0～3岁儿童血清25-羟维生素D、血清总钙与骨密度的关系研究

A study on the relationship between the levels of serum 25-hydroxy vitamin D, total calcium and bone mineral density in 0～3 years old children

目的分析0~3岁儿童血清25-羟维生素D[25-hydroxy vitamin D,25(OH)D]和总钙水平与骨密度(bone mineral density,BMD)的关系,为儿童佝偻病的防治提供参考依据。方法选取2013年6月至2016年6月咸阳市中心医院儿科门诊常规体检的0~3岁儿童为研究对象,检测其血清25(OH)D和总钙水平及BMD Z值,观察不同血清25(OH)D和总钙水平儿童Z值及BMD异常率,并采用Pearson相关性分析探究血清25(OH)D和总钙水平与BMD的关系。结果 425名儿童中,94名儿童BMD异常,BMD异常率为22.12%。随着儿童月龄的减少及户外活动时间的增加,其BMD异常率显著下降(P<0.05)。随着儿童血清25(OH)D水平的上升,其BMD异常率显著下降(P<0.05)。血清总钙水平<2.25 mmol/L的儿童BMD异常率显著高于血清总钙水平≥2.25 mmol/L的儿童(P<0.05)。Pearson相关性分析示,Z值在-1~1时,血清25(OH)D水平(r=0.719)和总钙水平(r=0.685)与Z值均呈显著正相关(P<0.05)。结论 0~3岁儿童BMD异常现象较为严重,且其Z值在一定范围内与血清25(OH)D和总钙水平呈正相关,科学、合理地补充维生素D和钙剂并注重户外活动有望降低儿童BMD异常率。

Objective To analyze the relationship between the levels of serum25-hydroxy vitamin D[25(OH)D]and total calcium and bone mineral density(BMD)of children aged0～3years old,and to provide reference for prevention and control of rickets in children.Method Selected the children aged0～3years old accepted routine examination from June2013to June2016in Xianyang Central Hospital department of Pediatrics,detected the levels of serum25(OH)D and total calcium and Z scores of BMD,then observed Z scores and the abnormal rate of BMD in children with different levels of serum25(OH)D and total calcium,and Pearson correlation analysis was used to explore the relationship between the levels of serum25(OH)D and total calcium and BMD.Result Among the425children,94were BMD abnormal,and the abnormal rate of BMD was22.12%.With the reduce of age and the time of outdoor activities,the abnormal rate of BMD decreased significantly(P<0.05).With the increase of the level of serum25(OH)D,the abnormal rate of BMD decreased significantly(P<0.05).The abnormal rate of BMD in children with serum total calcium level<2.25mmol/L was significantly higher than those with serum total calcium level≥2.25mmol/L(P<0.05).Pearson correlation analysis showed that the levels of serum25(OH)D(r=0.719)and total calcium(r=0.685)were positively correlated with Z scores(P<0.05)when the Z scores were in the range of-1～1.Conclusion The abnormal phenomenon of BMD in children aged0～3years old is more serious,and whe the Z scores are in a certain range they are positively related to the levels of serum25(OH)D and total calcium.So give children scientific and reasonable supplement of vitamin D and calcium and pay attention to the outdoor activities are expected to reduce the abnormal rate of BMD.