Gül İhsan, Gür Emel, Erener Ercan Tuğba, Can Günay
Department of Pediatrics, Suleymaniye Maternity and Women's Hospital, Istanbul, Turkey.
Department of Social Pediatrics, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey.
Turk Arch Pediatr. 2021 Nov;56(6):618-623. doi: 10.5152/TurkArchPediatr.2021.21166.
Vitamin D deficiency is a major public health problem. The aim of our study was to determine serum 25-hydroxyvitamin D levels among healthy children aged 3-36 months in a setting where vitamin D prophylaxis is a national policy for infants during the first year of life and among pregnant women.
A total of 190 healthy children with a mean age of 15.9 ± 10.4 months were prospectively enrolled.
The mean 25-hydroxyvitamin D level of children was 38.1 ± 16.2 ng/mL. 25 Hydroxyvitamin D level was ≥20 ng/mL in 87.4% of children while it was between 12 and 19 ng/mL in 10.5% and <12 ng/mL in 2.1% of the children. Children who were on vitamin D prophylaxis were found to have significantly higher 25-hydroxyvitamin D levels than those who were not on prophylaxis (41.6 ± 17.6 vs 33.6 ± 13.1 ng/mL; P = .001). None of the children >1 year of age who were on prophylaxis had 25 hydroxyvitamin D levels <20 ng/mL. No significant difference in 25-hydroxyvitamin D levels was found between children who were receiving different vitamin D doses (400 IU vs >400 IU). Analysis of covariance revealed that vitamin D prophylaxis and vitamin D supplementation of the mother during lactation had significant effects on 25-hydroxyvitamin D levels (P = .034 and P = .009, respectively).
Although vitamin D prophylaxis at a dose of 400 IU seems to be sufficient to prevent vitamin D deficiency, we suggest that continuing vitamin D supplementation beyond 1 year of age with supplementation of pregnant and especially lactating mothers could have an impact on a replete vitamin D status among infants.
维生素D缺乏是一个主要的公共卫生问题。我们研究的目的是在维生素D预防是该国针对婴儿出生后第一年及孕妇的一项国家政策的背景下,确定3至36个月健康儿童的血清25-羟维生素D水平。
前瞻性纳入了190名平均年龄为15.9±10.4个月的健康儿童。
儿童的平均25-羟维生素D水平为38.1±16.2 ng/mL。87.4%的儿童25-羟维生素D水平≥20 ng/mL,10.5%的儿童在12至19 ng/mL之间,2.1%的儿童<12 ng/mL)。发现接受维生素D预防的儿童的25-羟维生素D水平显著高于未接受预防的儿童(41.6±17.6 vs 33.6±13.1 ng/mL;P = .001)。接受预防的1岁以上儿童中,没有一个25-羟维生素D水平<20 ng/mL。接受不同维生素D剂量(400 IU vs>400 IU)的儿童之间,25-羟维生素D水平没有显著差异。协方差分析显示,维生素D预防和母亲在哺乳期补充维生素D对25-羟维生素D水平有显著影响(分别为P = .034和P = .009)。
虽然400 IU剂量的维生素D预防似乎足以预防维生素D缺乏,但我们建议1岁以后继续补充维生素D,并对孕妇尤其是哺乳期母亲进行补充,这可能会对婴儿充足的维生素D状态产生影响。