摘要
目的调查我国11省、自治区、直辖市7岁以下儿童维生素D营养现状,并探讨维生素D缺乏和不足的相关影响因素。方法按照“省-市-医院”的技术抽样路线,于2020年11月至2021年11月采用整群抽样的方法,抽取来自11个省、自治区、直辖市的1531名7岁以下健康儿童为研究对象。通过统一制定的调查问卷收集儿童基本信息、家庭情况、行为生活习惯及饮食喂养等信息。应用液相色谱-串联质谱法检测儿童血清维生素D水平,血清25(OH)D<30 nmol/L为缺乏,30~50 nmol/L为不足。以25(OH)D≤50 nmol/L为因变量,采用多因素Logistic回归分析维生素D缺乏和不足的影响因素。结果我国11省、自治区、直辖市7岁以下儿童维生素D缺乏和不足检出率为14.0%(215/1531),其中0~<3岁和3~<7岁分别为3.8%(25/664)和21.9%(190/867)。与0~<3岁相比,3~<7岁儿童发生维生素D缺乏和不足的风险增加2.60倍(OR=3.60,95%CI 1.93~6.72,P<0.001)。皮肤经常阳光暴露(OR=0.46,95%CI 0.29~0.73,P=0.001)、维生素D补充(有时补充,OR=0.33,95%CI 0.21~0.51,P<0.001;每天补充,OR=0.20,95%CI 0.11~0.36,P<0.001)和婴幼儿配方摄入(每周4~7次,OR=0.43,95%CI 0.28~0.68,P<0.001)均为儿童维生素D缺乏和不足的保护性因素。结论我国11省、自治区、直辖市7岁以下儿童维生素D缺乏和不足问题普遍,年龄、阳光暴露程度、维生素D补充和婴幼儿配方摄入等因素均可影响维生素D营养状况。
Objective To explore current vitamin D status and influential factors of vitamin D deficiency and insufficiency among children under 7 years of age in 11 provinces,autonomous regions or municipalities of China.Methods According to the"province-city-hospital"sampling technical route,a total of 1531 healthy children under 7 years of age were sampled from 11 provinces,autonomous regions or municipalities in China by the cluster random sampling method from November 2020 to November 2021.The demographic information,family conditions,behavior and living habits and feeding behaviors were collected using unified questionnaire.Serum 25-hydroxyvitamin D(25(OH)D)levels were measured by liquid chromatography-tandem mass spectrometry.Serum 25(OH)D<30 nmol/L was considered deficient and 30-50 nmol/L was considered insufficient.With 25(OH)D≤50 nmol/L as the dependent variable,multivariate Logistic regression was applied to analyze the association between vitamin D deficiency and insufficiency and potential influential factors.Results The prevalence of vitamin D deficiency and insufficiency among children under 7 years of age in 11 provinces,autonomous regions or municipalities of China was 14.0%(215/1531),3.8%(25/664)and 21.9%(190/867)in 0-<3 and 3-<7 of age years,respectively.Compared to children aged 0-<3 years,children aged 3-<7 years had a 2.6-fold increased risk of vitamin D deficiency and insufficiency(OR=3.60,95%CI 1.93-6.72,P<0.001).Frequent sunlight exposure(OR=0.46,95%CI 0.29-0.73,P=0.001),vitamin D supplementation(sometimes,OR=0.33,95%CI 0.21-0.51,P<0.001;daily,OR=0.20,95%CI 0.11-0.36,P<0.001)and infant formula intake(4-7 times per weeks,OR=0.43,95%CI 0.28-0.68,P<0.001)were protective factors for vitamin D deficiency and insufficiency.Conclusion Vitamin D deficiency and insufficiency are common among children under 7 years of age in 11 provinces,autonomous regions or municipalities of China,which is affected by age,sunlight exposure,vitamin D supplementation and infant formula intake.
作者
李娈娈
李晓南
贾飞勇
池美珠
温志红
杨凡
李宇宁
哈丽君
杨颖
龙晓玲
方拴锋
张会丰
余晓丹
Li Luanluan;Li Xiaonan;Jia Feiyong;Chi Meizhu;Wen Zhihong;Yang Fan;Li Yuning;Ha Lijun;Yang Ying;Long Xiaoling;Fang Shuanfeng;Zhang Huifeng;Yu Xiaodan(Department of Developmental and Behavioral Pediatrics,Shanghai Children′s Medical Center,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China;Department of Child Health Care,Children′s Hospital of Nanjing Medical University,Nanjing 210008,China;Department of Developmental and Behavioral Pediatrics,the First Hospital of Jilin University,Changchun 130021,China;Department of Child Health Care,the First Hospital of Wenzhou Medical University,Wenzhou 325000,China;Department of Pediatrics,the People′s Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China;Department of Child Health Care,West China Second University Hospital,Sichuan University,Chengdu 610041,China;Department of Pediatrics,the First Hospital of Lanzhou University,Lanzhou 730013,China;Department of Child Health Care,Yinchuan Maternity and Child Health Care Hospital,Yinchuan 750000,China;Department of Child Health Care and Neurological Rehabilitation,Sports Center Branch of Dalian Municipal Women and Children′s Medical Center(Group),Dalian 116033,China;Department of Pediatrics,Boai Hospital of Zhongshan,Zhongshan 528405,China;Department of Child Health Care,Children′s Hospital of Zhengzhou University,Zhengzhou 450007,China;Department of Pediatrics,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2022年第5期413-420,共8页
Chinese Journal of Pediatrics
基金
中国妇幼保健协会妇儿健康临床标准与规范化项目(ZGFY-B-201904)。
关键词
儿童
维生素D
影响因素
Child
Vitamin D
Influence factors
