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[肥胖儿童脂溶性维生素A、D、E水平及其影响因素]

[Levels of fat-soluble vitamins A, D, and E and their influencing factors in children with obesity].

作者信息

Liu Rui-Ping, Chen Yang, Wu Hai-Bin, Xiong Feng-Mei, He Fang-Yuan, Li Yuan-Yuan

机构信息

Department of Clinical Nutrition, Xi'an Children's Hospital, Xi'an 710003, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2022 May 15;24(5):572-578. doi: 10.7499/j.issn.1008-8830.2111031.

Abstract

OBJECTIVES

To investigate the levels of fat-soluble vitamins A, D, and E in children with obesity and their influencing factors.

METHODS

A total of 273 children with obesity who attended the Department of Clinical Nutrition, Xi'an Children's Hospital, from January 2019 to April 2021 were enrolled as the obesity group. A total of 226 children with normal body weight who underwent physical examination during the same period were enrolled as the control group. Anthropometric parameters and body composition were measured for both groups, and the serum concentrations of vitamins A, D, and E were also measured.

RESULTS

Compared with the control group, the obesity group had significantly higher serum levels of vitamin A [(1.32±0.21) μmol/L vs (1.16±0.21) μmol/L, <0.001] and vitamin E [(9.3±1.4) mg/L vs (8.3±1.2) mg/L, <0.001] and a significant reduction in the level of 25-hydroxyvitamin D [(49±22) nmol/L vs (62±24) nmol/L, <0.001]. In the obesity group, the prevalence rates of marginal vitamin A deficiency, vitamin D deficiency/insufficiency, and vitamin E insufficiency were 5.5% (15/273), 56.8% (155/273), and 4.0% (11/273), respectively. After adjustment for body mass index Z-score and waist-to-height ratio, serum vitamin A level was positively correlated with age (<0.001), while vitamins E and 25-hydroxyvitamin D levels were negatively correlated with age in children with obesity (<0.001). After adjustment for age, the serum levels of vitamin A, vitamin E and 25-hydroxyvitamin D were not correlated with degree of obesity, percentage of body fat, and duration of obesity in children with obesity, while the serum levels of vitamins A and E were positively correlated with waist-to-height ratio (<0.001).

CONCLUSIONS

There are higher serum levels of vitamins A and E in children with obesity, especially in those with abdominal obesity, while serum vitamin D nutritional status is poor and worsens with age. Therefore, vitamin D nutritional status should be taken seriously for children with obesity, and vitamin D supplementation should be performed when necessary.

摘要

目的

探讨肥胖儿童脂溶性维生素A、D、E水平及其影响因素。

方法

选取2019年1月至2021年4月在西安市儿童医院临床营养科就诊的273例肥胖儿童作为肥胖组。选取同期进行体检的226例体重正常儿童作为对照组。测量两组儿童的人体测量参数和身体成分,并检测血清维生素A、D、E浓度。

结果

与对照组相比,肥胖组血清维生素A水平显著升高[(1.32±0.21)μmol/L对(1.16±0.21)μmol/L,<0.001]和维生素E水平显著升高[(9.3±1.4)mg/L对(8.3±1.2)mg/L,<0.001],而25-羟维生素D水平显著降低[(49±22)nmol/L对(62±24)nmol/L,<0.001]。在肥胖组中,边缘性维生素A缺乏、维生素D缺乏/不足和维生素E不足的患病率分别为5.5%(15/273)、56.8%(155/273)和4.0%(11/273)。校正体重指数Z评分和腰高比后,肥胖儿童血清维生素A水平与年龄呈正相关(<0.001),而维生素E和25-羟维生素D水平与年龄呈负相关(<0.001)。校正年龄后,肥胖儿童血清维生素A、维生素E和25-羟维生素D水平与肥胖程度、体脂百分比和肥胖持续时间无关,而血清维生素A和E水平与腰高比呈正相关(<0.001)。

结论

肥胖儿童血清维生素A和E水平较高,尤其是腹型肥胖儿童,而血清维生素D营养状况较差且随年龄增长而恶化。因此,应重视肥胖儿童的维生素D营养状况,必要时进行维生素D补充。

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