婴幼儿血清25-羟维生素D与骨密度的相关性分析

Correlation Analysis between Serum 25-hydroxyvitamin D and Bone Mineral Density in Infants and Young Children

目的:探讨婴幼儿血清25-羟维生素D[25-(OH)D]与骨密度(BMD)的相关性。方法:选取2015年6月-2016年6月就诊于本院儿童保健科并存在"身材矮小、营养不良、夜惊、出汗多、烦躁"等相关症状的婴幼儿354例作为研究对象,对其进行血清25-(OH)D及骨密度水平检测。比较不同月龄段婴幼儿的25-(OH)D与骨密度水平及构成比情况,并分析25-(OH)D及骨密度的相关性。结果:354例婴幼儿的25-(OH)D和骨密度平均水平分别为(28.32±9.15)ng/mL和(-1.33±0.49)。随着月龄的增加,25-(OH)D和骨密度水平均呈逐渐降低趋势,且不同月龄段比较,差异均有统计学意义(P<0.05)。不同月龄段婴幼儿的25-(OH)D及骨密度水平在男女性别中比较,差异均无统计学意义(P>0.05)。不同月龄段间婴幼儿的25-(OH)D构成比比较,差异有统计学意义(X^2=51.653,P<0.001),月龄越高,严重不足率也越高;不同月龄段间骨密度构成比比较,差异有统计学意义(X^2=33.964,P<0.001),月龄越高,重度不足率也越高。骨密度轻、中、重度不足总水平的25-(OH)D不足比例均明显高于正常比例,差异均有统计学意义(P<0.05)。婴幼儿25-(OH)D水平与骨密度Z值呈正相关(r=0.819,P<0.001)。结论:25-(OH)D与骨密度有一定的相关性,临床上可根据25-(OH)D及骨密度的水平来指导维生素D及钙剂的补充。早期干预维生素D的缺乏对婴幼儿的骨骼发育,预防佝偻病有着重要意义,值得临床进一步研究。

Objective:To discuss the correlation between serum 25-hydroxyvitamin D[25-(OH)D]and bone mineral density(BMD)in infants and young children.Method:A total of 354 infants and young children with clinical symptoms of short stature,malnutrition,night terror,profuse sweating and agitation treated in Children’s Rehabilitation Department of our hospital from June 2015 to June 2016 were selected as the study objects.Serum 25-(OH)D and bone mineral density of infants and young children were measured.The 25-(OH)D and bone mineral density in infants and young children at different age groups were compared and correlation of 25-(OH)D and bone mineral density was analyzed.Result:The average levels of 25-(OH)D and bone mineral density of 354 infants and young children were(28.32±9.15)ng/mL and(-1.33±0.49)respectively.With the increase of month age,the levels of 25-(OH)D and bone mineral density decreased gradually,and there were significant differences among different age groups(P<0.05).There were no significant differences in 25-(OH)D and bone mineral density levels of different age groups between male and female infants(P >0.05).There were significant differences in the ratio of 25-(OH)D among different age groups(χ^2=51.653,P<0.001).The higher the age,the higher the rate of serious insufficiency.There were significant differences in the ratio of bone mineral density among different age groups(χ^2=33.964,P<0.001).The higher the age,the higher the rate of severe insufficiency.The proportion of 25-(OH)D deficiency in the total level of slight,moderate and severe bone mineral density deficiency were significantly higher than those in the normal proportion,the differences were statistically significant(P<0.05).There was a positive correlation between 25-(OH)D level and Z value of bone mineral density in infants and young children(r=0.819,P<0.001).Conclusion:25-(OH)D has a certain correlation with bone mineral density,which can guide the supplementation of vitamin D and calcium according to the levels of 25-(OH)D and bone mineral density.The early intervention of vitamin D deficiency is of great significance to the skeletal development of infants and children and the prevention of rickets.It is worthy of further clinical study.