婴儿期补充维生素 D 对生命最初 2 年生长的影响。
The Effects of Vitamin D Supplementation During Infancy on Growth During the First 2 Years of Life.
机构信息
Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, HUS, Helsinki, Finland.
Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
出版信息
J Clin Endocrinol Metab. 2021 Mar 8;106(3):e1140-e1155. doi: 10.1210/clinem/dgaa943.
CONTEXT
The relationship between maternal and infant vitamin D and early childhood growth remains inadequately understood.
OBJECTIVE
This work aimed to investigate how maternal and child 25-hydroxyvitamin D (25[OH]D) and vitamin D supplementation affect growth during the first 2 years of life.
METHODS
A randomized, double-blinded, single-center intervention study was conducted from pregnancy until offspring age 2 years. Altogether 812 term-born children with complete data were recruited at a maternity hospital. Children received daily vitamin D3 supplementation of 10 μg (group 10) or 30 μg (group 30) from age 2 weeks to 2 years. Anthropometry and growth rate were measured at age 1 and 2 years.
RESULTS
Toddlers born to mothers with pregnancy 25(OH)D greater than 125 nmol/L were at 2 years lighter and thinner than the reference group with 25(OH)D of 50 to 74.9 nmol/L (P < .010). Mean 2-year 25(OH)D concentrations were 87 nmol/L in group 10 and 118 nmol/L in group 30 (P < .001). When group 30 was compared with group 10, difference in body size was not statistically significant (P > .053), but group 30 had slower growth in length and head circumference between 6 months and 1 year (P < .047), and more rapid growth in weight and length-adjusted weight between 1 and 2 years (P < .043). Toddlers in the highest quartile of 25(OH)D (> 121 nmol/L) were shorter (mean difference 0.2 SD score [SDS], P = .021), lighter (mean difference 0.4 SDS, P = .001), and thinner (in length-adjusted weight) (mean difference 0.4 SDS, P = .003) compared with the lowest quartile (< 81.2 nmol/L).
CONCLUSION
Vitamin D and early childhood growth may have an inverse U-shaped relationship.
背景
母婴维生素 D 与儿童早期生长之间的关系仍未得到充分理解。
目的
本研究旨在探究母体和儿童 25-羟维生素 D（25[OH]D）以及维生素 D 补充对生命最初 2 年生长的影响。
方法
这是一项在一家妇产医院进行的随机、双盲、单中心干预研究，从妊娠开始一直持续到儿童 2 岁。共招募了 812 名足月出生且数据完整的儿童。从 2 周龄至 2 岁，儿童每天接受 10 μg（10 组）或 30 μg（30 组）维生素 D3 补充。在 1 岁和 2 岁时测量体格和生长速度。
结果
母亲孕期 25(OH)D 大于 125 nmol/L 的婴儿在 2 岁时体重和体围比参考组（25(OH)D 为 50-74.9 nmol/L）轻且瘦（P<0.010）。10 组和 30 组的平均 2 岁时 25(OH)D 浓度分别为 87 nmol/L 和 118 nmol/L（P<0.001）。与 10 组相比，30 组的体尺差异无统计学意义（P>0.053），但 30 组在 6 个月至 1 岁之间的身长和头围增长速度较慢（P<0.047），1 岁至 2 岁之间的体重和体重调整后的身长增长速度较快（P<0.043）。25(OH)D 最高四分位数（>121 nmol/L）的婴儿较短（平均差异 0.2 标准差得分[SDS]，P=0.021），较轻（平均差异 0.4 SDS，P=0.001），且更瘦（在体重调整后的身长方面）（平均差异 0.4 SDS，P=0.003）与最低四分位数（<81.2 nmol/L）相比。
结论
维生素 D 与儿童早期生长之间可能呈倒 U 型关系。
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