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肯尼亚内罗毕一家三级保健机构中纯母乳喂养婴儿维生素 D 缺乏症的流行情况。

Prevalence of vitamin D deficiency in exclusively breastfed infants at a tertiary healthcare facility in Nairobi, Kenya.

机构信息

Department of Pediatrics and Child Health, The Aga Khan University Hospital, Nairobi, Kenya,

Department of Pediatrics, Avenue Hospital Kisumu, Kisumu, Kenya.

出版信息

Arch Endocrinol Metab. 2021 May 18;64(6):726-734. doi: 10.20945/2359-3997000000281.

Abstract

OBJECTIVE

To determine the prevalence of vitamin D deficiency (VDD) in exclusively breastfed infants at the Aga Khan University Hospital Nairobi, Kenya (AKUHN). The relationships between 25-hydroxyvitamin D; 25OHD, parathyroid hormone (PTH), maternal vitamin D supplementation, and sunlight exposure were also determined.

METHODS

Blood from 98 infants was assayed for 25OHD, calcium, phosphate, and PTH. Socio-demographic and clinical characteristics were analyzed using descriptive statistics and inferential analysis ( < 0.05).

RESULTS

The prevalence of VDD (25OHD <12 ng/mL), vitamin D insufficiency (VDI, 25OHD 12-20 ng/mL) and vitamin D sufficiency (VDS, 25OHD >20 ng/mL) was 11.2% (95% CI 8.0%-14.4%), 12.2% (95% CI 8.9%-15.5%), and 76.5% (95% CI 72.3%-80.8%) respectively. There was no difference in the mean age, head circumference, length, or weight of infants in VDD, VDI, and VDS groups. PTH was elevated when 25OHD was <12 ng/mL and normal when 25OHD was between 12-20 ng/mL. 25OHD and PTH were normal in infants whose mothers received vitamin D supplements. Infants who received <30 minutes/day of exposure to sunlight were 5 times more likely to have VDI than infants who received ≥30 minutes/day ( = 0.042).

CONCLUSION

The prevalence of VDD in exclusively breastfed infants at AKUHN is low. The current national policy that recommends exclusive breastfeeding of infants in the first 6 months of life appears to be effective in staving off vitamin D deficiency but those infants with < 30 minutes sunlight exposure may benefit from low dose supplemental vitamin D during times of low sunlight exposure.

摘要

目的

在肯尼亚内罗毕 Aga Khan 大学医院(AKUHN)确定纯母乳喂养婴儿的维生素 D 缺乏症(VDD)的流行率。还确定了 25-羟维生素 D;25OHD、甲状旁腺激素(PTH)、母亲维生素 D 补充剂和阳光暴露之间的关系。

方法

对 98 名婴儿的血液进行 25OHD、钙、磷和 PTH 检测。使用描述性统计和推断分析(<0.05)分析社会人口统计学和临床特征。

结果

VDD(25OHD <12ng/mL)、维生素 D 不足(VDI,25OHD 12-20ng/mL)和维生素 D 充足(VDS,25OHD >20ng/mL)的患病率分别为 11.2%(95%CI 8.0%-14.4%)、12.2%(95%CI 8.9%-15.5%)和 76.5%(95%CI 72.3%-80.8%)。25OHD 为<12ng/mL 时,PTH 升高,25OHD 在 12-20ng/mL 之间时,PTH 正常。接受维生素 D 补充剂的母亲的婴儿 25OHD 和 PTH 正常。每天接受阳光照射<30 分钟的婴儿发生 VDI 的可能性是每天接受阳光照射≥30 分钟的婴儿的 5 倍(=0.042)。

结论

AKUHN 纯母乳喂养婴儿的 VDD 患病率较低。目前建议婴儿在生命的前 6 个月内进行纯母乳喂养的国家政策似乎有效地预防了维生素 D 缺乏症,但那些每天接受阳光照射<30 分钟的婴儿在阳光照射较少时可能需要补充低剂量的维生素 D。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5b4/10528608/3795051634c4/2359-4292-aem-64-06-0726-gf01.jpg

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