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儿童严重残疾且紫外线暴露有限导致维生素 D 缺乏。

Vitamin D deficiency in children with severe disabilities under limited ultraviolet exposure.

机构信息

Iwate Prefectural Rehabilitation and Nursery Center for Disabled Children, 2-1-3 Idai-dori Yahaba-cho, Shiwa-gun, Iwate, 028-3603, Japan.

Department of Developmental Disability Medicine, School of Medicine, Iwate Medical University, Morioka, Japan.

出版信息

J Bone Miner Metab. 2023 Jan;41(1):52-60. doi: 10.1007/s00774-022-01376-w. Epub 2022 Nov 11.

Abstract

INTRODUCTION

Nutritional prevention of osteoporosis management is an important issue for children with severe disabilities. Due to the coronavirus disease 2019 (COVID-19) pandemic that started in 2020, children admitted to institutions had fewer opportunities for ultraviolet (UV) exposure owing to restrictions on attending school and going out. Hence, the vitamin D (VD) status of these children has been a cause of concern. This study aimed to assess the correlation between VD intake and VD status among children with severe disabilities who had limited UV exposure.

MATERIALS AND METHODS

This research included patients admitted to Iwate Prefectural Rehabilitation and Nursery Center for Disabled Children. Serum 25-hydroxyvitamin D [25(OH)D] levels were assessed during school/outing restriction periods and after restriction removal and the introduction of sunbathing periods. The trends in 25(OH)D levels and oral VD intake before the two measurements were analyzed.

RESULTS

Although 17 of 32 patients had VD intake above the recommended level of Dietary Reference Intakes for Japanese during the first measurement, 31 patients had VD deficiency. The 25(OH)D levels of 13 patients without UV exposure before the first evaluation and those with UV exposure before the second evaluation were 2.03 times higher, despite of constant VD intakes. In contrast, there were no remarkable changes in both VD intakes and 25(OH)D levels in five patients without UV exposure before both assessments.

CONCLUSION

Japanese children with severe disabilities who consume the recommended oral VD intake but who have limited UV exposure can still present VD deficiency.

摘要

简介

营养预防骨质疏松症管理是严重残疾儿童的一个重要问题。由于 2020 年开始的 2019 年冠状病毒病(COVID-19)大流行,由于限制上学和外出,入住机构的儿童接受紫外线(UV)照射的机会减少。因此,这些儿童的维生素 D(VD)状况一直令人关注。本研究旨在评估在紫外线照射有限的严重残疾儿童中,VD 摄入量与 VD 状况之间的相关性。

材料和方法

本研究纳入了岩手县残疾儿童康复和托儿所的患者。在学校/户外活动限制期间以及限制解除和引入日光浴期间评估血清 25-羟维生素 D [25(OH)D] 水平。分析了两次测量前的 25(OH)D 水平和口服 VD 摄入量的趋势。

结果

尽管在第一次测量时,32 名患者中有 17 名患者的 VD 摄入量高于日本膳食参考摄入量的推荐水平,但仍有 31 名患者患有 VD 缺乏症。在第一次评估前没有接受过紫外线照射的 13 名患者和在第二次评估前接受过紫外线照射的患者的 25(OH)D 水平高了 2.03 倍,尽管 VD 摄入量保持不变。相比之下,在两次评估前均未接受过紫外线照射的五名患者中,VD 摄入量和 25(OH)D 水平均无明显变化。

结论

日本严重残疾儿童即使摄入推荐的口服 VD 量,但由于紫外线照射有限,仍可能出现 VD 缺乏症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/396a/9649399/9c5ac13fc669/774_2022_1376_Fig1_HTML.jpg

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