Modifiable Determinants of Serum 25-Hydroxyvitamin D Status in Early Childhood
Modifiable Determinants of Serum 25-Hydroxyvitamin D Status in Early Childhood
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DOI：
10.1001/2013.jamapediatrics.226
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发表时间：
2013-03-01
期刊：
影响因子：
26.1
通讯作者：
Parkin, Patricia C.
中科院分区：
文献类型：
--
作者：
Maguire, Jonathon L.;Birken, Catherine S.;Parkin, Patricia C.
目的：确定可改变的膳食摄入变量的影响（当前维生素D补充和每日牛奶摄入量）对幼儿期25-羟维生素D水平的影响，并评估这些可改变的饮食因素与其他基本不可改变的维生素D状态决定因素（包括皮肤色素沉着和季节）之间的关系。设计：横断面研究。初级保健儿科和家庭医学实践参与目标儿童！参与者：从2008年12月到2011年6月，在常规医生访问期间招募了1至5岁的健康儿童。干预措施：调查，人体测量和实验室数据收集。建立了一个多变量线性回归模型，以研究维生素D补充和每日牛奶量对维生素D补充的独立影响。主要结果测量：25-羟维生素D水平。结果：1898名儿童的血液。两个可改变的饮食摄入量变量，维生素D补充剂和牛奶，每天每250 mL杯分别增加3.4 ng/mL（95% CI，2-4 ng/mL）和1.6 ng/mL（95% CI，1-2 ng/mL）的25-羟基维生素D水平。反映皮肤维生素D合成的两个不可改变的变量（皮肤色素沉着和季节）也与25-羟基维生素D状态密切相关，但在25-羟基维生素D水平的解释变化中所占的比例要小得多。维生素D补充和牛奶摄入量对25-hydroxyvitamin D水平的影响出现类似的皮肤色素沉着或season.Conclusion：两个可修改的饮食摄入量变量（维生素D补充和牛奶摄入量）是最重要的决定因素，25-hydroxyvitamin D的状态在幼儿期。JAMA Pediatr. 2013;167（3）：230-235. 2013年1月14日在线发布。doi：10.1001/2013.jamapediatrics.226
Objectives: To determine the effect of modifiable dietary intake variables (current vitamin D supplementation and daily cow's milk intake) on 25-hydroxyvitamin D level in early childhood and to evaluate the relationship between these modifiable dietary factors and other largely nonmodifiable determinants of vitamin D status including skin pigmentation and season.Design: Cross-sectional study.Setting: Primary care pediatric and family medicine practices participating in the TARGet Kids! practice-based research network in Toronto, Ontario, Canada.Participants: From December 2008 to June 2011, healthy children 1 to 5 years of age were recruited during a routine physician's visit.Interventions: Survey, anthropometric measurements, and laboratory data were collected. A multivariable linear regression model was developed to examine the independent effects of vitamin D supplementation and daily volume of cow's milk on vitamin D supplementation. Main Outcome Measures: 25-Hydroxyvitamin D level.Results: Blood was obtained in 1898 children. Two modifiable dietary intake variables, vitamin D supplementation and cow's milk, increased 25-hydroxyvitamin D level by 3.4 ng/mL (95% CI, 2-4 ng/mL) and 1.6 ng/mL per 250-mL cup per day (95% CI, 1-2 ng/mL), respectively. Two nonmodifiable variables reflecting cutaneous vitamin D synthesis (skin pigmentation and season) were also strongly associated with 25-hydroxyvitamin D status but accounted for a much smaller proportion of the explained variation in 25-hydroxyvitamin D level. The effect of vitamin D supplementation and milk intake on 25-hydroxyvitamin D level appeared similar regardless of skin pigmentation or season.Conclusion: Two modifiable dietary intake variables (vitamin D supplementation and cow's milk intake) are the most important determinants of 25-hydroxyvitamin D status in early childhood. JAMA Pediatr. 2013;167(3):230-235. Published online January 14, 2013. doi:10.1001/2013.jamapediatrics.226