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新冠疫情封锁措施的影响:青少年中有症状的维生素D缺乏症患病率上升。

Impact of COVID lockdown: Increased prevalence of symptomatic Vitamin D deficiency in adolescents.

作者信息

Chandankere Vidyasagar, Konanki Ramesh, Maryada Venkat Reddy, Reddy Av Gurava

机构信息

KIMS-Sunshine Hospitals, Hyderabad, India.

Rainbow Children's Hospital, Hyderabad, India.

出版信息

J Clin Orthop Trauma. 2023 Dec 12;47:102316. doi: 10.1016/j.jcot.2023.102316. eCollection 2023 Dec.

Abstract

BACKGROUND

During the COVID lockdown in India, which lasted for more than a year, all schools were closed and children were homebound. When the lockdown was lifted, we observed an increased prevalence of Vitamin D deficiency(VDD) in adolescents. We want to highlight the effect of home lockdown on adolescents, which can predispose such children to VDD.

AIM

To document the increased prevalence of symptomatic VDD in adolescents after COVID lockdown and to study the symptoms, biochemical abnormalities, and response to therapy in this subset.

METHODS

This prospective observational study was done from November 2021 to May 2022 with a minimum follow-up of six months.

INCLUSIONS

Consecutive children presenting with gait abnormalities, proximal myopathy, and pains, with documented VDD. Exclusion: Genetic, neuromuscular disorders, juvenile rheumatoid arthritis, chronic renal failure, thyroid disorders and those on anti-epileptic medications and vitamin D supplementation in the past 6 months were excluded from the study. We recorded the symptomatology, biochemical abnormalities, and muscle weakness and followed their improvement after Vitamin D and Calcium supplementation.

RESULTS

A statistically significant increase in symptomatic VDD in adolescents, in six months post-lockdown was noted. Thirty-one adolescents between 9 to 14 years were studied. All cases were relieved of pain and muscle power normalized in 12 weeks.

CONCLUSION

Prolonged house arrest may cause VDD in adolescents. Physicians should consider VDD in adolescents with myopathy and pain after pandemic lockdowns. Supplementation of Vitamin D and calcium resolves most symptoms except deformities. Follow-up is needed until growth spurt completion for recurrence of symptoms.

摘要

背景

在印度持续了一年多的新冠疫情封锁期间,所有学校关闭,孩子们只能待在家中。封锁解除后,我们观察到青少年维生素D缺乏症(VDD)的患病率有所上升。我们想强调居家封锁对青少年的影响,这种影响可能使这些儿童易患VDD。

目的

记录新冠疫情封锁后青少年有症状的VDD患病率增加的情况,并研究该亚组中的症状、生化异常及对治疗的反应。

方法

这项前瞻性观察性研究于2021年11月至2022年5月进行,最短随访期为6个月。

纳入标准

连续出现步态异常、近端肌病和疼痛且有记录的VDD患儿。排除标准:患有遗传性、神经肌肉疾病、青少年类风湿性关节炎、慢性肾衰竭、甲状腺疾病以及在过去6个月内服用抗癫痫药物和补充维生素D的患儿被排除在研究之外。我们记录了症状、生化异常和肌肉无力情况,并在补充维生素D和钙后观察其改善情况。

结果

注意到封锁后6个月青少年中有症状的VDD在统计学上显著增加。研究了31名9至14岁的青少年。所有病例的疼痛均得到缓解,肌肉力量在12周内恢复正常。

结论

长期居家隔离可能导致青少年患VDD。医生在疫情封锁后应对患有肌病和疼痛的青少年考虑VDD的可能性。补充维生素D和钙可缓解大多数症状,但畸形除外。在生长突增完成前需要进行随访以观察症状是否复发。

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本文引用的文献

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Vitamin D in adolescents: Are current recommendations enough?青少年中的维生素D:当前的建议足够吗?
J Steroid Biochem Mol Biol. 2017 Oct;173:265-272. doi: 10.1016/j.jsbmb.2017.02.010. Epub 2017 Feb 16.

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