1型糖尿病儿童及青少年维生素D缺乏症的患病率及相关因素：来自里约热内卢一项临床试验的基线数据

Prevalence and factors associated with vitamin D deficiency in children and adolescents with type 1 diabetes mellitus: Baseline data from a clinical trial in Rio de Janeiro.

作者信息

Moreira Carolina Ferraz Figueiredo, Proença da Fonseca Ana Carolina, Ferreira Aline Alves, Nascimento Bárbara Folino, de Araújo Beatriz Bastos, Rodrigues Farias Dayana, Junior Mario Campos, Luescher Jorge Luiz, de Carvalho Padilha Patricia

机构信息

Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.

Laboratório de Genética Humana, Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Rio de Janeiro, Brazil; Laboratório de Genética, Universidade do Grande Rio, Duque de Caxias, Brazil; Laboratório de Imunofarmacologia, Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Rio de Janeiro, Brazil.

出版信息

Nutrition. 2025 Mar;131:112634. doi: 10.1016/j.nut.2024.112634. Epub 2024 Nov 15.

DOI:10.1016/j.nut.2024.112634

PMID:39693927

Abstract

OBJECTIVES

The therapeutic potential of vitamin D has been studied regarding adjuvant interventions. Some studies have evaluated the factors associated with vitamin D deficiency (VDD) in healthy populations, but they are scarce in children and adolescents with type 1 diabetes mellitus (T1DM). The objective of this study was to describe the prevalence of and factors associated with VDD in children and adolescents with T1DM.

METHODS

This was a cross-sectional analysis of the baseline data from a controlled clinical trial. Participants were between 7 and 16 y old, diagnosed with T1DM for at least 1 y, and classified as having VDD when 25-hydroxyvitamin D (25[OH]D) was less than 30 ng/mL. The following data were collected: sociodemographic, clinical, laboratory, lifestyle, anthropometric, and Fok-I polymorphism (rs2228570). A multivariable logistic regression model was developed to adjust the effect of potential confounders. The odds ratio (OR) with 95% confidence interval (CI) was used. The significance level used was 5%.

RESULTS

A total of 143 children and adolescents were enrolled; 51% were female and the mean age was 11.5 ± 2.2 y old. The prevalence of VDD was 79% and the mean 25(OH)D of participants with VDD was 19.2 ± 6.1 ng/mL. The factors associated with VDD were low level of physical activity (OR, 2.9, 95% CI, 1.1-7.6, P = 0.031), poor glycemic control (OR, 5.0, 95% CI, 1.9-13.2, P = 0.001), and excess weight (OR, 3.6, 95% CI, 1.1-11.1, P = 0.029).

CONCLUSIONS

A high prevalence of VDD was observed as well as some associated lifestyle and clinical variables. Recommendations for children and adolescents with T1DM include monitoring their 25(OH)D and encouraging healthy eating practices and routine physical exercise.

摘要

目的

已对维生素D在辅助干预方面的治疗潜力进行了研究。一些研究评估了健康人群中与维生素D缺乏（VDD）相关的因素，但在1型糖尿病（T1DM）儿童和青少年中此类研究较少。本研究的目的是描述T1DM儿童和青少年中VDD的患病率及相关因素。

方法

这是一项对一项对照临床试验的基线数据进行的横断面分析。参与者年龄在7至16岁之间，确诊T1DM至少1年，当25-羟基维生素D（25[OH]D）低于30 ng/mL时被归类为患有VDD。收集了以下数据：社会人口统计学、临床、实验室、生活方式、人体测量学和Fok-I基因多态性（rs2228570）。建立了多变量逻辑回归模型以调整潜在混杂因素的影响。使用了具有95%置信区间（CI）的比值比（OR）。使用的显著性水平为5%。

结果

共招募了143名儿童和青少年；51%为女性，平均年龄为11.5±2.2岁。VDD的患病率为79%，VDD参与者的平均25(OH)D为19.2±6.1 ng/mL。与VDD相关的因素包括身体活动水平低（OR，2.9，95%CI，1.1 - 7.6，P = 0.031）、血糖控制差（OR，5.0，95%CI，1.9 - 13.2，P = 0.001）和超重（OR，3.6，95%CI，1.1 - 11.1，P = 0.029）。