Levaillant Lucie, Linglart Agnès, Gajdos Vincent, Benachi Alexandra, Souberbielle Jean-Claude
Centre de référence des maladies rares du métabolisme du calcium et du phosphate, AP-HP, Hôpital Bicêtre Paris-Saclay, service d'endocrinologie et diabète de l'enfant, filière OSCAR, DMU 3 SEA, 94270 Le Kremlin-Bicêtre, France.
Department of Pediatric Endocrinology and Diabetology, University Hospital of Angers, 49933 Angers Cedex 9, France.
J Clin Endocrinol Metab. 2024 Dec 18;110(1):e68-e71. doi: 10.1210/clinem/dgae167.
Serum calcium is frequently measured during the neonatal period, and it is known to be influenced by the vitamin D status.
We hypothesized that the 25-hydroxyvitamin D (25OHD) concentration may influence the lower limit of the serum calcium normal range in neonates.
We included in our prospective cohort study 1002 mother-newborn pair recruited from April 2012 to July 2014, in 2 centers located in the neighborhoods of Paris, France, whose serum calcium was measured at 3 days of life. We established, after exclusion of outliers, a 95% CI for serum calcium (i) in our whole population of 1002 neonates; (ii) in neonates with a cord blood 25OHD concentration ≥ 30 nmol/L; and (iii) in those with a 25OHD ≥ 50 nmol/L.
The mean serum total calcium was 2.46 ± 0.13 nmol/L (95% CI: 2.19-2.72 mmol/L), 2.47 ± 0.25 mmol/L (95% CI: 2.22-2.72 mmol/L), and 2.50 ± 0.25 mmol/L (95% CI: 2.25-2.75 mmol/L) in the whole group, in the 514 neonates with 25OHD ≥ 30 nmol/L, and in the 202 neonates with 25OHD ≥ 50 nmol/L respectively. The lower limit of the 95% range was significantly higher in neonates with 25 OHD ≥ 30 nmol/L (P < 0.05) and ≥ 50 nmol/L (P < .001) than in the entire cohort.
We show that the lower limit of the normal serum calcium range is higher in groups with a higher 25OHD than in unselected subjects. We propose that the reference range for serum calcium in neonates is 2.25 to 2.75 mmol/L.
新生儿期经常检测血清钙，且已知其受维生素D状态影响。
我们假设25-羟基维生素D（25OHD）浓度可能会影响新生儿血清钙正常范围的下限。
我们在2012年4月至2014年7月期间，从法国巴黎附近的2个中心招募了1002对母婴纳入前瞻性队列研究，在出生3天时测量其血清钙。在排除异常值后，我们为血清钙建立了95%置信区间：（i）在1002名新生儿的总体人群中；（ii）在脐带血25OHD浓度≥30 nmol/L的新生儿中；（iii）在25OHD≥50 nmol/L的新生儿中。
在整个组、514名25OHD≥30 nmol/L的新生儿以及202名25OHD≥50 nmol/L的新生儿中，血清总钙均值分别为2.46±0.13 nmol/L（95%置信区间：2.19 - 2.72 mmol/L）、2.47±0.25 mmol/L（95%置信区间：2.22 - 2.72 mmol/L）和2.5±0.25 mmol/L（95%置信区间：2.25 - 2.75 mmol/L）。25OHD≥30 nmol/L（P<0.05）和≥50 nmol/L（P<0.001）的新生儿95%范围的下限显著高于整个队列。
我们表明，25OHD水平较高组的血清钙正常范围下限高于未筛选人群。我们建议新生儿血清钙的参考范围为2.25至2.75 mmol/L。
