Oral findings of hypophosphatemic vitamin D-resistant rickets:report of two cases

Hypophosphatemic vitamin D-resistant rickets or X-linked hypophosphatemia （XLH） is a rare hereditary metabolic disease manifesting marked hypophosphatemia, short stature and rickets. Its prevalence is approximately 1 in 20 000. Except early exfoliation of the teeth, there are a few oral findings of XLH described in China. Here we present two cases in one family.

Vitamin D, Parathyroid Hormone, Insulin Sensitivity and Islet β-Cell Secretory Function in Diabetic Patients from South Kivu in the Democratic Republic of Congo: Cross-Sectional Study

Background: The role of vitamin D and parathyroid hormone in the metabolic profile of type 2 diabetes mellitus in sub-Saharan Africa has not been adequately assessed. The aim of this study was to determine the prevalence of low vitamin D level and secondary hyperparathyroidism and their association with insulin sensitivity and β-cell secretory function among Congolese type 2 diabetics. Methodology: Fasting glycaemia, fasting insulin, 25OH D3 and human parathyroid hormone (hPTH) were measured in one hundred and eighty-four type 2 diabetic patients followed as outpatients in South Kivu. Levels of 25OH D3 65 pg/ml defined low vitamin D and elevated parathyroid hormone levels, respectively. The HOMA model was used to measure insulin sensitivity and β-cell secretory function. Results: Medians (IQR) were 25.3 (20.4 - 32.4) ng/ml for 25OH D3 and 53.7 (38.4 - 115.7) pg/ml for hPTH. 58.7% of diabetics had insulin resistance, 126 (68.5%) had low vitamin D and 80 (43.5%) had hyperparathyroidism. In multivariate analysis, hPTH (partial r = −0.28;p = 0.0002) and 25OH D3 (partial r = 0.16;p = 0.03) showed an independent association with insulin sensitivity after adjustment for body mass index and waist circumference. Finally, hPTH (partial r = 0.27;p = 0.0002) was the sole determinant of β-cell secretory function. Conclusions: This study confirms the high prevalence of low vitamin D level and secondary hyperparathyroidism and their association with insulin resistance and impaired islet β-cell secretory function among Congolese with type 2 diabetes mellitus. Vitamin D and calcium supplementation should be envisaged for cases of deficiency in this region.

Vitamin D Status among Infants Attending a Reproductive and Child Health Clinic in Arusha, Tanzania: A Cross-Sectional Study

Background: Globally there is a high burden of low serum vitamin D deficiency (VDD) with children being acknowledged at risk due to low vitamin D content in both breastmilk and available foods and inadequate cutaneous synthesis of vitamin D. Even in countries with abundant sunshine, vitamin D deficiency (VDD) remains a problem. There is little characterization of the status of vitamin D among infants in East Africa. This study aimed to determine the prevalence and factors associated with vitamin D deficiency among infants attending the Reproductive and Child Health (RCH) Clinic in Arusha, Tanzania. Methods: A cross-sectional study of 304 infants aged 6 weeks to 12 months was conducted at Arusha Lutheran Medical Centre (ALMC). Infants were enrolled during the warm season between November 2018 and January 2019. A pre-coded questionnaire was used to collect data on sociodemographic characteristics of the infant with consent from their caretakers. Physical examination was done for anthropometric measures and signs of rickets. Blood was drawn for assessment of serum 25-hydroxyvitamin D 25(OH)D, calcium, phosphorus and alkaline phosphate. Vitamin D deficiency was defined as 25(OH)D level below 20 ng/ml (<50 nmol/L) and Vitamin D insufficiency defined as a 25(OH)D level 20 - 30 ng/ml (50 - 75 nmol/L). Statistical analysis was performed using STATA 14 version and factors associated with VDD explored with multivariate analysis. Results: The mean serum 25(OH)D among infants was 34.51 ng/ml (±15.53). Vitamin D deficiency was found in 67/304 (22%) infants and Vitamin D insufficiency in 50 (16.5%) infants. Hypocalcemia was observed in 33 (10.9%) infants and clinical findings of rickets were found in 11 infants (3.6%). Factors independently associated with VDD included age < 6 months (Adjusted Odds Ratio (AOR) 1.56, 95% CI 1.19 - 4.0, p value < 0.026), serum signs of rickets and serum hypocalcemia (p-value < 0.001 and <0.002, respectively). Conclusion and Recommendation: A high prevalence of Vitamin D deficiency (22%) and insufficiency (16.5%) was observed among infants attending RCH Clinic in Arusha, Tanzania. Age < 6 months, a single serum measurement of hypocalcemia and the presence of the clinical sign of rickets were independently associated with VDD. Clinicians should actively assess for VDD and supplement with vitamin D as indicated, especially among infants < 6 months.

