Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom.
Contributed equally as co-first authors.
Pediatrics. 2021 Jan;147(1). doi: 10.1542/peds.2020-0815. Epub 2020 Dec 18.
Vitamin D is essential for healthy development of bones, but little is known about the effects of supplementation in young stunted children. Our objective was to assess the effect of vitamin D supplementation on risk of rickets and linear growth among Afghan children.
In this double-blind, placebo-controlled trial, 3046 children ages 1 to 11 months from inner-city Kabul were randomly assigned to receive oral vitamin D (100 000 IU) or placebo every 3 months for 18 months. Rickets Severity Score was calculated by using wrist and knee radiographs for 631 randomly selected infants at 18 months, and rickets was defined as a score >1.5. Weight and length were measured at baseline and 18 months by using standard techniques, and scores were calculated.
Mean (95% confidence interval [CI]) serum 25-hydroxyvitamin D (seasonally corrected) and dietary calcium intake were insufficient at 37 (35-39) nmol/L and 372 (327-418) mg/day, respectively. Prevalence of rickets was 5.5% (placebo) and 5.3% (vitamin D): odds ratio 0.96 (95% CI: 0.48 to 1.92); = .9. The mean difference in height-for-age score was 0.05 (95% CI: -0.05 to 0.15), = .3, although the effect of vitamin D was greater for those consuming >300 mg/day of dietary calcium (0.14 [95% CI: 0 to 0.29]; = .05). There were no between-group differences in weight-for-age or weight-for-height scores.
Except in those with higher calcium intake, vitamin D supplementation had no effect on rickets or growth.
维生素 D 对骨骼的健康发育至关重要，但人们对其在发育迟缓的幼儿中的补充效果知之甚少。我们的目的是评估维生素 D 补充对阿富汗儿童佝偻病和线性生长风险的影响。
在这项双盲、安慰剂对照试验中，来自喀布尔市中心的 3046 名 1 至 11 个月大的儿童被随机分为口服维生素 D（100000IU）或安慰剂组，每 3 个月服用一次，持续 18 个月。在 18 个月时，对 631 名随机选择的婴儿进行腕部和膝部 X 光检查，计算佝偻病严重程度评分，定义得分>1.5 为佝偻病。使用标准技术在基线和 18 个月时测量体重和身长，计算 Z 评分。
平均（95%置信区间[CI]）血清 25-羟维生素 D（季节性校正）和膳食钙摄入量分别为 37（35-39）nmol/L 和 372（327-418）mg/天，均不足。佝偻病的患病率为 5.5%（安慰剂）和 5.3%（维生素 D）：比值比 0.96（95%CI：0.48 至 1.92）；=.9。身高年龄 Z 评分的平均差异为 0.05（95%CI：-0.05 至 0.15），=.3，尽管对于摄入>300mg/天膳食钙的儿童，维生素 D 的效果更大（0.14 [95%CI：0 至 0.29]；=.05）。体重年龄 Z 评分和体重身高 Z 评分在两组之间无差异。
除了在钙摄入量较高的人群中，维生素 D 补充对佝偻病或生长没有影响。
