Zhumalina Akmaral, Tusupkaliev Balash, Mania Anna, Kim Irina, Zharlykasinova Mairamkul
Department of Children's Diseases No. 1 with Neonatology (AZ, BT, IK, MZ), West Kazakhstan Marat Ospanov Medical University, Aktobe, Republic of Kazakhstan.
Department of Infectious Diseases and Child Neurology (AM), Poznan University of Medical Sciences, Poznan, Poland.
J Pediatr Pharmacol Ther. 2024 Aug;29(4):410-416. doi: 10.5863/1551-6776-29.4.410. Epub 2024 Aug 13.
The research aimed to determine the importance of vitamin D and markers of bone metabolism in the overall assessment of bone mineralization during a child's first year of life.
The 198 children were selected by screening all infants seen at our pediatric clinic over a 2-year period from 2020-2022 and including those who met the eligibility criteria of being aged 0 to 1 year, healthy with no chronic conditions, and not on vitamin D supplementation. Children were divided into 3 groups depending on the content of vitamin D in the blood serum: sufficient, insufficient, and deficient. The markers of bone tissue status included: markers of mineral metabolism (calcium, phosphorus, parathyroid hormone, calcitonin), a marker of bone formation (osteocalcin), resorption marker (deoxypyridinoline). Laboratory values were obtained at the time of study enrollment during the initial study visit. Labs were not repeated during the course of the study.
A quarter of the infants exhibited vitamin D deficiency at enrollment with serum 25OHD concentrations below 20 ng/mL, which showed a positive correlation with serum calcium and phosphorus -concentrations and a negative correlation with PTH, while osteocalcin and deoxypyridinoline concentrations remained consistent regardless of vitamin D status.
The study's practical significance allows for the recommendation of using vitamin D -concentrations as a marker to detect bone formation and mineral metabolism disorders in children during their first year of life. By identifying and addressing these issues early on, the health care system aims to ensure better musculoskeletal health for children.
本研究旨在确定维生素D和骨代谢标志物在儿童出生后第一年骨矿化综合评估中的重要性。
通过筛查2020年至2022年两年间在我们儿科诊所就诊的所有婴儿,并纳入符合年龄在0至1岁、健康无慢性病且未补充维生素D资格标准的婴儿,选取了198名儿童。根据血清中维生素D的含量,将儿童分为3组:充足、不足和缺乏。骨组织状态的标志物包括:矿物质代谢标志物(钙、磷、甲状旁腺激素、降钙素)、骨形成标志物(骨钙素)、吸收标志物(脱氧吡啶啉)。在初次研究访视时研究入组时获取实验室值。在研究过程中未重复检测实验室指标。
四分之一的婴儿在入组时表现出维生素D缺乏,血清25OHD浓度低于20 ng/mL,这与血清钙和磷浓度呈正相关,与甲状旁腺激素呈负相关,而无论维生素D状态如何,骨钙素和脱氧吡啶啉浓度保持一致。
该研究的实际意义在于建议将维生素D浓度作为检测儿童出生后第一年骨形成和矿物质代谢紊乱的标志物。通过尽早识别和解决这些问题,医疗保健系统旨在确保儿童拥有更好的肌肉骨骼健康。