Zheng Xiaofei, Wu Qijun, Weng Dadong, Fu Yeju, Yue Duxian, Wang Yu
Department of Child Health Care, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China.
Zhenxiong People's Hospital, Zhaotong, Yunnan, China.
J Int Med Res. 2020 Nov;48(11):300060520969311. doi: 10.1177/0300060520969311.
We tested the hypothesis that vitamin D supplementation is associated with early body mass index (BMI) patterns.
Using retrospective longitudinal data of infants and toddlers in a 2-year follow-up study, we identified BMI-for-age Z score (BAZ) growth trajectories using latent class growth modeling (LCGM) analysis. Logistic regression models were adopted to investigate the impact of vitamin D supplementation on BAZ patterns.
Five BAZ trajectories were derived using LCGM. Higher intake of vitamin D supplement was significantly associated with lower odds of rapid weight gain or mild undernutrition in the first 2 years (odds ratios: 0.60-0.83 for class 2: early rapid growth; 0.69-0.82 for class 3: early weight loss, late rapid growth; 0.83-0.89 for class 4: suboptimal growth). Adherence to 400 IU Vitamin D ≥ 1 year was significantly associated with less likelihood of being in class 3 (odds ratio 0.17).
Among infants and toddlers aged 0 to 2 years, dietary supplementation of vitamin D is insufficient in rural areas of China. Insufficient vitamin D intake was found to be associated with suboptimal BAZ growth at early stages. Effective collaboration is needed between pediatricians and caregivers, to assure adherence to the nutritional guideline.
我们检验了维生素D补充与早期体重指数(BMI)模式相关的假设。
在一项为期2年的随访研究中,利用婴幼儿的回顾性纵向数据,我们通过潜在类别增长模型(LCGM)分析确定了年龄别BMI Z评分(BAZ)的生长轨迹。采用逻辑回归模型研究维生素D补充对BAZ模式的影响。
通过LCGM得出了五条BAZ轨迹。在前两年中,较高的维生素D补充摄入量与较低的快速体重增加或轻度营养不良几率显著相关(比值比:第2类:早期快速生长为0.60 - 0.83;第3类:早期体重减轻,后期快速生长为0.69 - 0.82;第4类:生长欠佳为0.83 - 0.89)。坚持服用400 IU维生素D≥1年与处于第3类的可能性显著降低相关(比值比0.17)。
在中国农村地区,0至2岁婴幼儿的膳食维生素D补充不足。维生素D摄入不足与早期BAZ生长欠佳相关。儿科医生和护理人员之间需要有效合作,以确保遵守营养指南。