2013年中国乳母维生素D营养状况及其影响因素

Nutritional status and influence of vitamin D among Chinese lactating women in 2013

目的：通过分析2013年中国乳母血清维生素D水平，评价乳母维生素D的营养状况及其影响因素。方法数据来源于2013年中国居民营养与健康状况监测。采用多阶段分层整群抽样，调查对象为中国内地除西藏自治区以外的30个省（直辖市、自治区）的55个县（市/区）产后0～24个月的乳母。问卷调查收集乳母基本情况、血样采集季节等信息，通过食物频率调查收集受试者近1个月的膳食信息；采用质谱法测定了1981名乳母血清维生素D水平。应用多因素logistic回归模型分析乳母维生素D缺乏的影响因素。结果乳母血清维生素D含量为（16.6±6.5）ng/ml，维生素D缺乏率（〈12 ng/ml）为25.2%（499名），不足率（12 ng/ml≤血清维生素D〈20 ng/ml）为45.4%（900名）。相对于汉族乳母，回族及维吾尔族乳母维生素D缺乏OR值为13.37；相对于初中及以下乳母，高中以上乳母维生素D缺乏OR值为1.40；相对于家务/待业乳母，专业技术乳母维生素D缺乏OR值为1.62；相对于普通农村乳母，大城市、中小城市、贫困农村乳母维生素D缺乏OR值分别为1.99、1.46、2.66；相对于秋季调查的乳母，冬春季调查的乳母维生素D缺乏OR值为2.19；乳母维生素D缺乏率随纬度增加而增加（OR=1.12），随每日摄入的畜肉量增加而降低（OR=0.73），P值均〈0.05。结论中国乳母维生素D缺乏和不足的状况较普遍；回族/维吾尔族、文化水平较高、从事专业技术类工作、高纬度地区和冬春季的乳母是维生素D缺乏的高风险人群。

Objective To analyze serum vitamin D levels in Chinese lactating women, in 2013, and to evaluate their vitamin D nutritional status and influencing factors. Methods Data were from the Chinese National Nutrition and Health Surveillance in 2013. Using the multistage stratified cluster sampling method, serum samples from lactating women, at 0-24 months postpartum, were obtained from 55 sites in 30 provinces of China, excluding the Tibet Autonomous Region. The concentration of serum vitamin D was determined by mass spectroscopy. A standard questionnaire was used to obtain basic information and the season of blood collection. Dietary information for one recent month was collected using a food frequency questionnaire. A total of 1 981 lactating women were included in the study. A multiple logistic regression model was used to analyze the factors related to vitamin D levels among lactating women. Results The mean vitamin D level was （16.6±6.5） ng/ml, the prevalence of vitamin D deficiency （VDD） （vitamin D〈12 ng/ml） was 25.2% （499 cases） and the prevalence of vitamin D inadequacy （12 ng/ml≤vitamin D〈20 ng/ml） was 45.4% （900 cases）. Compared with in the Han ethnic group, the OR value of VDD was 13.37 for Muslim ethnic women. Compared with women having a junior high school education or below, the OR value of VDD was 1.40 for those women with an educational level of senior high, middle school or above. Compared with housewives or nonworking women, the OR value of VDD was 1.62 for professional women. Compared with women living in general rural settings, the OR values of VDD for women living in large cities, medium and small cities or poor rural settings were 1.99, 1.46 and 2.66 respectively. Compared with the women surveyed in the fall, the OR value of VDD was 2.19 for the women surveyed in winter or spring. The VDD prevalence increased with higher latitude （OR=1.12） and decreased with increased meat consumption per day （OR= 0.73）. （P〈0.05 for all comparisons）. Conclusion Vitamin D deficiency and vitamin D inadequacy were common in lactating women in China. Those with increased risk of VDD included lactating women who were ethnic Muslims, with higher education levels, engaged in a professional occupation, living in higher latitude region and were surveyed in winter and spring.