Kubota Takuo, Nakayama Hirofumi, Kitaoka Taichi, Nakamura Yosikazu, Fukumoto Seiji, Fujiwara Ikuma, Hasegawa Yukihiro, Ihara Kenji, Kitanaka Sachiko, Koyama Satomi, Kusuda Satoshi, Mizuno Haruo, Nagasaki Keisuke, Oba Koji, Sakamoto Yuko, Takubo Noriyuki, Shimizu Toshiaki, Tanahashi Yusuke, Hasegawa Kosei, Tsukahara Hirokazu, Yorifuji Tohru, Michigami Toshimi, Ozono Keiichi
Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan.
Study group of Survey and Estimation of Incidence Rate of Childhood Symptomatic Vitamin D.
Endocr J. 2018 Jun 27;65(6):593-599. doi: 10.1507/endocrj.EJ18-0008. Epub 2018 Mar 10.
There is concern that vitamin D deficiency is prevalent among children in Japan as well as worldwide. We conducted a nationwide epidemiologic survey of symptomatic vitamin D deficiency to observe its incidence rate among Japanese children. A questionnaire inquiring the number of new patients with vitamin D deficiency rickets and/or hypocalcemia for 3 years was sent to 855 randomly selected hospitals with a pediatrics department in Japan. In this survey, we found that 250 children were diagnosed with symptomatic vitamin D deficiency. The estimated number of patients with symptomatic vitamin D deficiency per year was 183 (95% confidence interval (CI): 145-222). The overall annual incidence rate among children under 15 years of age was 1.1 per 100,000 population (95% CI: 0.9-1.4). The second survey has provided detailed information on 89 patients with symptomatic vitamin D deficiency under 5 years of age in hospitals in the current research group. The nationwide and second surveys estimated the overall annual incidence rate of symptomatic vitamin D deficiency in children under 5 years of age to be 3.5 (2.7-4.2) per 100,000 population. The second survey revealed 83% had bowed legs, 88% had exclusive breastfeeding, 49% had a restricted and/or unbalanced diet and 31% had insufficient sun exposure among the 89 patients. This is the first nationwide survey on definitive clinical vitamin D deficiency in children in Japan. Elucidating the frequency and characteristics of symptomatic vitamin D deficiency among children is useful to develop preventative public health strategies.
人们担心维生素D缺乏症在日本儿童以及全球儿童中都很普遍。我们针对有症状的维生素D缺乏症进行了一项全国性的流行病学调查，以观察其在日本儿童中的发病率。一份询问过去3年维生素D缺乏性佝偻病和/或低钙血症新患者数量的问卷被发送给了日本855家随机挑选的设有儿科的医院。在这项调查中，我们发现有250名儿童被诊断为有症状的维生素D缺乏症。每年有症状的维生素D缺乏症患者的估计数量为183例（95%置信区间（CI）：145 - 222）。15岁以下儿童的总体年发病率为每10万人中有1.1例（95%CI：0.9 - 1.4）。第二项调查提供了关于本研究组医院中89名5岁以下有症状的维生素D缺乏症患者的详细信息。全国性调查和第二项调查估计，5岁以下儿童有症状的维生素D缺乏症的总体年发病率为每10万人中有3.5例（2.7 - 4.2）。第二项调查显示，在这89名患者中，83%有膝内翻，88%为纯母乳喂养，49%饮食受限和/或不均衡，31%日照不足。这是日本首次针对儿童明确临床维生素D缺乏症进行的全国性调查。阐明儿童有症状的维生素D缺乏症的发生频率和特征有助于制定预防性公共卫生策略。
