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5 岁以下巴西儿童维生素 D 不足的患病率及其预测因素:巴西儿童营养状况调查(ENANI-2019)。

Prevalence and predictors of vitamin D insufficiency in Brazilian children under 5 years of age: Brazilian National Survey on Child Nutrition (ENANI-2019).

机构信息

Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ21941-902, Brazil.

Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.

出版信息

Br J Nutr. 2024 Jan 28;131(2):312-320. doi: 10.1017/S0007114523001836. Epub 2023 Aug 17.

Abstract

To analyse the association of socio-demographic and health factors with vitamin D insufficiency and 25-hydroxyvitamin D (25(OH)D) concentration in Brazilian children aged 6-59 months. Data from 8145 children from the Brazilian National Survey on Child Nutrition (ENANI-2019) were analysed. The serum concentration of 25(OHD)D was measured using a chemiluminescent immunoassay. The prevalence of vitamin D insufficiency (25(OH)D < 50 nmol/l) and 95 % CI was calculated. Logistic and linear regression models were used to identify the variables associated with vitamin D insufficiency and serum 25(OH)D concentrations, respectively. The mean 25(OH)D concentration was 98·6 ± 36·0 nmol/l, and 4·3 % of the children presented vitamin D insufficiency. Children aged 6-23 months (OR = 2·23; 95 % CI 1·52, 3·26); belonging to Southeast (OR = 5·55; 95 % CI 2·34, 13·17) and South (OR = 4·57; 95 % CI 1·77, 11·84) regions; the second tertile of the National Wealth Score (OR = 2·14; 95 % CI 1·16, 3·91) and winter (OR = 5·82; 95 % CI 2·67, 12·71) and spring (OR = 4·84; 95 % CI 2·17, 10·80) seasons of blood collection were associated with a higher chance of vitamin D insufficiency. Female sex ( = -5·66, 95 % CI - 7·81, -3·51), urban location ( = -14·19, 95 % CI -21·0, -7·22) and no vitamin D supplement use ( = -6·01, 95 % CI -9·64, -2·39) were inversely associated with serum 25(OH)D concentration. The age of children and the Brazilian geographical region of household location were the main predictors of vitamin D insufficiency. In Brazil, vitamin D insufficiency among children aged 6-59 months is low and is not a relevant public health problem.

摘要

分析巴西 6-59 月龄儿童社会人口学和健康因素与维生素 D 不足及 25-羟维生素 D(25(OH)D)浓度的相关性。分析了来自巴西全国儿童营养调查(ENANI-2019)的 8145 名儿童的数据。使用化学发光免疫分析法测量血清 25(OH)D 浓度。计算了维生素 D 不足(25(OH)D < 50 nmol/L)的患病率和 95%CI。分别使用逻辑回归和线性回归模型来确定与维生素 D 不足和血清 25(OH)D 浓度相关的变量。平均 25(OH)D 浓度为 98.6 ± 36.0 nmol/L,4.3%的儿童存在维生素 D 不足。6-23 月龄儿童(OR = 2.23;95%CI 1.52,3.26);属于东南部(OR = 5.55;95%CI 2.34,13.17)和南部(OR = 4.57;95%CI 1.77,11.84)地区;国家财富评分的第二 tertile(OR = 2.14;95%CI 1.16,3.91)以及冬季(OR = 5.82;95%CI 2.67,12.71)和春季(OR = 4.84;95%CI 2.17,10.80)采集血液季节与更高的维生素 D 不足几率相关。女性( = -5.66,95%CI -7.81,-3.51)、城市地点( = -14.19,95%CI -21.0,-7.22)和不使用维生素 D 补充剂( = -6.01,95%CI -9.64,-2.39)与血清 25(OH)D 浓度呈负相关。儿童年龄和儿童家庭所在的巴西地理位置是维生素 D 不足的主要预测因素。在巴西,6-59 月龄儿童的维生素 D 不足率较低,不是一个相关的公共卫生问题。

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