Children's Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland.
Folkhälsan Research Center, Helsinki, Finland.
Horm Res Paediatr. 2017;88(2):147-154. doi: 10.1159/000477298. Epub 2017 Jun 23.
Vitamin D supplementation is widely recommended for infants, but the optimal dose remains unclear. High intake may result in hypercalcemia.
We evaluated the incidence of hypercalcemia during the first year of life in a cohort of 987 healthy children who received 10 or 30 μg of vitamin D3 supplementation daily. Ionized calcium (Ca-ion) was analyzed at 6 and 12 months, and serum 25-hydroxyvitamin D (25-OHD) and parathyroid hormone (PTH) concentration at 12 months. Severe hypercalcemia was defined as Ca-ion exceeding the reference limit (1.16-1.39 mmol/L) by 10%.
No severe hypercalcemia occurred. Mild hypercalcemia (1.40-1.52 mmol/L) was present at 6 months in 28% and at 12 months in 2% of infants. At 12 months, 25-OHD ranged between 23 and 241 nmol/L (median 97), and PTH was between undetectable and 104 pg/mL (median 24) and was below the reference range (11.5-78.4 pg/mL) in 11%. 25-OHD and Ca-ion correlated positively (r = 0.149), and 25-OHD was slightly higher in the 12 infants with mild hypercalcemia (median 97 vs. 110 nmol/L, p = 0.046).
Vitamin D3 supplementation of 10 or 30 µg did not cause severe hypercalcemia. Mild hypercalcemia was more prevalent at 6 months than at 12 months, and was associated weakly with 25-OHD at 12 months.
维生素 D 补充剂被广泛推荐用于婴儿，但最佳剂量仍不清楚。高摄入量可能导致高钙血症。
我们评估了 987 名健康儿童在接受每天 10 或 30μg 维生素 D3 补充剂后的第一年生命中高钙血症的发生率。在 6 个月和 12 个月时分析离子钙 (Ca-ion)，在 12 个月时分析血清 25-羟维生素 D (25-OHD) 和甲状旁腺激素 (PTH) 浓度。严重高钙血症定义为 Ca-ion 超过参考范围（1.16-1.39mmol/L）10%。
没有发生严重高钙血症。轻度高钙血症（1.40-1.52mmol/L）在 6 个月时出现在 28%的婴儿中，在 12 个月时出现在 2%的婴儿中。在 12 个月时，25-OHD 范围在 23 至 241nmol/L 之间（中位数 97），PTH 范围在不可检测到 104pg/mL 之间（中位数 24），并且在 11%的婴儿中低于参考范围（11.5-78.4pg/mL）。25-OHD 和 Ca-ion 呈正相关（r=0.149），并且在 12 名轻度高钙血症婴儿中，25-OHD 略高（中位数 97 与 110nmol/L，p=0.046）。
维生素 D3 补充 10 或 30μg 不会导致严重高钙血症。轻度高钙血症在 6 个月时比 12 个月时更为普遍，并且与 12 个月时的 25-OHD 呈弱相关。
