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

Prevalence of vitamin D insufficiency/deficiency among overweight and obese preschool children in Yuelu District of Changsha

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/m L]率和缺乏[血清总25(OH)D<20 ng/m L]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Vit D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Vit D不足的ORadj=1.37(95%CI:1.26~1.93);与Vit D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Vit D缺乏干预的重点人群。

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/deficienc）a Results： The prevalence rates of vitamin D insufficiency/deficiency among children aged 3-5 years old were 39.6% （95% CI 37.8% to 41.4%） and 19.5% （95% C1 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）1. 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.