Is there a relationship between vitamin D with insulin resistance and diabetes mellitus?

Available data suggest a possible link between abnormalvitamin D level and abnormal glucose homeostasis,two of the most common chronic medical conditions.Both conditions are associated with inflammation,and the exact mechanism for role of either on the other is not well clear.Literature investigating the link between vitamin D and either pre-diabetic states or diabetes is reviewed.Vitamin D deficiency is detrimental to insulin synthesis and secretion in animal and human studies.In humans,it has been shown by majority of observational studies,that vitamin D is positively correlated with insulin sensitivity and its role is mediated both by direct mechanism through the availability of vitamin D receptors in several tissues and indirectly through the changes in calcium levels.Large number of,but not all,variable samples cross sectional human trials have demonstrated an inverse relation between vitamin D status and impaired glucose tolerance,insulin resistance or diabetes.To compliment this conclusively,evidence from intervention studies is critically warranted before we can frankly state that vitamin D plays a role in diabetes prevention or treatment.Absence of both sizable prospective observational trials utilizing 25(OH)D as the main variable and the non-availability of randomized studies specifically designed to assess the effects of vitamin D on pre-diabetes and diabetes states,are the main obstacles to draw solid and conclusive relationships.

Is there any correlation between vitamin D insufficiency and diabetic retinopathy?

AIM: To determine a relation between vitamin D level,which is an inhibitor of angiogenesis, and diabetic retinopathy and its risk factorsMETHODS: In a clinic-based cross sectional study two hundred and thirty-five type 2 diabetic patients older than 20 y were selected. Patients were classified according to ophthalmologic examination as following:no diabetic retinopathy(NDR)(n =153), non-proliferative diabetic retinopathy(NPDR)(n =64) and proliferative diabetic retinopathy(PDR)(n =18). Study subjects were tested for fasting blood glucose, glycated hemoglobin A1C(Hb A1C), lipid profile, microalbuminuria, Hs CRP,IGF1, insulin(in patients without history of insulin taking)and 25 hydroxy vitamin D [25(OH) D] levels. Vitamin D insufficiency was defined according to 25(OH) D level less than 30 ng/m L. The relationship between diabetic retinopathy and serum 25(OH) D insufficiency was evaluated.RESULTS: The prevalence of diabetic retinopathy was34.8% in our patients. Long duration of diabetes,hypertension, poor glycemic control, diabetic nephropathy, hyperinsulinemia and insulin resistance were risk factors for diabetic retinopathy but 25(OH) D level was not significant different between NDR, NPDR and PDR groups. Correlation between 25(OH) D level and other known risk factors of diabetic retinopathy was not significant.CONCLUSION: This study did not find any association between diabetic retinopathy and its severity and vitamin D insufficiency. Vitamin D insufficiency is not related to risk factors of diabetic retinopathy.

Metabolic syndrome:A review of the role of vitamin D in mediating susceptibility and outcome

Despite the well-recognised role of vitamin D in a wide range of physiological processes,hypovitaminosis is common worldwide(prevalence 30%-50%) presumably arising from inadequate exposure to ultraviolet radiation and insufficient consumption.While generally not at the very low levels associated with rickets,hypovitaminosis D has been implicated in various very different,pathophysiological processes.These include putative effects on the pathogenesis of neoplastic change,inflammatory and demyelinating conditions,cardiovascular disease(CVD) and diabetes.This review focuses on the association between hypovitaminosis D and the metabolic syndrome as well as its component characteristics which are central obesity,glucose homeostasis,insulin resistance,hypertension and atherogenic dyslipidaemia.We also consider the effects of hypovitaminosis D on outcomes associated with the metabolic syndrome such as CVD,diabetes and non-alcoholic fatty liver disease.We structure this review into 3 distinct sections; the metabolic syndrome,vitamin D biochemistry and the putative association between hypovitaminosis D,the metabolic syndrome and cardiovascular risk.

