中小学生维生素D水平与血红蛋白、血清铁蛋白的相关性研究

Association of vitamin D levels with hemoglobin and serum ferritin levels among primary and middle school students

目的了解北京市西城区中小学生维生素D水平,分析其与血红蛋白(Hb)、血清铁蛋白(SF)的相关性,为预防中小学生贫血提供依据。方法于2019年采用多阶段分层整群抽样法抽取西城区小学一、三、五年级和初中一年级学生为调查对象,收集性别、年龄、身高、体重和Hb等资料;采用电化学发光法检测25-羟维生素D[25-(OH)D],采用免疫比浊法检测SF,根据美国内分泌协会推荐标准判断维生素D缺乏程度。采用Pearson相关和Spearman秩相关分析分析25-(OH)D与Hb、SF的相关性。结果调查403人,其中男生196人,占48.64%;女生207人,占51.36%。6岁~、9岁~和12~13岁分别为179、114和110人,占44.41%、28.29%和27.30%。25-(OH)D为(14.80±5.96)ng/mL。维生素D严重缺乏90人,占22.33%;缺乏243人,占60.30%;不足63人,占15.63%;充足7人,占1.74%。Hb和SF分别为(136.28±8.33)g/L和56.80(14.36)ng/mL。25-(OH)D与Hb(r=0.364,P<0.001)、SF(rs=0.374,P<0.001)水平均呈正相关;控制年龄和体质指数后,25-(OH)D与Hb(r=0.157,P=0.048)、SF(rs=0.174,P=0.022)水平仍呈正相关。结论西城区中小学生维生素D缺乏比例较高,25-(OH)D与Hb和SF水平均呈正相关,提示25-(OH)D缺乏可能与贫血有关。

Objective To investigate vitamin D levels among primary and middle school students in Xicheng District,Beijing Municipality,and to examine the association of vitamin D levels with hemoglobin(Hb)and serum ferritin(SF)levels,so as to provide insights into the prevention of anemia among primary and middle school students.Methods The first,third and fifth grade primary school students and the first grade junior high school students were sampled from Xicheng District in 2019,using the multistage stratified cluster sampling method,and students’gender,age,height,weight and Hb levels were collected.The 25-hydroxyvitamin D[25-(OH)D]was measured using electrochemiluminescence assay,and SF was detected using immunoturbidimetry.The vitamin D deficiency was determined according to the American College of Endocrinology guidelines.The associations of 25-(OH)D levels with Hb and SF levels were examined using Pearson correlation analysis and Spearman rank correlation analysis.Results Totally 403 primary and junior high school students were investigated,including 196 boys(48.64%)and 207 girls(51.36%).There were 179,114 and110 students at ages of 6 to 8 years(44.41%),9 to 11 years(28.29%)and 12 to 13 years(27.30%),respectively.The mean 25-(OH)D level was(14.80±5.96)ng/mL among the study students,and there were 90 students(22.33%)with severe vitamin D deficiency,243 students(60.30%)with vitamin D deficiency,63 students(15.63%)with vitamin D inadequacy and 7 students(1.74%)with vitamin D sufficiency.The mean Hb level was(136.28±8.33)g/L and the median SF level(interquartile range)was 56.80(14.36)ng/mL among the study students,respectively.The 25-(OH)D level positively correlated with Hb(r=0.364,P<0.001)and SF levels(r;=0.374,P<0.001),and after adjustment for age and body mass index,the 25-(OH)D still correlated positively with Hb(r=0.157,P=0.048)and SF levels(r;=0.174,P=0.022).Conclusions Vitamin D deficiency is prevalent among primary and middle school students in Xicheng District,and the 25-(OH)-D levels correlate positively with Hb and SF levels.25-(OH)-D deficiency may contribute to the development of anemia.