血清25-羟维生素D3水平与儿童心血管病危险因素相关性的研究

Relationship between serum 25(OH)D3 and cardiovascular risk factors in children

目的探索血清25-羟维生素D3(VD)水平与儿童心血管病危险因素的关系。方法在2014—2016年重庆地区已建立的1212例儿童心血管病队列中随机抽取260例学龄儿童,收集人口学信息和运动情况,完成体格检查,检测血清VD等生化指标,其中168例满足标准纳入研究。根据血清VD四分位数(P25=34.98,P75=45.80)分为血清VD低(<35 nmol/L,42例)、中(35~45 nmol/L,76例)和高组(>45 nmol/L,49例)。运用协方差分析和多因素Logistic回归模型分析血清VD与肥胖、高血压、代谢综合征等心血管病危险因素的相关性。结果肥胖、高血糖、高甘油三酯和代谢综合征的儿童血清VD平均水平分别低于非肥胖、血糖正常、甘油三酯正常、无代谢综合征的儿童(34.9±7.2 vs.43.4±9.8、35.8±7.5 vs.41.0±9.9、35.8±9.5 vs.41.0±9.7、34.7±7.5 vs.41.0±9.8 nmol/L),P<0.05。在校正年龄、性别、母乳喂养时间、出身体重、每日锻炼时间、家庭收入、父母教育年数后,血清VD水平与高密度脂蛋白胆固醇、收缩压、体重指数(BMI)、腰围的相关系数分别为0.225、-0.289、-0.379、-0.484,P<0.05,血清VD<35 nmol/L的儿童患肥胖、高血糖、高三油甘脂和代谢综合征的危险性分别是血清VD>45 nmol/L儿童的14.5(95%CI:4.3~49.6)、4.6(95%CI:1.1~20.5)、4.1(95%CI:1.1~15.8)和6.1(95%CI:1.1~35.9)倍,P<0.05。调整BMI后,血清VD水平与高血糖、高甘油三酯和代谢综合征均无关。结论重庆地区儿童血清VD水平低下与心血管病危险因素相关,心血管疾病的预防应从儿童时期开始,并倡导在儿童期行VD补充。

ObjectiveTo explore the relationship between serum 25-hydroxyvitamin D3(VD)and cardiovascular risk factors in children.MethodsA total of 260 school-age children were randomly selected from the 1212 children cohorts established in Chongqing from 2014 to 2016.The data of biochemical tests,physical activity,physical examination and demographic information were collected.One hundred and sixty-eight of them met the criteria and were included in the study.According to the serum VD quartile(P25=34.98,P75=45.80),the children were divided into the serum VD low group(<35 nmol/L,42 cases),medium group(35 to 45 nmol/L,76 cases)and high(>45 nmol/L,49 cases)group.Covariance analysis and multivariate logistic regression model were used to analyze the correlation of serum VD with the cardiovascular risk factors including obesity,hypertension and metabolic syndrome.ResultsChildren with obesity,hyperglycemia,hypertriglycerides and metabolic syndrome had lower average serumVDthanthose without obesity,hyperglycemia,hypertriglycerides and metabolic syndrome(34.9±7.2 vs.43.4±9.8,35.8±7.5 vs.41.0±9.9,35.8±9.5 vs.41.0±9.7,34.7±7.5 vs.41.0±9.8 nmol/L,respectively,P<0.05).The correlation coefficients of serum VD with high density lipoprotein cholesterol,systolic blood pressure,BMI and waist circumference were0.225,-0.289,-0.379 and-0.484,respectively(all P<0.05),after adjusting for age,gender,breastfeeding duration,birth weight,time of daily physical activity,family income and parents’education level.The risk(OR)of obesity,hyperglycemia,hypertriglycerides and metabolic syndrome in children with serum VD<35 nmol/L was 14.5(95%CI:4.3-49.6),4.6(95%CI:1.1-20.5),4.1(95%CI:1.1-15.8)and 6.1(95%CI:1.1-35.9)times of those children with serum VD>45 nmol/L(all P<0.05).After adjusting BMI,serum VD was not associated with hyperglycemia,hypertriglycerides or metabolic syndrome.ConclusionThe lower serum VD of children in Chongqing is related to cardiovascular risk factors.The prevention of cardiovascular disease should start from childhood,and VD supplementation should be provided in childhood.