江苏省0~5岁儿童维生素D营养状况研究

Vitamin D status among 0-5 years old children in Jiangsu province of China

目的了解江苏省0~5岁儿童维生素D营养状况,分析年龄、性别、出生情况、地区、季节和户籍的儿童维生素D营养状况。方法本研究首次进行了多中心大样本的抽样调查,于2014年4月-2015年3月采用分层整群随机抽样方法从江苏省的10个城市招募0~5岁的儿童。采用自行设计的问卷调查儿童一般健康状况,采用酶联免疫法检测血清25-羟维生素D[(25-(OH)D)]含量。结果本次研究共调查5289名儿童。0~5岁儿童维生素D缺乏率为30.1%,不足率为35.5%。0~、12~、24~、36~、48~、60~<72月龄儿童维生素D缺乏率分别为23.0%,21.3%、27.8%、32.4%、37.9%、39.7%;维生素D不足率分别为26.9%、34.4%、36.5%、38.6%、39.6%、38.4%。0~5岁儿童25-(OH)D平均水平M(P25~P75)为64.0(46.3~83.0)nmol/ml。女童维生素D缺乏率(32.1%)显著高于男童(28.3%)(Z=8.709,P=0.003),女童25-(OH)D平均水平(62.7 nmol/ml)显著低于男童(65.1 nmol/ml)(Z=9.453,P=0.002)。2~5岁儿童、女童,第一胎,第一产,在春冬季调查,在苏南地区、苏中地区和苏北地区的儿童患维生素D缺乏的风险增加(P<0.05)。结论江苏省0~5岁儿童普遍处于维生素D缺乏状态,尤其学龄前儿童是防治维生素D缺乏关键人群。维生素D状况与年龄、性别、胎次、产次、出生体重、季节、城乡户籍和地区相关,与胎龄、分娩方式无关。

Objective To explore vitamin D status of 0-to 5-year-old children in Jiangsu province,and to analyze the association between age,sex,birth conditions,region of residence,season,location in Jiangsu province and vitamin D.Methods This was the first large population-based multicenter study in which the representative children aged 0-5 years were recruited from 10 cities by a stratified cluster random-sampling method in Jiangsu Province from April 2014 to March 2015.A face to face investigation was conducted by the prepared doctors with the structured questionnaire to collect related details and serum 25-hydroxyvitamin D[25-(OH)D]concentration was tested by ELISA.Results A total of 5289 children were investigated.The prevalence rates of vitamin D deficiency and vitamin D insufficiency in 0-to 5-year-old children were 30.1%and 35.5%,respectively.The prevalence rates of vitamin D deficiency in children aged 0-month,12-months,24-months,36-months,48-months and 60-<72 months were 23.0%,21.3%,27.8%,32.4%,37.9%and 39.7%,respectively.And the prevalence rates of vitamin D insufficiency in those children were 26.9%,34.4%,36.5%,38.6%,39.6%and 38.4%,respectively.The level of 25-(OH)D was 64.0(46.3~83.0)nmol/ml.And the prevalence of vitamin D deficiency in girls(32.1%)was significantly higher than that in boys(28.3%)(Z=8.709,P=0.003).The level of 25(OH)D in girls(62.7 nmol/ml)was significantly lower than that in boys(65.1 nmol/ml)(Z=9.453,P=0.002).Multivariate analysis indicated children with higher risk of vitamin D deficiency were more likely to be children aged 2 to 5 years,girls,the first parity and birth,investigated in Spring and Winter,located in southern,central region and northern of Jiangsu province(P<0.05).Conclusions Vitamin D level of children is generally low in Jiangsu province,especially for preschool children.The vitamin D deficiency and lower 25-(OH)D level are related to age,gender,the number of pregnancy,parity,birth weight,season of survey,region of residence and location in Jiangsu province,but are not associated with gestational age and delivery mode.