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北纬 55 度地区冬季补充胆钙化醇对 4-8 岁健康儿童心血管代谢风险标志物无影响。

Winter Cholecalciferol Supplementation at 55°N Has No Effect on Markers of Cardiometabolic Risk in Healthy Children Aged 4-8 Years.

机构信息

Departments of Nutrition, Exercise and Sports and Veterinary and Animal Sciences, University of Copenhagen, Denmark.

Departments of Veterinary and Animal Sciences, University of Copenhagen, Denmark.

出版信息

J Nutr. 2018 Aug 1;148(8):1261-1268. doi: 10.1093/jn/nxy080.

Abstract

BACKGROUND

Low serum 25-hydroxyvitamin D [25(OH)D] has been associated with unfavorable cardiometabolic risk profiles in many observational studies in children, but very few randomized controlled trials have investigated this.

OBJECTIVE

We explored the effect of winter-time cholecalciferol (vitamin D3) supplementation on cardiometabolic risk markers in young, white, 4- to 8-y-old healthy Danish children (55°N) as part of the pan-European ODIN project.

METHODS

In the ODIN Junior double-blind, placebo-controlled, dose-response trial, 119 children (mean ± SD age: 6.7 ± 1.5 y; 36% male; 82% normal weight) were randomly allocated to 0, 10 or 20 µg/d of vitamin D3 for 20 wk (October-March). Cardiometabolic risk markers including BMI-for-age z score (BMIz), waist circumference, systolic and diastolic blood pressure, serum triglycerides and cholesterol (total, LDL, HDL, and total:HDL), plasma glucose and insulin, and whole-blood glycated hemoglobin were measured at baseline and endpoint as secondary outcomes together with serum 25(OH)D. Intervention effects were evaluated in linear regression models as between-group differences at endpoint adjusted for baseline value of the outcome, and additionally for age, sex, baseline serum 25(OH)D, BMIz, time since breakfast, and breakfast content.

RESULTS

Mean ± SD serum 25(OH)D was 56.7 ± 12.3 nmol/L at baseline and differed between groups at endpoint with concentrations of 31.1 ± 7.5, 61.8 ± 10.6, and 75.8 ± 11.5 nmol/L in the 0-, 10-, and 20 µg/d groups, respectively (P < 0.0001). Vitamin D3 supplementation had no effect on any of the cardiometabolic risk markers in analyses adjusted for baseline value of the outcome (all P ≥ 0.05), and additional covariate adjustment did not change the results notably.

CONCLUSIONS

Preventing the winter decline in serum 25(OH)D with daily vitamin D3 supplementation of 10 or 20 µg had no cardiometabolic effects in healthy 4- to 8-y-old Danish children. This trial was registered at www.clinicaltrials.gov as NCT02145195.

摘要

背景

许多观察性研究表明,血清 25-羟维生素 D [25(OH)D]水平较低与不良的心血管代谢风险特征相关,但很少有随机对照试验对此进行研究。

目的

我们在欧洲 ODIN 项目中,探索了在丹麦 4-8 岁的白人健康儿童(55°N)中,冬季补充胆钙化醇(维生素 D3)对心血管代谢风险标志物的影响。

方法

在 ODIN Junior 双盲、安慰剂对照、剂量反应试验中,119 名儿童(平均年龄 ± 标准差:6.7 ± 1.5 岁;36%为男性;82%为正常体重)被随机分配到 0、10 或 20 μg/d 的维生素 D3 组,共 20 周(10 月至 3 月)。心血管代谢风险标志物包括 BMI 年龄别 z 评分(BMIz)、腰围、收缩压和舒张压、血清甘油三酯和胆固醇(总胆固醇、LDL、HDL 和总胆固醇:HDL)、血浆葡萄糖和胰岛素以及全血糖化血红蛋白,在基线和终点进行测量,作为次要结局,同时测量血清 25(OH)D。干预效果通过线性回归模型评估,终点时的组间差异调整为结局的基线值,并进一步调整年龄、性别、基线血清 25(OH)D、BMIz、早餐后时间和早餐内容。

结果

平均 ± 标准差血清 25(OH)D 在基线时为 56.7 ± 12.3 nmol/L,终点时各组间存在差异,0、10 和 20 μg/d 组分别为 31.1 ± 7.5、61.8 ± 10.6 和 75.8 ± 11.5 nmol/L(P < 0.0001)。在调整结局基线值的分析中,维生素 D3 补充对任何心血管代谢风险标志物均无影响(均 P ≥ 0.05),进一步的协变量调整并未显著改变结果。

结论

在丹麦 4-8 岁健康儿童中,每天补充 10 或 20 μg 维生素 D3 以预防血清 25(OH)D 冬季下降,对心血管代谢没有影响。该试验在 www.clinicaltrials.gov 上注册为 NCT02145195。

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