西安地区524例住院新生儿维生素D营养状况分析

Survey of vitamin D nutritional status of 524 hospitalized neonates in Xi’an

目的分析住院新生儿维生素D营养状况。方法采用现况调查,检测2016年1月至2018年12月西安市儿童医院524例住院新生儿血清25-羟维生素D[25(OH)D]水平,分析不同出生情况下新生儿25(OH)D水平的差异。结果 (1)所有住院新生儿25(OH)D水平平均为(16.77±8.26)ng/mL,早产儿与足月儿(t=3.85)、居住地在城市与农村(t=6.80)、单胎与双胎(t=6.70)新生儿25(OH)D水平比较差异均有统计学意义(均P<0.05)。(2)住院新生儿维生素D总体缺乏率为92.18%(483/524);居住地在城市与农村(χ^2=10.31)、单胎与双胎(χ^2=4.31)的新生儿维生素D缺乏率比较差异均有统计学意义(均P<0.05);不同胎龄新生儿维生素D缺乏率比较差异有统计学意义(χ^2=6.11,P<0.05)。(3)9月份出生的新生儿25(OH)D水平最高,为(19.08±8.83)ng/mL,1月份出生的新生儿最低,为(12.87±5.80)ng/mL。(4)25(OH)D水平与出生体重呈正相关(r=0.19,t_r=4.44,P<0.05),与出生胎龄呈正相关(r=0.19,t_r=4.50,P<0.05)。结论住院新生儿维生素D营养状况差,维生素D缺乏率高,尤其是早产儿、低出生体重儿、双胎、城市地区、冬季出生的新生儿。出生胎龄越小,出生体重越低,维生素D缺乏程度越重。应加强对住院新生儿维生素D的检测及补充,补充剂量应个体化。

Objective To investigate nutritional status of vitamin D in hospitalized neonates.Methods A cross-sectional investigation was conducted.The serum levels of 25-hydroxyvitamin D[25(OH)D] of 524 hospitalized neonates in our hospital were detected,and the differences in 25(OH)D under different birth conditions were analyzed.Results(1) The average serum level of 25(OH)D of all hospitalized neonates was 16.77±8.26 ng/mL.Between the premature infants(14.45±7.68 ng/mL) and term infants(17.58±8.31 ng/mL)(t=3.85),the urban infants(14.71±7.42 ng/mL) and rural infants(19.47±8.54 ng/mL)(t=6.80),the singleton infants(17.79±8.18 ng/mL) and the twin infants(11.52±6.54 ng/mL)(t=6.70),there was significant difference in the serum level of 25(OH)D respectively(all P<0.05).(2)The overall vitamin D deficiency rate in hospitalized neonates was 92.18%(483/524).Between the urban infants and rural infants(χ^2=10.31),the singleton infants and the twin infants(χ^2=4.31),there was significant difference in the vitamin D deficiency rate(both P<0.05).And also,there was statistically significant difference in vitamin D deficiency rate among different gestational age groups(χ^2=6.11, P<0.05).(3)The serum level of 25(OH)D of those infants born in September was the highest(19.08±8.83) ng/mL,the lowest serum level of 25(OH)D was found in those infants born in January(12.87±5.80 ng/mL),and that was higher in those infants born in summer and autumn than those infants born in winter and spring.(4)The serum level of 25(OH)D was positively correlated with birth weight(r=0.19,t_r=4.44,P<0.001) and gestational age(r=0.19,t_r=4.50,P<0.001).Conclusions The nutritional status of vitamin D in hospitalized neonates is poor and the vitamin D deficiency rate is high,especially in premature infants,low birth weight infants,twins,urban infants and those infants born in winter.The younger the gestational age and the smaller the birth weight,the more severe the vitamin D deficiency.The detection and supplementation of serum level of vitamin D for these hospitalized neonates should be strengthened,and the supplementation dose should be individualized.