黑龙江省儿童、青少年血清维生素D营养状况的调查

摘要

Objective To study vitamin D nutritionalstatus of children and adolescents in Heilongjiang, and to investigate its correlation with sex,age,season and region,so as to provide a reference for vitamin D supplement. Methods A total of 9502 children and adolescents(1 month old-20 years old) were enrolled. Liquid chromatography tandem mass spectrometry(LC-MS/MS) was used to determine serum 25-hydroxyvitamin D2[25(OH)D2] and 25-hydroxyvitamin D3[25(OH)D3]. Their sum was the level of serum 25-hydroxyvitamin D [25(OH)D]. Its correlation with sex,age,season and region was evaluated.Results The level of serum 25(OH) D among 9502 children and adolescents was 25.12(17.50~33.00)ng/mL,in which 3122 cases (32.85%)were normal,3268 cases(34.39%) were subclinically deficient,2934 cases(30.88%)were deficient,144 cases(1.52%)were seriously deficient,24 cases(0.25%)were overdose,10 cases(0.11%) were toxic,and the overall level was subclinically deficienct. The 25(OH)D2/25(OH)D3 ratios were 0.02(0.01-0.05)for males and 0.02(0.01-0.06)for females(P=0.099). Serum 25(OH)D levels decreased with age, in which that of school-age group was the lowest [19.80(13.25-26.69)ng/mL],and that of baby group was the highest [30.28(29.48-30.92)ng/ mL](P<0.0001). With the changes of seasons,temperature and sunshine time exist difference,the level of serum 25(OH)D in spring [19.43(12.07-27.68)ng/mL] was the lowest,that in autumn [29.49(23.45-36.43)ng/mL] was the highest,and there was statistical significance among the 4 seasons (P<0.05). Serum 25(OH)D had no statistical significance in different regions of Heilongjiang(P=0.275). Conclusions The level of serum 25(OH)D is low among children and adolescents in Heilongjiang. Children and adolescents over 3 years old should receive reasonable supplement of vitamin D,especially in spring and winter.%目的 了解黑龙江省儿童和青少年维生素D营养状况及其与性别、年龄、季节和地域的关系,为本地区儿童、青少年合理补充维生素D提供科学依据.方法 选取黑龙江省各地区儿童及青少年(1个月~20岁)9502名,采用液相色谱串联质谱法(LC-MS/MS)检测血清25-羟基维生素D2[25(OH)D2]、血清25-羟基维生素D3[25(OH)D3],二者相加即为血清25-羟基维生素D[25(OH)D]水平,按性别、年龄、季节和地域分别分组进行比较.结果 9502名儿童及青少年的血清25(OH)D水平为25.12(17.50~33.00)ng/mL,其中维生素D正常3122名(32.85%)、亚临床缺乏3268例(34.39%)、缺乏2934例(30.88%)、严重缺乏144例(1.52%)、过量24例(0.25%)、中毒10例(0.11%),整体处于亚临床缺乏状态.男、女性25(OH)D2/25(OH)D3比值分别为0.02(0.01~0.05)、0.02(0.01~0.06),二者差异无统计学意义(P=0.099).随着年龄的增长,血清25(OH)D水平明显下降,其中学龄期最低[19.80(13.25~26.69)ng/mL],婴儿期最高[30.28(29.48~30.92)ng/mL](P<0.001).随季节更替,温度和日照时间差异较大,春季血清25(OH)D水平最低[19.43(12.07~27.68)ng/mL]、秋季最高[29.49(23.45~36.43)ng/mL],不同季节之间差异有统计学意义(P<0.05).黑龙江省内各地区血清25(OH)D水平差异无统计学意义(P=0.275).结论 黑龙江省儿童和青少年血清 25(OH)D水平低下,应对3岁以上儿童、青少年合理补充维生素D,适当增加春、冬季户外活动.