Wójcik Marek, Jaworski Maciej, Pludowski Pawel
Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children's Memorial Health Institute, Warsaw, Poland.
Front Endocrinol (Lausanne). 2018 Nov 8;9:656. doi: 10.3389/fendo.2018.00656. eCollection 2018.
The numerous evidence showing spectrum of vitamin D effects on human health resulted in both updates of vitamin D supplementation guidelines for general population and concerns on potential risk of hypercalcaemia. The aim of this study was to analyse trends in serum 25-hydroxyvitamin D concentration (25(OH)D) change over the 30 years of operation of a single pediatric diagnostic unit. Calcium-phosphate metabolism markers and 25(OH)D concentrations were analyzed in a group that consisted of newborns and infants commissioned for diagnostics due to suspected calcium-phosphate metabolic disturbances ( = 3,163; mean age 8.0 ± 3.0 months). 25(OH)D < 10 ng/ml was noted in 4.5% of patients ( = 163), 10-20 ng/ml in 14.7% ( = 465), 20-30 ng/ml in 23.9% ( = 756) and 30-50 ng/ml in 35.9% ( = 1,136). The mean 25(OH)D concentration in analyzed group was 37.5 ± 24.5 ng/ml. In patients with 25(OH)D concentration < 10 ng/ml a normal calcaemia (2.25-2.65 mmol/l) was noted in 83.4% cases ( = 136). Eighty one patients had 25(OH)D concentrations above 100 ng/ml with co-existing calcaemia in range of 2.6-4.38 mmol/l (mean Ca = 2.69 mmol/l). Hypocalcaemia (Ca < 2.25 mmol/l) was observed in 0.54%, ( = 17). 13.8% patients revealed calcium levels >2.65 mmol/l ( = 435). In general, the mean calcium-phosphate markers values were within the reference range for age. The highest mean 25(OH)D concentration of 51.8 ng/ml ± 38.8 was noted in years 1981-1999 ( = 305). The lowest mean 25(OH)D value was observed in years 2010-2011 (29.0 ng/ml ± 13.6; = 412). The trend of decreasing 25(OH)D concentration during analyzed time period was significant ( = -0.29, < 0.0001). Eighty percentage of children aged 0-36 months had 25(OH)D concentration >20 ng/ml, however, during 3 decades a mean 25(OH)D concentrations trended significantly to decrease. A direct relationship between low 25(OH)D concentration and hypocalcaemia was not observed nor between high 25(OH)D concentration and hypercalcemia.
大量证据表明维生素D对人类健康具有多种影响，这既促使了针对普通人群的维生素D补充指南的更新，也引发了对高钙血症潜在风险的担忧。本研究的目的是分析在一个单一儿科诊断科室运营的30年期间血清25-羟基维生素D浓度（25(OH)D）变化趋势。对一组因疑似钙磷代谢紊乱而接受诊断的新生儿和婴儿（n = 3163；平均年龄8.0±3.0个月）进行了钙磷代谢标志物和25(OH)D浓度分析。4.5%的患者（n = 163）25(OH)D<10 ng/ml，14.7%（n = 465）为10 - 20 ng/ml，23.9%（n = 756）为20 - 30 ng/ml，35.9%（n = 1136）为30 - 50 ng/ml。分析组的平均25(OH)D浓度为37.5±24.5 ng/ml。在25(OH)D浓度<10 ng/ml的患者中，83.4%的病例（n = 136）血钙正常（2.25 - 2.65 mmol/l）。81例患者25(OH)D浓度高于100 ng/ml，同时血钙浓度在2.6 - 4.38 mmol/l范围内（平均Ca = 2.69 mmol/l）。低钙血症（Ca<2.25 mmol/l）发生率为0.54%（n = 17）。13.8%的患者血钙水平>2.65 mmol/l（n = 435）。总体而言，钙磷标志物平均值在年龄参考范围内。1981 - 1999年期间25(OH)D平均浓度最高，为51.8 ng/ml±38.8（n = 305）。2010 - 2011年观察到最低的25(OH)D平均值（29.0 ng/ml±13.6；n = 412）。在分析时间段内25(OH)D浓度下降趋势显著（r = -0.29，P<0.0001）。80%的0 - 36个月儿童25(OH)D浓度>20 ng/ml，然而，在30年期间25(OH)D平均浓度呈显著下降趋势。未观察到低25(OH)D浓度与低钙血症之间以及高25(OH)D浓度与高钙血症之间的直接关系。
