Demographic, dietary, and biochemical determinants of vitamin D status in inner-city children
Demographic, dietary, and biochemical determinants of vitamin D status in inner-city children
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DOI：
10.3945/ajcn.111.018721
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发表时间：
2012-01-01
影响因子：
7.1
通讯作者：
Cole, David E. C.
中科院分区：
文献类型：
--
作者：
Carpenter, Thomas O.;Herreros, Francisca;Cole, David E. C.
背景资料：临床佝偻病的报告在少数民族婴儿和儿童中特别明显，但在这一人口群体中只有有限的维生素D分析。目的：我们试图描述循环25-羟基维生素D [25（OH）D]，1，25-二羟基维生素D [1，25（OH）（2）D]及其决定因素，包括循环甲状旁腺激素（PTH），总碱性磷酸酶活性（ALP），设计：我们获得了人口统计学信息和血液样本，用于测量>750名6个月至3岁儿童的PTH、ALP、25（OH）D和1，25（OH）（2）D。结果：平均（+/- SD）25（OH）D浓度为66 +/- 22 nmol/L（26.3 +/- 8.7 ng/dL）。共有15%的儿童25（OH）D浓度低于推荐的目标阈值50 nmol/L。仅2.5%的儿童出现PTH和ALP联合升高。25（OH）D的决定因素包括维生素D摄入量、年龄（随着年龄的增长而减少）、皮肤类型（浅色皮肤儿童的浓度高于深色皮肤儿童）、配方奶粉使用（摄入量较高）、季节（夏季和秋季的浓度高于冬季和春季）以及PTH。平均1，25（OH）（2）D浓度为158 +/- 58 pmol/L（60.6 +/- 22.5 pg/mL），与参考范围41-274 pmol/L或15.7-105.5 pg/mL一致。1，25（OH）（2）D的决定因素是年龄（随年龄的增长而下降），性别（女孩的浓度高于男孩），皮肤类型（较浅皮肤的儿童比深色皮肤的儿童浓度更高），相反，血清钙和磷。结论：虽然15%的受试者维生素D不足，只有2.5%的受试者有PTH和ALP升高。使用配方奶粉时观察到的25（OH）D浓度更高，这证实了膳食维生素D强化在这一人口群体中是有效的。婴儿的循环1，25（OH）（2）D高于年龄较大的儿童和成人，与25（OH）D相反，与营养素摄入量没有直接关系。美国临床营养杂志2012;95：137-46。
Background: Reports of clinical rickets are particularly evident in minority infants and children, but only limited analyses of vitamin D are available in this demographic group.Objective: We sought to characterize circulating 25-hydroxyvitamin D [25(OH)D], 1,25-dihydroxyvitamin D [1,25(OH)(2)D], and their determinants, including circulating parathyroid hormone (PTH), total alkaline phosphatase activity (ALP), calcium, and phosphorus, in minority infants and children.Design: We obtained demographic information and blood samples for measurement of PTH, ALP, 25(OH)D, and 1,25(OH)(2)D in >750 6-mo- to 3-y-old children. Dietary intake data were obtained and analyzed.Results: The mean (+/- SD) 25(OH)D concentration was 66 +/- 22 nmol/L (26.3 +/- 8.7 ng/dL). A total of 15% of children had 25(OH) D concentrations less than the recommended target threshold of 50 nmol/L. Combined elevations of PTH and ALP occurred in only 2.5% of children. Determinants of 25(OH)D included vitamin D intake, age (decreasing with age), skin type (greater concentrations in lighter-skinned children than in darker-skinned children), formula use (higher intakes), season (greater concentrations in the summer and fall than in the winter and spring), and, inversely, PTH. The mean 1,25(OH)(2)D concentration was 158 +/- 58 pmol/L (60.6 +/- 22.5 pg/mL), which was consistent with a reference range of 41-274 pmol/L or 15.7-105.5 pg/mL. Determinants for 1,25(OH)(2)D were age (decreasing with age), sex (greater concentrations in girls than in boys), skin type (greater concentrations in lighter-skinned children than in darker-skinned children), and, inversely, serum calcium and phosphorus.Conclusions: Although 15% of subjects were vitamin D insufficient, only 2.5% of subjects had elevations of both PTH and ALP. The greater 25(OH)D concentrations observed with formula use confirm that dietary vitamin D fortification is effective in this demographic group. Circulating 1,25(OH)(2)D is higher in infants than in older children and adults and, in contrast to 25(OH)D, is not directly correlated with nutrient intakes. Am J Clin Nutr 2012;95:137-46.