Service de Réanimation Néonatale et Néonatologie, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 69677 Bron, France.
Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, 69003 Lyon, France.
Nutrients. 2023 Oct 18;15(20):4423. doi: 10.3390/nu15204423.
Low 25-Hydroxyvitamin D (25(OH)D) in preterm infants is a risk factor for bronchopulmonary dysplasia (BPD), but increased supplementation failed to demonstrate a beneficial effect on BPD. In neonatal animal models, deficiency and excessive vitamin D exposure have been associated with increased mortality and histological alterations in the lung evocative of BPD. Our hypothesis is that 25(OH)D levels ≥ 120 nmol/L are also a risk factor for BPD or death. This retrospective single-center cohort study included only infants born at <31 weeks gestational age without major malformations with at least a determination of 25(OH)D at <36 weeks corrected age and no determination <50 nmol/L. Routine 25(OH)D determination was performed at 1 month and monthly thereafter. A total of 175 infants were included. Infants with BPD or who died had a significantly lower term and weight, but a similar frequency of 25(OH)D ≥120 nmol/L (50.5% vs. 43.9%, = 0.53). The logistic regression identified weight (OR 0.997, 95% CI [0.995-0.998]) and term (OR 0.737, 95% CI [0.551-0.975]) as significantly associated with BPD or death; the occurrence of excessive 25(OH)D was not significantly associated (OR 1.029, 95% CI [0.503-2.093]). The present study did not demonstrate any significant association between excessive 25(OH)D after one month of age and BPD or death.
早产儿血清 25-羟维生素 D（25（OH）D）水平较低是支气管肺发育不良（BPD）的危险因素，但增加补充剂未能显示对 BPD 有益的效果。在新生儿动物模型中，维生素 D 缺乏和过量暴露与死亡率增加以及肺部组织学改变有关，这些改变类似于 BPD。我们的假设是，血清 25（OH）D 水平≥120 nmol/L 也是 BPD 或死亡的危险因素。本回顾性单中心队列研究仅纳入胎龄<31 周且无重大畸形的婴儿，且至少在校正胎龄<36 周时有 25（OH）D 测定值，且<50 nmol/L 时无测定值。常规在 1 个月时进行 25（OH）D 测定，之后每月测定一次。共纳入 175 例婴儿。患有 BPD 或死亡的婴儿的胎龄和体重明显较低，但血清 25（OH）D 水平≥120 nmol/L 的频率相似（50.5%与 43.9%，=0.53）。逻辑回归确定体重（OR 0.997，95%CI[0.995-0.998]）和胎龄（OR 0.737，95%CI[0.551-0.975]）与 BPD 或死亡显著相关；25（OH）D 水平过高的发生与 BPD 或死亡无显著相关性（OR 1.029，95%CI[0.503-2.093]）。本研究未发现 1 个月后血清 25（OH）D 水平过高与 BPD 或死亡之间存在任何显著相关性。