Effects of vitamin D supplementation on glucose and lipid metabolism in patients with type 2 diabetes mellitus and risk factors for insulin resistance

BACKGROUND Type 2 diabetes mellitus(T2DM)is a chronic metabolic disease featured by insulin resistance(IR)and decreased insulin secretion.Currently,vitamin D deficiency is found in most patients with T2DM,but the relationship between vitamin D and IR in T2DM patients requires further investigation.AIM To explore the risk factors of IR and the effects of vitamin D supplementation on glucose and lipid metabolism in patients with T2DM.METHODS Clinical data of 162 T2DM patients treated in First Affiliated Hospital of Harbin Medical University between January 2019 and February 2022 were retrospectively analyzed.Based on the diagnostic criteria of IR,the patients were divided into a resistance group(n=100)and a non-resistance group(n=62).Subsequently,patients in the resistance group were subdivided to a conventional group(n=44)or a joint group(n=56)according to the treatment regimens.Logistic regression was carried out to analyze the risk factors of IR in T2DM patients.The changes in glucose and lipid metabolism indexes in T2DM patients with vitamin D deficiency were evaluated after the treatment.RESULTS Notable differences were observed in age and body mass index(BMI)between the resistance group and the non-resistance group(both P<0.05).The resistance group exhibited a lower 25-hydroxyvitamin D_(3)(25(OH)D_(3))level,as well as notably higher levels of 2-h postprandial blood glucose(2hPG),fasting blood glucose(FBG),and glycosylated hemoglobin(HbA1c)than the non-resistance group(all P<0.0001).Additionally,the resistance group demonstrated a higher triglyceride(TG)level but a lower high-density lipoprotein-cholesterol(HDL-C)level than the non-resistance group(all P<0.0001).The BMI,TG,HDL-C,25(OH)D_(3),2hPG,and HbA1c were found to be risk factors of IR.Moreover,the posttreatment changes in levels of 25(OH)D_(3),2hPG,FBG and HbA1c,as well as TG,total cholesterol,and HDL-C in the joint group were more significant than those in the conventional group(all P<0.05).CONCLUSION Patients with IR exhibit significant abnormalities in glucose and lipid metabolism parameters compared to the noninsulin resistant group.Logistic regression analysis revealed that 25(OH)D_(3)is an independent risk factor influencing IR.Supplementation of vitamin D has been shown to improve glucose and lipid metabolism in patients with IR and T2DM.

维生素D对自发性糖尿病大鼠肠道菌群结构和多样性的影响

目的探讨维生素D(VD)对自发性糖尿病大鼠肠道菌群的影响。方法自发性肥胖型2型糖尿病(ZDF)大鼠随机分为正常对照(Con)组、VD对照(VD)组、模型(T2DM)组和VD干预(VD+T2DM)组。检测各组大鼠空腹血糖情况和口服糖耐量水平。采用16S rDNA测序技术检测大鼠肠道菌群变化,进行OTU分析(韦恩图)、α多样性分析(chao1、observed species、PD whole tree、shannon和simpson)、β多样性分析(主坐标分析(PCoA))、菌群结构及菌群物种差异性分析(线性判别分析及影响因子(LEfSe)分析)。结果VD干预显著改善了T2DM大鼠的空腹血糖水平和胰岛素抵抗情况(P<0.05)。α多样性结果表明T2DM组和VD+T2DM组的chao1、observed species、PD whole tree、shannon和simpson指数无显著差异(P>0.05);β多样性分析结果显示,与T2DM组相比,VD+T2DM组与Con组的物种相似度更高。各组大鼠肠道菌群的优势菌具有显著差异;相较于T2DM组,VD+T2DM组的Bacteroidetes丰度下降、Firmicutes和Clostridium XIVa丰度增加。结论VD可改善T2DM大鼠的空腹血糖升高和胰岛素抵抗情况;VD可改善T2DM大鼠的肠道菌群结构,降低Bacteroidetes丰度,升高Firmicutes和Clostridium XIVa丰度。

