Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo-USP, Ribeirão Preto, Brazil.
Department of Medicine, Federal University of São Carlos-UFSCAR, São Carlos, Brazil.
PLoS One. 2018 Apr 12;13(4):e0195368. doi: 10.1371/journal.pone.0195368. eCollection 2018.
A high prevalence of vitamin D deficiency (VDD) in children has been observed worldwide, but there are few studies on the nutritional status of vitamin D (VD) in healthy infants. The main cause of deficiency in healthy children is breastfeeding without supplementation and lack or insufficiency of sun exposure. The aims of this study were to determine serum concentrations of 25(OH)D and verify its association with parathyroid hormone (PTH) concentrations and use of VD supplementation in healthy infants aged ≥ 6 to ≤ 24 months attended at two Primary Health Care Units in Ribeirão Preto city, São Paulo, Brazil. A cross-sectional, observational and analytical study was performed in which serum concentrations of 25(OH)D, PTH, alkaline phosphatase (AP), calcium (Ca), phosphorus (P) and albumin were determined in 155 healthy infants. Information on sun exposure, sociodemographic aspects of mothers and clinical and nutritional characteristics of infants were obtained through interviews with responsible infants's legal representatives. Ten infants (6%) presented deficient 25(OH)D serum concentration (≤20ng/ml) and 46 (30%), insufficient (21 to 29ng/ml). No changes in serum P, Ca and albumin concentrations were detected. Only one infant had an increase in PTH serum concentrations. 35% (55/155) of infants had high AP e 40% (22/55) presented insufficient serum concentrations of 25(OH)D but none presented deficient ones. There was a weak association between serum concentrations of 25(OH)D and PTH and an association between serum concentrations of 25(OH)D and P when adjusted for sex, age and BMI. There were no associations between inadequate serum concentrations of 25(OH)D (deficient ou insufficient), sun exposure and VD supplementation. This study found a low prevalence of deficient 25(OH)D serum concentration and high prevalence of insufficient ones which was not associated with changes in serum PTH, AP, P, Ca and albumin concentrations, VD supplementation and the formula volume intake.
全世界范围内都观察到儿童中维生素 D 缺乏（VDD）的患病率很高，但关于健康婴儿维生素 D（VD）营养状况的研究很少。健康儿童中缺乏的主要原因是母乳喂养而不补充以及缺乏或不足的阳光暴露。本研究旨在确定 25(OH)D 的血清浓度，并验证其与甲状旁腺激素（PTH）浓度的关系以及在巴西圣保罗里贝朗普雷托市的两个初级保健单位接受治疗的年龄为 6 至 24 个月的健康婴儿中使用 VD 补充剂的情况。进行了一项横断面、观察性和分析性研究，其中测定了 155 名健康婴儿的血清 25(OH)D、PTH、碱性磷酸酶（AP）、钙（Ca）、磷（P）和白蛋白浓度。通过与负责婴儿的法定代表人进行访谈获得有关阳光暴露、母亲的社会人口统计学方面以及婴儿的临床和营养特征的信息。10 名婴儿（6％）的血清 25(OH)D 浓度不足（≤20ng/ml），46 名（30％）浓度不足（21 至 29ng/ml）。未检测到血清 P、Ca 和白蛋白浓度的变化。只有一名婴儿的 PTH 血清浓度升高。35％（55/155）的婴儿的 AP 升高，40％（22/55）的婴儿的血清 25(OH)D 浓度不足，但均未出现不足。血清 25(OH)D 浓度与 PTH 之间存在弱相关性，并且在调整性别，年龄和 BMI 后，血清 25(OH)D 浓度与 P 之间存在相关性。血清 25(OH)D 浓度不足（不足或不足），阳光暴露和 VD 补充之间无相关性。本研究发现血清 25(OH)D 浓度不足的发生率较低，而不足的发生率较高，但与血清 PTH，AP，P，Ca 和白蛋白浓度，VD 补充剂和配方奶摄入量的变化无关。
