儿童中期维生素 D 缺乏与青少年行为问题有关。

Vitamin D Deficiency in Middle Childhood Is Related to Behavior Problems in Adolescence.

机构信息

Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA.

Department of Medicine, University of La Sabana, Chia, Colombia.

出版信息

J Nutr. 2020 Jan 1;150(1):140-148. doi: 10.1093/jn/nxz185.

DOI:10.1093/jn/nxz185

PMID:31429909

Abstract

BACKGROUND

Vitamin D deficiency (VDD) is associated with depression and schizophrenia in adults. The effect of VDD in childhood on behavioral development is unknown.

OBJECTIVES

We aimed to study the associations of VDD and vitamin D binding protein (DBP) in middle childhood with behavior problems in adolescence.

METHODS

We quantified plasma total 25-hydroxyvitamin D [25(OH)D] and DBP in 273 schoolchildren aged 5-12 y at recruitment into a cohort study in Bogota, Colombia. Externalizing and internalizing behavior problems were assessed after a median 6-y follow-up by parental report [Child Behavior Checklist (CBCL)] and self-report [Youth Self-Report (YSR)]. We estimated mean problem score differences with 95% CIs between exposure categories using multivariable linear regression. We also compared the prevalence of clinical behavior problems (score >63) between exposure groups. We assessed whether the associations between DBP and behavior problems were mediated through VDD.

RESULTS

Mean ± SD CBCL and YSR externalizing problems scores were 56.5 ± 9.3 and 53.2 ± 9.5, respectively. Internalizing problems scores averaged 57.1 ± 9.8 and 53.7 ± 9.8, respectively. VDD [25(OH)D <50 nmol/L] prevalence was 10.3%. VDD was associated with an adjusted 6.0 (95% CI: 3.0, 9.0) and 3.4 (95% CI: 0.1, 6.6) units higher CBCL and YSR externalizing problems scores, respectively, and an adjusted 3.6 (95% CI: 0.3, 6.9) units higher CBCL internalizing problems scores. The prevalence of clinical total externalizing problems was 1.8 (95% CI: 1.1, 3.1) times higher in children with VDD than that in children without VDD. DBP concentration below the population median was related to higher YSR aggressive behavior and anxious/depressed subscale scores and to higher prevalence of clinical total externalizing problems. The associations between DBP and behavior problems were not mediated through VDD.

CONCLUSIONS

VDD and low DBP in middle childhood are related to behavior problems in adolescence.

摘要

背景

维生素 D 缺乏症（VDD）与成年人的抑郁和精神分裂症有关。维生素 D 缺乏症在儿童时期对行为发育的影响尚不清楚。

目的

我们旨在研究儿童中期 VDD 和维生素 D 结合蛋白（DBP）与青春期行为问题的关联。

方法

我们在哥伦比亚波哥大的一项队列研究中，对 273 名 5-12 岁的学龄儿童进行了招募，测定了其血浆总 25-羟维生素 D [25（OH）D]和 DBP。在中位 6 年的随访后，通过父母报告[儿童行为检查表（CBCL）]和自我报告[青年自我报告（YSR）]评估了外化和内化行为问题。我们使用多变量线性回归，估计了暴露类别之间 95%置信区间（CI）的平均问题评分差异。我们还比较了暴露组之间临床行为问题（评分>63）的患病率。我们评估了 DBP 和行为问题之间的关联是否通过 VDD 介导。

结果

CBCL 和 YSR 外化问题的平均得分分别为 56.5±9.3 和 53.2±9.5，内化问题的平均得分分别为 57.1±9.8 和 53.7±9.8。VDD（25（OH）D<50 nmol/L）的患病率为 10.3%。VDD 与调整后的 CBCL 和 YSR 外化问题评分分别高出 6.0（95%CI：3.0，9.0）和 3.4（95%CI：0.1，6.6）单位有关，与调整后的 CBCL 内化问题评分高出 3.6（95%CI：0.3，6.9）单位有关。VDD 儿童的临床总外化问题患病率是无 VDD 儿童的 1.8（95%CI：1.1，3.1）倍。DBP 浓度低于人群中位数与 YSR 攻击性行为和焦虑/抑郁子量表评分较高以及临床总外化问题患病率较高有关。DBP 与行为问题之间的关联不是通过 VDD 介导的。