Association of vitamin D and magnesium with insulin sensitivity and their influence on glycemic control

Insulin resistance increases the risk of developing diabetes,and the degree of resistance influences the glycemic control of patients with diabetes.Numerous researchers have focused on improving insulin sensitivity in order to prevent diabetes-related complications and other chronic diseases.Several studies have also linked vitamin D levels to insulin secretion and resistance,given that both vitamin D and its receptor complex play important roles in regulating pancreaticβ-cells.It has been suggested that vitamin D supplementation improves vitamin D levels,but further research is needed to confirm this as neither insulin function nor glycemic control improves when vitamin D levels increase.Magnesium is a cofactor for many enzymes.Although the role of magnesium in the management of diabetes has long been evaluated,it has not yet been determined whether magnesium supplements improve insulin function.However,several researchers have found that patients with good glycemic control have high magnesium levels.Magnesium is closely related to vitamin D and is necessary for the transport and activation of vitamin D in humans.Combined supplementation with vitamin D and magnesium improves glycemic control in patients with diabetes.

Vitamin D and Diabetes Mellitus: A Review

Vitamin D deficiency and Diabetes are both disorders of high prevalence in the world. Currently, evidences suggest a possible correlation of low levels of vitamin D with the diagnosis of Diabetes Mellitus. Hypovitaminosis D could be associated with insulin resistance and Diabetes Mellitus, which would in part explain mechanisms involved in the pathogenesis of Diabetes. The aim of this work is to discuss the association between Vitamin D and Diabetes, questioning if vitamin D can prevent the settlement of diabetes or slow down its clinical evolution, and improve the pancreatic function, thus providing a better glycaemic control.

血清25羟维生素D与妊娠期糖尿病胰岛素抵抗的相关性分析

目的探讨血清25-羟维生素D(25-hydroxy-vitamin D,25-OH-VD)水平与妊娠期糖尿病患者胰岛素抵抗的相关性。方法选择2021年3月—2023年3月淄博市妇幼保健院接收的65例妊娠期糖尿病孕妇作为观察组,选择同时期医院接收的65名健康孕妇作为对照组。采集空腹静脉血进行血清25-OH-VD、血糖、胰岛素指标检测,比较2组各指标水平。采取Pearson相关性分析25-OH-VD与血糖、胰岛素指标的关系,采取多因素logistic回归分析妊娠期糖尿病的独立危险因素。结果观察组糖化血红蛋白(glycosylated hemoglobin,HbAlc)、空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖(2 hour postprandial blood glucose,2 hPBG)、空腹胰岛素(fasting insulin,FINS)、稳态模型评估-胰岛素抵抗指数(homeostasis model assessment-insulin resistance index,Homa-IR)水平高于对照组,胰岛B细胞功能指数(homeostasismodel assessmentβcell function,Homa-β)、25-OH-VD水平低于对照组(P<0.05)。观察组维生素D营养状态缺乏占36.92%、不足占58.46%、充足占4.62%,对照组维生素D营养状态缺乏占15.38%、不足占53.85%、充足占30.77%,差异有统计学意义(P<0.05)。25-OH-VD与HbAlc、FBG、2 hPBG、FINS、Homa-IR呈负相关(P<0.05),与Homa-β呈正相关(P<0.05)。25-OH-VD缺乏为妊娠期糖尿病发病的独立危险因素(P<0.05)。结论妊娠期糖尿病患者血清25-OH-VD与血糖、胰岛素抵抗密切相关,25-OH-VD缺乏是引发妊娠期糖尿病的独立危险因素,研究价值较高。

