云南省4个少数民族贫困地区6～23月龄婴幼儿维生素D水平及影响因素

Vitamin D status and determinants among children aged 6 to 23 months in 4 poverty-stricken ethnic minority areas of Yunnan Province

目的了解云南省4个少数民族贫困地区6-23月龄婴幼儿维生素D( vitamin D,VD)水平及影响因素。方法采用多阶段分层整群抽样的方法,在云南省剑川县、彝良县、墨江县和泸水县各选取3-4个乡镇6~23月龄婴幼儿1 255名,完成问卷调查、体格检查和血清25(OH)D测定,描述并分析婴幼儿VD水平及影响因素。结果 VD总体水平为20.6(16.3,25.4) ng/ml,VD缺乏、VD不足、VD充足检出率分别为7. 1%、39. 2%、53. 7%。婴幼儿年龄越大、未补充VD、VD不足的危险性均增加(均有P <0. 05)。哈尼族婴幼儿VD缺乏及不足的危险性降低(均有P <0.05),而女性“傈僳族、白族、宝宝未补充营养包”婴幼儿患VD缺乏及VD不足的危险性均增加(均有P<0.05)。结论云南省少数民族贫困地区6-23月龄婴幼儿VD水平偏低,以VD不足为主。女童、傈僳族、白族、18月龄以上幼儿为重点干预人群,提高看护人VD营养认知、积极补充VD及营养包有利于改善VD营养水平。

Objective To investigate the vitamin D ( VD) level and determinants among young children aged 6 to 23 months in 4 povertystricken ethnic minority areas of Yunnan Province. Methods Multistage stratified cluster sampling method was used. 1 255 young children aged 6-23 months from 3 to 4 towns of Jianchuan County, Yiliang County, Mojiang County and Lushui County. Questionnaires on caregivers, physical and serum 25 ( OH) D measure were achieved. VD level and influencing factors were described and analyzed. Results Overall VD level was 20. 6( 16. 3,25. 4) ng/ml. The proportion of VD deficiency, VD insufficiency and VD sufficiency were 7. 1%, 39. 2% and 53. 7% respectively. The risk of VD insufficiency elevated with children' age increasing or no VD supplement ( P < 0. 05 ). Hani minority can decrease the risk of VD deficiency and insufficiency ( all P < 0. 05 ). Thus, the risk of VD deficiency and insufficiency in children of female, Lisu or Bai minority, or in children who had no nutritional package supplement would increase (all P < 0. 05 ). Conclusions The VD level of children aged 6-23 months in poverty-stricken ethnic minority areas of Yunnan Province was low. VD insufficiency was dominating. The intervention of VD deficiency and insufficiency may focus on the children of female, Lisu minority, Bai minority or older than 18 months. This study highlight that enhancing caregivers1 knowledge of VD nutrition, adding VD and nutritional package supplement actively are beneficial to improve VD nutrition of young children in minority poverty areas of Yunnan.