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一份适用于评估儿童维生素 D 缺乏风险的问卷,该问卷经过改编,有助于指导临床干预。

An Adapted Questionnaire Tailored for Assessing the Risk of Vitamin D Deficiency in Children That Is Proving Useful in Guiding Clinical Interventions.

机构信息

Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy.

Pediatric Department, Buzzi Children's Hospital, 20154 Milano, Italy.

出版信息

Nutrients. 2024 Mar 27;16(7):971. doi: 10.3390/nu16070971.

Abstract

BACKGROUND

The identification of vitamin D (VitD) deficiency in pediatric populations is essential for preventive healthcare. We refined and tested the Evaluation of Deficiency Questionnaire (EVIDENCe-Q) for its utility in detecting VitD insufficiency among children.

PATIENTS AND METHODS

We enrolled 201 pediatric patients (aged between 3 and 18 years). Clinical evaluation and serum vitamin D levels were assessed in all subjects. The EVIDENCe-Q was updated to incorporate factors influencing VitD biosynthesis, intake, assimilation, and metabolism, with scores spanning from 0 (optimal) to 36 (poor).

RESULTS

We established scores for severe deficiency (<10 mg/dL) at 20, deficiency (<20 mg/dL) at 22, and insufficiency (<30 mg/dL) at 28. A score of 20 or greater was determined as the optimal cut-off for distinguishing VitD deficient from sufficient statuses, as evidenced by ROC curve analysis AUC = 0.7066; SE = 0.0841; sensitivity 100%, 95% CI 0.561-1. The most accurate alignment was seen with VitD insufficiency, defined as 25-OH-D3 < 20 ng/mL.

CONCLUSIONS

This study confirms that the EVIDENCe-Q is a valid instrument for assessing the risk of vitamin D deficiency and insufficiency in children. It offers a practical approach for determining the need for clinical intervention and dietary supplementation of VitD in the pediatric population.

摘要

背景

在儿科人群中识别维生素 D(VitD)缺乏对于预防保健至关重要。我们对评估缺乏问卷(EVIDENCe-Q)进行了改进和测试,以确定其在检测儿童 VitD 不足方面的实用性。

患者和方法

我们招募了 201 名儿科患者(年龄在 3 至 18 岁之间)。所有受试者均进行了临床评估和血清维生素 D 水平检测。EVIDENCe-Q 已更新,纳入了影响 VitD 生物合成、摄入、吸收和代谢的因素,评分范围从 0(最佳)到 36(最差)。

结果

我们确定了严重缺乏症(<10mg/dL)的评分为 20,缺乏症(<20mg/dL)的评分为 22,不足症(<30mg/dL)的评分为 28。评分≥20 被确定为区分 VitD 缺乏和充足状态的最佳截断值,这一点通过 ROC 曲线分析 AUC=0.7066;SE=0.0841;敏感性 100%,95%CI 0.561-1 得到证明。与 VitD 不足症(定义为 25-OH-D3<20ng/mL)的吻合度最高。

结论

本研究证实,EVIDENCe-Q 是评估儿童 VitD 缺乏和不足风险的有效工具。它提供了一种实用的方法,用于确定儿科人群中临床干预和 VitD 饮食补充的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79e7/11013822/71b254fd0e15/nutrients-16-00971-g001.jpg

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