VITAMIN D STATUS AND IMPACT ON BONE MINERALIZATION IN HUMAN MILK FED HISPANIC

母乳喂养的西班牙裔人的维生素 D 状况及其对骨矿化的影响

• 批准号: 8356696
• 负责人: STEVEN A ABRAMS
• 金额: $ 4.15万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-12-01 至 2011-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8356696
• 关键词: 25-hydroxyvitamin D; Age-Months; Autoimmune Diseases; Birth; Bone Mineral Contents; Breast Feeding; Caucasians; Caucasoid Race; Child; Childhood; Cholecalciferol; Clinical Research; Data; Disease; Dual-Energy X-Ray Absorptiometry; Frequencies; Funding; Grant; Hispanics; Human Milk; Immune; Individual; Infant; Intake; Life; Link; Malignant Neoplasms; Measures; Milk; Minerals; Mothers; National Center for Research Resources; Newborn Infant; Nutritional; Outcome; Physiologic calcification; Predisposition; Principal Investigator; Public Health; Relative (related person); Reporting; Research; Research Infrastructure; Resources; Rickets; Risk; Serum; Skin; Source; Speed; Sun Exposure; Supplementation; Texas; Ultrasonography; Umbilical Cord Blood; United States National Institutes of Health; Urbanization; Vitamin D; Vitamin D Deficiency; bone; bone health; cohort; cost; feeding; fetal; follow-up; high risk; imprint; neonate; sound

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. Primary support for the subproject and the subproject's principal investigator may have been provided by other sources, including other NIH sources. The Total Cost listed for the subproject likely represents the estimated amount of Center infrastructure utilized by the subproject, not direct funding provided by the NCRR grant to the subproject or subproject staff. ABSTRACT Vitamin D deficiency is widespread and linked to decreased bone mineral content. Little data exists regarding the vitamin D status and the relationship of 25-OHD status to functional bone health outcomes in Hispanic infants. To evaluate this, we plan an observational cohort of full term, healthy, exclusively breastfed Hispanic and Caucasian infants. We hypothesize serum 25-OHD measured in cord blood will be significantly lower in Hispanic than Caucasian infants, with 25-OHD 50% of Hispanic neonates. Hypothesis #2: Speed of sound bone ultrasound (SOS U/S) and dual-energy X-ray absorptiometry (DXA) whole body bone mineral content measured in the first week of life will correlate positively with 25-OHD concentration in cord blood. Hypothesis #3: Supplementation with 400 IU/d of vitamin D3 from birth will allow all infants to achieve 25-OHD levels 20 ng/mL. Baseline-adjusted bone mineral content and SOS U/S will be significantly correlated with 25-OHD status at 3 months. II. SPECIFIC AIMS Primary Aim: To evaluate the relative frequency of vitamin D deficiency in human milk fed Hispanic compared to Caucasian newborn infants in Houston, Texas. Secondary Aims: To determine if infant vitamin D status is related to bone mineral status at birth and to determine the effects of vitamin D supplementation on 25-hydroxyvitamin D (25-OHD) concentration and bone mineral status vitamin D deficient and vitamin D replete infants at 3 months of age. III. BACKGROUND AND SIGNIFICANCE In recent years, severe vitamin D deficiency has resurfaced as a major public health concern. Nutritional rickets is widespread, and a recent report on this disease in Texas showed Hispanic children are at increased risk. Long-term follow-up has demonstrated that vitamin D deficient infants are more likely to have decreased bone mineral status in late childhood. Additionally, vitamin D deficiency has been linked to changes in fetal imprinting and increased susceptibility to autoimmune diseases, immune deficiency, and malignancy. At birth, an infants vitamin D status is entirely dependent on the vitamin D status of the mother. Many studies have shown vitamin D deficiency is very common in mother-child pairs, especially in dark-skinned individuals. However, few data exist regarding the vitamin D status in Hispanic infants. Low milk intakes and decreased sun exposure with urbanization makes this a very high-risk group among infants in Texas.

这个子项目是许多利用资源的研究子项目之一 由NIH/NCRR资助的中心拨款提供。子项目的主要支持 而子项目的主要调查员可能是由其他来源提供的， 包括其它NIH来源。 列出的子项目总成本可能 代表子项目使用的中心基础设施的估计数量， 而不是由NCRR赠款提供给子项目或子项目工作人员的直接资金。 摘要 维生素D缺乏症很普遍，与骨矿物质含量下降有关。 关于西班牙裔婴儿的维生素D状态和25-OHD状态与功能性骨健康结果的关系，几乎没有数据。 为了评估这一点，我们计划对足月、健康、纯母乳喂养的西班牙裔和白人婴儿进行观察。 我们假设在脐带血中测得的血清25-OHD在西班牙裔婴儿中显著低于白人婴儿，25-OHD在西班牙裔新生儿中占50%。 假设#2：在出生后第一周内测量的声音骨超声速度（SOS U/S）和双能X线吸收法（DXA）全身骨矿物质含量与脐带血中25-OHD浓度呈正相关。 假设#3：从出生起每天补充400 IU维生素D3将使所有婴儿达到25-OHD水平20 ng/mL。基线调整的骨矿物质含量和SOS U/S将与3个月时的25-OHD状态显著相关。 二. 具体目标 主要目的：评价在德克萨斯州休斯顿，西班牙裔人喂养的母乳与白人新生儿喂养的母乳相比维生素D缺乏的相对频率。 次要目标：确定婴儿维生素D状态是否与出生时的骨矿物质状态相关，并确定维生素D补充对3个月龄时维生素D缺乏和维生素D充足婴儿的25-羟基维生素D（25-OHD）浓度和骨矿物质状态的影响。 三. 背景和意义 近年来，严重的维生素D缺乏症重新成为一个主要的公共卫生问题。营养性佝偻病很普遍，最近在德克萨斯州的一份关于这种疾病的报告显示，西班牙裔儿童的风险增加。长期随访表明，维生素D缺乏的婴儿更有可能在儿童晚期出现骨矿物质状态下降。此外，维生素D缺乏症与胎儿印记的变化以及对自身免疫性疾病、免疫缺陷和恶性肿瘤的易感性增加有关。出生时，婴儿的维生素D状况完全取决于母亲的维生素D状况。许多研究表明，维生素D缺乏症在母亲和孩子中非常常见，特别是在深色皮肤的人中。然而，关于西班牙裔婴儿维生素D状况的数据很少。低牛奶摄入量和城市化导致的阳光照射减少使德克萨斯州的婴儿成为一个非常高风险的群体。