长沙市岳麓区3～5岁学龄前超重及肥胖儿童维生素D不足和缺乏的现状

摘要

Objective:To investigate the prevalence of vitamin D insufficiency/deficiency among 3-5 years old overweight and obese children in Yuelu district of Changsha and to give scientific suggestion for children health promotion.Methods:Based on the stratified cluster sampling method,2 872 children aged 3-5 years old from Yuelu district were enrolled from Oct to Dec 2015.All participants have received biochemical and physical examination.According to the body mass index,the prevalence rates of vitamin D insufficiency [serum 25(OH)D level 20-＜30 ng/mL] and deficiency [serum 25(OH)D level＜20 ng/mL] among normal weight,overweight/obese children were calculated,respectively.Multivariate logistic regression was used to evaluate the association between overweight/obese and vitamin D insufficiency/deficiency.Results:The prevalence rates of vitamin D insufficiency/deficiency among children aged 3-5 years old were 39.6％ (95％ CI37.8％ to 41.4％) and 19.5％ (95％ CI 18.1％ to 21.0％),respectively.Compared to children with normal weight,overweight/obese children had higher prevalence rate of vitamin D insufficiency [48.6％ (95％ CI 44.4％ to 52.9％)] and deficiency [24.6％ (95％ CI 21.1％ to 28.4％)] (P＜0.017).After adjustment with confounding variables,the associations between overweight/obese and vitamin D insufficiency/deficiency were still statistically significant [for insufficiency ORadj=1.17 (95％ CI 1.06 to 1.43);for deficiency ORadj=1.22 (95％ CI 1.12 to 1.51)].Conclusion:Compared with normal weight children,overweight/obese children have higher prevalence rate of vitamin D insufficiency/deficiency.More attention should be paid to those populations for prevention of vitamin D insufficiency/deficiency.%目的:调查长沙市岳麓区3～5岁学龄前儿童维生素D(vit D)不足与缺乏的现状,了解3～5岁学龄前儿童超重及肥胖与Vit D不足与缺乏的关联强度.方法:2015年10至12月,采用分层整群抽样法,选取岳麓区3个街道16所幼儿园的2 872名3～5岁儿童,进行体格及生化检查,对儿童家长进行问卷调查.根据其体重指数和Vit D缺乏情况,分别计算正常体型、超重及肥胖儿童的Vit D不足[血清总25(OH)D 20～＜30 ng/mL]率和缺乏[血清总25(OH)D＜20 ng/mL]率.利用多因素logistic模型,分析超重及肥胖与Vit D不足和缺乏的关联.结果:长沙3～5岁儿童Vit D不足率和缺乏率分别为39.6％(95％ CI:37.8％～41.4％)和19.5％(95％CI:18.1％～21.0％);5岁儿童较4岁及以下儿童的VitD不足率高(P＜0.05);补充过Vit D制剂、课外活动量＞5 h/周者的Vit D不足率和缺乏率较其他人群低(P＜0.05);牛奶饮用量越多,Vit D不足率和缺乏率越低(P＜0.05);3～5岁儿童超重及肥胖总患病率为19.3％(95％ CI:17.8％～20.7％).不同体型儿童Vit D不足率和缺乏率不完全相同;超重、肥胖儿童的Vit D不足率和缺乏率高于正常体型组(P＜0.017),分别为48.6％(95％ CI:44.4％～52.9％)和24.6％(95％ CI:21.1％～28.4％);在调整混杂因素的情况下,儿童超重或肥胖仍是Vit D不足和缺乏的危险因素[与VitD不足的ORadj=1.37(95％ CI:1.26～1.93);与VitD缺乏的ORadj=1.40(95％ CI:1.32～2.01)].结论:长沙岳麓区3～5岁超重及肥胖儿童的Vit D不足率和缺乏率高于正常体型儿童,超重及肥胖儿童是VitD缺乏干预的重点人群.