Hypovitaminosis D in healthy schoolchildren
Hypovitaminosis D in healthy schoolchildren
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DOI：
10.1542/peds.107.4.e53
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发表时间：
2001-04-01
期刊：
影响因子：
8
通讯作者：
Tannous, R
中科院分区：
文献类型：
--
作者：
El-Hajj Fuleihan, G;Nabulsi, M;Tannous, R
背景维生素D对骨骼生长至关重要，但目前尚无婴儿期后补充维生素D的指南。本研究调查了健康儿童维生素D不足的情况。年龄在10至16岁的儿童从3所私立学校在贝鲁特，黎巴嫩，不同的社会经济地位（SES）进行了研究：169在1999年春季和177年秋季，83名学生参加了两个研究阶段。他们进行了体格检查，回答了饮食调查问卷，并抽取了血液用于促钙激素和骨转换指数。总体而言，52%的学生维生素D不足;冬季不足的比例为65%，夏季结束时为40%。在这两个季节，女孩的维生素D水平低于男孩;那些遵循头部，手臂和腿的着装规范的人的水平最低。中等社会经济地位学校的学生比高社会经济地位学校的学生有更低的25-羟基维生素D（25-OHD）水平。在调整混杂因素后，性别，SES和体重指数仍然是两个季节维生素D水平的重要预测因素（R-2 = 0.53，春季和秋季分别为0.28）。25-OHD水平与甲状旁腺激素水平呈显著负相关，相关系数R-2 = 0.19。即使在阳光充足的国家，维生素D缺乏症在学龄儿童中也很常见，尤其是在冬天。女孩，特别是那些社会经济地位较低的女孩，面临的风险特别大。甲状旁腺激素的反向变化表明，维生素D水平不足可能会对健康青少年的骨骼代谢产生不利影响。维生素D不足可能在许多其他国家普遍存在，在这些国家，补充维生素D的牛奶不是强制性的。我们的研究结果呼吁重新考虑高危青少年的维生素D补充，以进一步优化骨骼健康。
Background. Vitamin D is essential for skeletal growth, but there are currently no guidelines for vitamin D supplementation after infancy. This study investigates vitamin D insufficiency in healthy children.Methods. Children ages 10 to 16 years from 3 private schools in Beirut, Lebanon, with differing socioeconomic status (SES) were studied: 169 in the spring of 1999 and 177 in the following fall; 83 students participated in both study phases. They had a physical examination, answered a dietary questionnaire, and blood was drawn for calciotropic hormones and indices of bone turnover.Results. Overall, 52% of the students were vitamin D-insufficient; the proportion of insufficiency was 65% in the winter and 40% at the end of the summer. During both seasons, girls had lower vitamin D levels than did boys; those who followed the dress code of covered head, arms, and legs had the lowest levels. Students in the mid-SES school had lower 25-hydroxyvitamin D (25-OHD) levels than did the ones from the high-SES school. After adjusting for confounders, gender, SES, and body mass index remained the significant predictors of vitamin D levels in both seasons (R-2 = 0.53, for spring and 0.28 for fall). There was a significant inverse correlation between 25-OHD levels and parathyroid hormone levels that was best fitted by a curvilinear model (R-2 = 0.19).Conclusion. Even in a sunny country, hypovitaminosis D is common in schoolchildren, more so in the winter. Girls, especially those with a lower SES, are at particular risk. The inverse changes in parathyroid hormone suggest that insufficient vitamin D levels may deleteriously affect skeletal metabolism in healthy adolescents. Vitamin D insufficiency may be prevalent in many other countries where supplementation of milk with vitamin D is not mandatory. Our results call to a reconsideration of vitamin D supplementation in high-risk adolescents to further optimize skeletal health.