儿童早期维生素D水平与神经发育的关系

Relationship between vitamin D level and neurodevelopment in early childhood

目的分析儿童早期维生素D水平对神经心理发育的影响。方法选取2015年1月-2017年10月在广东省妇幼保健院儿童保健门诊常规体检的1 065名0~2岁健康儿童为研究对象。儿童均在6~12月龄之间测定血清25-羟维生素D水平,利用首都儿科研究所编制的《0~6岁小儿神经心理发育检查表》在儿童10~14月龄之间进行神经发育评估。结果血清维生素D水平介于10.50~207.50 nmol/L之间,平均浓度为(85.83±24.32)nmol/L;维生素D缺乏率(<50 nmol/L)为4.60%,维生素D不足率(50~75 nmol/L)为30.61%;维生素D缺乏组儿童在大运动、精细运动和社会行为方面发生发育落后的比例高于其他组,但组间比较差异无统计学意义(P>0.05);维生素D水平与大运动发育商呈正相关(r=0.062,95%CI:0.001,0.124)。结论维生素D缺乏与儿童神经发育落后之间未发现显著关联,但提示维生素D水平与儿童大运动发育之间存在关联。

Objective To analyze the effect of vitamin D level on neurodevelopment in early childhood.Methods From January 2015 to October 2017,1 065 healthy children under two years old receiving conventional physical examination in Child Health Clinic of Guangdong Provincial Maternal and Child Health Care Hospital were selected.Serum 25-hydroxyvitamin D levels were measured when the children were aged 6-12 months.Neurodevelopment of children aged 10-14 months was assessed using 0-6-year-old pediatric examination table of neuropsychological development developed by Capital Institute of Pediatrics.Results The levels of serum vitamin D ranged from 10.5 nmol/L to 207.5 nmol/L,（ 85.83±24.32） nmol/L on average.The incidence rates of vitamin D deficiency（ 50 nmol/L） and vitamin D insufficiency（ 50-75 nmol/L） were 4.60% and 30.61%,respectively.The proportions of children with gross motor developmental delay,fine motor developmental delay,social developmental delay in vitamin D deficiency were higher than those in the other groups,but there was no statistically significant difference（ P〉0.05）.Vitamin D level was positively correlated with development quotient of gross motor（ r = 0.062,95%CI： 0.001-0.124）.Conclusion Vitamin D deficiency is not significantly correlated with neurodevelopmental delay of children,but vitamin D level is related to gross motor neurodevelopment of children.