Department of Pediatrics and Child Health, The Aga Khan University Hospital, Nairobi, Kenya,
Department of Pediatrics, Avenue Hospital Kisumu, Kisumu, Kenya.
Arch Endocrinol Metab. 2021 May 18;64(6):726-734. doi: 10.20945/2359-3997000000281.
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.
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).
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).
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.
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。
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。
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)。
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。