Sacheck Jennifer M, Van Rompay Maria I, Chomitz Virginia R, Economos Christina D, Eliasziw Misha, Goodman Elizabeth, Gordon Catherine M, Holick Michael F
Friedman School of Nutrition Science and Policy, Tufts University.
Tufts University School of Medicine.
J Clin Endocrinol Metab. 2017 Dec 1;102(12):4496-4505. doi: 10.1210/jc.2017-01179.
We investigated the daily dose of vitamin D needed to achieve serum 25-hydroxyvitamin D [25(OH)D] sufficiency among schoolchildren at risk for deficiency.
The Daily D Health Study was a randomized double-blind vitamin D supplementation trial among racially/ethnically diverse schoolchildren (n = 685) in the northeastern United States. Children were supplemented with vitamin D3 at 600, 1000, or 2000 IU/d for 6 months. Measurements included serum 25(OH)D at baseline (October to December), 3 months (January to March), 6 months (April to June), and 12 months (6 months after supplementation).
At baseline, mean ± standard deviation serum 25(OH)D level was 22.0 ± 6.8 ng/mL, with 5.5% severely vitamin D deficient (<12 ng/mL), 34.1% deficient (12 to 19 ng/mL), 49.0% insufficient (20 to 29 ng/mL), and 11.4% sufficient (≥30 ng/mL). The lowest levels of serum 25(OH)D were found among black (17.9 ± 6.7 ng/mL) and Asian children (18.9 ± 4.8 ng/mL), with no baseline differences by weight status. Serum 25(OH)D increased over 6 months in all three dose groups. The 2000 IU/d group achieved a higher mean serum 25(OH)D level than the other two dose groups (33.1 vs 26.3 and 27.5 ng/mL; P < 0.001), with 59.9% of this group attaining sufficiency at 3 months and only 5.3% remaining severely deficient/deficient at 6 months. All dose groups demonstrated a fall in 25(OH)D at 12 months.
Children at risk for vitamin D deficiency benefited from daily sustained supplementation of 2000 IU/d compared with lower doses closer to the current recommended daily allowance for vitamin D intake. This benefit occurred over the winter months, when serum 25(OH)D level tend to fall.
我们研究了处于维生素D缺乏风险的学龄儿童达到血清25-羟基维生素D[25(OH)D]充足水平所需的每日维生素D剂量。
每日维生素D健康研究是一项针对美国东北部种族/民族多样化的学龄儿童（n = 685）进行的随机双盲维生素D补充试验。儿童被补充600、1000或2000国际单位/天的维生素D3，为期6个月。测量指标包括基线（10月至12月）、3个月（1月至3月）、6个月（4月至6月）和12个月（补充后6个月）时的血清25(OH)D。
在基线时，血清25(OH)D水平的平均值±标准差为22.0±6.8纳克/毫升，其中5.5%严重维生素D缺乏（<12纳克/毫升），34.1%缺乏（12至19纳克/毫升），49.0%不足（20至29纳克/毫升），11.4%充足（≥30纳克/毫升）。血清25(OH)D水平最低的是黑人儿童（17.9±6.7纳克/毫升）和亚洲儿童（18.9±4.8纳克/毫升），体重状况在基线时无差异。在所有三个剂量组中，血清25(OH)D在6个月内均有所升高。2000国际单位/天组的平均血清25(OH)D水平高于其他两个剂量组（33.1对26.3和27.5纳克/毫升；P<0.001），该组在3个月时有59.9%达到充足水平，在6个月时仅有5.3%仍严重缺乏/缺乏。所有剂量组在12个月时25(OH)D水平均下降。
与接近当前维生素D摄入量推荐每日 allowance的较低剂量相比，处于维生素D缺乏风险的儿童每日持续补充2000国际单位/天有益。这种益处出现在冬季，此时血清25(OH)D水平往往会下降。
