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7 岁时的骨密度与婴儿期维生素 D 补充指南的依从性或妊娠和儿童期维生素 D 状态无关:奥登塞儿童队列研究。

Bone mineral density at age 7 years does not associate with adherence to vitamin D supplementation guidelines in infancy or vitamin D status in pregnancy and childhood: an Odense Child Cohort study.

机构信息

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.

出版信息

Br J Nutr. 2021 Nov 28;126(10):1466-1477. doi: 10.1017/S0007114521000301. Epub 2021 Jan 26.

Abstract

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.

摘要

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。

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