Linden Marcela Almeida, Freitas Renata Germano Borges de Oliveira Nascimento, Hessel Gabriel, Marmo Denise Barbieri, Bellomo-Brandão Maria Ângela
Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brasil.
Arq Gastroenterol. 2019 Oct-Dec;56(4):425-430. doi: 10.1590/S0004-2803.201900000-64.
Vitamin D deficiency is being recognized as a pandemic due to the volume of people affected by the deficiency and the number of illnesses generated or stimulated by the deficiency. There is a lack of consensus in the literature on what is considered vitamin D deficiency [25(OH)D].
This review brings together the most common levels of 25(OH)D found in healthy schoolchildren and what is considered deficient.
This systematic review was based on the literature accessed from the electronic databases: MEDLINE, EMBASE, LILACS, SCOPUS and WEB OF SCIENCE. The following descriptors were used in English, Portuguese and Spanish: "Vitamin D"; "Vitamin D deficiency"; "Nutritional Supplements" as well as all their synonyms. The meta-analysis was performed considering the random model. Inclusion criteria: healthy children aged 6 to 12 years, studies that had vitamin D levels, defined vitamin D deficiency.
Of the 191 potentially eligible articles, only six articles were included, with 2618 students in total. The mean value of 25(OH)D was estimated at 18.11 ng/mL with 95% confidence interval. Among the articles found, three were considered deficiency levels below 20 ng/mL, one considered below 18 ng/mL, another below 15 ng/mL, and the latter below 11 ng/ mL. The prevalence of vitamin D deficiency among the articles was 48.6%, 7%, 98%, 64.63%, 19.5%, 28.4%, according to each classification used by the same.
The most common definition in the literature of 25(OH)D deficiency in schoolchildren was at levels below 20 ng/mL. No side effects have been reported in studies that used fortification and/or vitamin D supplementation. Daily supplementation is more effective than seasonal supplementation. However, more studies are needed to define what can be considered as optimal levels of 25(OH)D in children.
由于维生素D缺乏症患者数量众多以及该缺乏症引发或刺激产生的疾病数量庞大，维生素D缺乏正被视为一种流行病。关于什么是维生素D缺乏[25(OH)D]，文献中尚未达成共识。
本综述汇总了健康学童中最常见的25(OH)D水平以及被视为缺乏的标准。
本系统综述基于从电子数据库MEDLINE、EMBASE、LILACS、SCOPUS和科学网获取的文献。使用英语、葡萄牙语和西班牙语的以下描述词：“维生素D”；“维生素D缺乏”；“营养补充剂”及其所有同义词。采用随机模型进行荟萃分析。纳入标准：6至12岁的健康儿童，有维生素D水平且定义了维生素D缺乏的研究。
在191篇潜在符合条件的文章中，仅纳入了6篇文章，共涉及2618名学生。25(OH)D的平均值估计为18.11 ng/mL，95%置信区间。在所发现的文章中，3篇认为缺乏水平低于20 ng/mL，1篇认为低于18 ng/mL，另一篇低于15 ng/mL，最后一篇低于11 ng/mL。根据各文章所采用的每种分类，维生素D缺乏的患病率分别为48.6%、7%、98%、64.63%、19.5%、28.4%。
文献中关于学童25(OH)D缺乏的最常见定义是低于20 ng/mL。在使用强化和/或维生素D补充剂的研究中未报告有副作用。每日补充比季节性补充更有效。然而，需要更多研究来确定儿童25(OH)D的最佳水平。
