疾的发病率也无关联。

结论

维生素D缺乏在婴儿早期很常见,尤其是在纯母乳喂养的婴儿中;然而,这些观察数据表明,它可能不是坦桑尼亚婴儿总体人群发病和生长的重要因素。未来可能有必要对高危婴儿,包括低出生体重和暴露于HIV的婴儿进行维生素D研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad65/5604126/9ce1feda271e/jpga-65-467-g001.jpg

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