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加拿大蒙特利尔市镰状细胞病患儿的维生素D摄入量与状况

Vitamin D Intake and Status of Children With Sickle Cell Disease in Montreal, Canada.

作者信息

Grégoire-Pelchat Pascale, Alos Nathalie, Ribault Virginie, Pastore Yves, Robitaille Nancy, Mailhot Geneviève

机构信息

Department of Nutrition, Université de Montréal.

Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada.

出版信息

J Pediatr Hematol Oncol. 2018 Nov;40(8):e531-e536. doi: 10.1097/MPH.0000000000001306.

Abstract

Sickle cell disease (SCD) and vitamin D deficiency share manifestations such as bone complications and bony pains. Canadian SCD children are characterized by compromised sun exposure all year long and potential dietary deficiency, which combined to SCD-causing high nutritional demands, may lead to impaired vitamin D status. The objectives of this study were to document vitamin D status and intake and assess the relationship between vitamin D status and SCD-related outcomes in Canadian children with SCD followed in a tertiary pediatric center. Our study population included 119 children (47% males, median age [interquartile range]: 11.1 [9.2-14.8]) mainly of Haitian and Sub-Saharan African origin who had at least one measure of serum 25-hydroxyvitamin D (25OHD) performed between June 2015 and February 2017. Predominant genotypes were homozygous hemoglobin S (60%) and sickle hemoglobin-C (32%). Vitamin D deficiency (25OHD<30 nmol/L) and insufficiency (30 to 49 nmol/L) were present in 31% and 37% of children, respectively. Vitamin D-sufficient children (25OHD>50 nmol/L) had higher hemoglobin levels, lower leukocyte, reticulocyte, and neutrophil counts, compared with vitamin D-deficient and insufficient children. Vitamin D intake was low and modestly correlated to serum 25OHD levels. Acute SCD complications in the preceding 2 years were not associated with vitamin D status in these children.

摘要

镰状细胞病(SCD)和维生素D缺乏有共同的表现,如骨骼并发症和骨痛。加拿大患有SCD的儿童全年日晒不足,且可能存在饮食缺乏,再加上SCD导致的高营养需求,可能会导致维生素D状态受损。本研究的目的是记录加拿大一家三级儿科中心随访的患有SCD的儿童的维生素D状态和摄入量,并评估维生素D状态与SCD相关结局之间的关系。我们的研究人群包括119名儿童(47%为男性,中位年龄[四分位间距]:11.1[9.2 - 14.8]),主要为海地和撒哈拉以南非洲裔,在2015年6月至2017年2月期间至少进行了一次血清25-羟基维生素D(25OHD)检测。主要基因型为纯合血红蛋白S(60%)和镰状血红蛋白-C(32%)。分别有31%和37%的儿童存在维生素D缺乏(25OHD<30 nmol/L)和不足(30至49 nmol/L)。与维生素D缺乏和不足的儿童相比,维生素D充足的儿童(25OHD>50 nmol/L)血红蛋白水平更高,白细胞、网织红细胞和中性粒细胞计数更低。维生素D摄入量较低,且与血清25OHD水平呈适度相关。在这些儿童中,前两年的急性SCD并发症与维生素D状态无关。

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