Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense C, Denmark.
Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense C, Denmark.
Br J Nutr. 2021 Nov 28;126(10):1466-1477. doi: 10.1017/S0007114521000301. Epub 2021 Jan 26.
Vitamin D supplementation in infancy is recommended to prevent rickets. At the population level, its effects on bone mineralisation are largely unknown. We aimed to explore whether adherence to national vitamin D supplementation guidelines (10 µg/d up to the age of 2 years), supplementation at the ages of 5 and 7 years, and serum 25-hydroxyvitamin D (s-25(OH)D) at various time points associated with bone mineral density (BMD) at the age of 7 years in the Odense Child Cohort, Denmark (n 1194). High adherence was defined as supplementation with 10 µg of vitamin D 6-7 times per week during ≥80 % of the observation time. s-25(OH)D was analysed using LC-MS/MS. Total-body-less-head (TBLH) BMD was measured by dual-energy X-ray absorptiometry. At the median age of 18·1 months, 53·9 % (n 475/881) reported high adherence. The median s-25(OH)D was 64·7, 78·8, 46·0 and 71·8 nmol/l in early pregnancy, late pregnancy, cord blood and at 5 years, respectively. The mean TBLH BMD at the median age of 7·1 years was 0·613 (SD 0·049) g/cm2 (z-score +0·363 (SD 0·824)). In adjusted analyses, vitamin D supplementation up to 18 months, and at 5 and 7 years, was not associated with TBLH BMD. Similarly, no robust associations were found between TBLH BMD and s-25(OH)D at any time point. No associations were found for TBLH bone mineral concentration or bone area. In this population with relatively high s-25(OH)D concentrations, no consistent associations were found between adherence to vitamin D supplementation recommendations or vitamin D status in pregnancy or childhood, and bone mineralisation at the age of 7 years.
建议在婴儿期补充维生素 D 以预防佝偻病。在人群层面，其对骨矿化的影响在很大程度上尚不清楚。我们旨在探索在丹麦奥登塞儿童队列（n=1194）中，2 岁以下补充维生素 D 的推荐剂量（10μg/d）、5 岁和 7 岁时补充维生素 D 以及不同时间点的血清 25-羟维生素 D（s-25（OH）D）与 7 岁时骨密度（BMD）之间的关系。高依从性定义为在观察期间的≥80%时间内，每周补充 10μg 维生素 D6-7 次。使用 LC-MS/MS 分析 s-25（OH）D。使用双能 X 射线吸收法测量全身（不包括头部）BMD。在 18.1 个月的中位年龄时，53.9%（n=475/881）报告了高依从性。早孕期、晚孕期、脐血和 5 岁时的 s-25（OH）D 中位数分别为 64.7、78.8、46.0 和 71.8nmol/L。在中位年龄为 7.1 岁时，全身（不包括头部）BMD 的平均值为 0.613（SD 0.049）g/cm2（z 分数为+0.363（SD 0.824））。在调整分析中，18 个月前、5 岁和 7 岁时补充维生素 D 与全身（不包括头部）BMD 无关。同样，在任何时间点均未发现 s-25（OH）D 与全身（不包括头部）BMD 之间存在可靠的关联。未发现全身（不包括头部）骨矿物质浓度或骨面积与维生素 D 之间存在关联。在这个 s-25（OH）D 浓度相对较高的人群中，没有发现维生素 D 补充建议的依从性或妊娠或儿童期维生素 D 状态与 7 岁时骨矿化之间存在一致的关联。