维生素D联合膳食管理对妊娠期糖尿病患者血糖控制及妊娠结局的影响

目的:探讨维生素D联合膳食管理对妊娠期糖尿病(gestational diabetes mellitus,GDM)患者血糖控制及产妇和胎儿妊娠结局的影响。方法:选取2022年5月—2023年5月在我院妇产科门诊定期产检的128例患有GDM的孕妇为研究对象,采用随机数字表法将128例孕妇随机分为观察组和对照组各64例。对照组接受临床常规治疗和健康宣教,观察组在此基础上给予维生素D (400 IU/次,1次/d)联合膳食管理干预,观察并比较两组血糖控制情况,包括空腹血糖(FBG)、餐后2 h血糖水平(2h PG)、糖化血红蛋白(HbA1c),胰岛素抵抗情况,包括空腹胰岛素(FINs)和胰岛素抵抗指数(HOMA-IR),以及孕妇和胎儿的妊娠结局。结果:观察组与对照组孕妇在年龄、孕周、BMI、文化程度、叶酸补充情况、规律运动及每日户外活动时间上均无差异(P>0.05)。干预前两组患者FBG、HbA1c、2h PG、HOMA-IR及FINS水平无差异,组间比较无统计学意义(P>0.05)。经干预后,两组患者上述指标均下降,且经维生素D及膳食管理干预的观察组孕妇下降程度显著高于对照组(P<0.05),产妇(4.69%vs32.81%)及胎儿(3.13%vs 31.25%)不良妊娠结局发生率也显著低于对照组(P<0.001)。结论:维生素D联合膳食管理辅助治疗可控制GDM患者血糖水平,降低胰岛素抵抗,降低产妇和胎儿不良妊娠结局的发生率。

维生素D联合诺和锐特充治疗GDM临床效果

目的:探究维生素D联合诺和锐特充治疗妊娠期糖尿病(GDM)效果。方法:选取2020年1月-2023年1月本院收治的GDM患者114例,随机数表法分为胰岛组(n=57)和联合组(n=57),两组均给予诺和锐特充皮下注射治疗,联合组同时口服维生素D滴剂,均持续治疗至血糖达标,比较两组治疗前、分娩前血糖指标[空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)]、胰岛素指标[空腹胰岛素(FINS)、胰岛素分泌指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)]、血脂指标(血浆脂肪酸、总胆固醇、甘油三酯)、同型半胱氨酸(Hcy)、Toll样受体4(TLR4)、血管细胞粘附分子(VCAM-1),随访母婴结局。结果:治疗后分娩前,两组FPG、2hPG、HbA1c均下降(P<0.05)但两组无差异(P>0.05),两组FINS、HOMA-IR均下降,HOMA-β均上升,且联合组指标(12.76±1.46μU/ml、2.98±0.23、89.52±8.10)改善优于胰岛组(12.87±1.52μU/ml、3.30±0.52、81.41±8.08),两组血脂指标均下降且联合组低于胰岛组,两组TLR4、VCAM-1、Hcy均下降且联合组(6.71±1.38 mU/L、43.63±7.47 ng/ml、8.47±1.85μmol/L)低于胰岛组(8.49±1.46 mU/L、52.47±7.63 ng/ml、11.21±2.76μmol/L)(均P<0.05);胰岛组与联合组不良母婴结局发生率(14.0%比8.8%)无差异(P>0.05)。结论:维生素D辅助诺和锐特充治疗GDM,有利于改善患者胰岛素抵抗及脂代谢功能,抑制Hcy等促炎因子表达,未增加不良母婴结局风险。

Detection of vitamin D in patients with gestational diabetes mellitus and its effects on insulin resistance, adipokines and TNF-α

Objective:To detect vitamin D levels in patients with gestational diabetes mellitus and the influence and clinical effect of Vitamin D supplement on insulin resistance, fatty factors and TNF-α.Methods:A total of 100 patients with GDM from September 2014 to May 2015 in our hospital were selected as object of observation (GDM Group). 52 cases patients with Vitamin D deficiency were randomly divided into two groups. At the same time, 50 cases of healthy pregnant women were selected as normal group. Biochemical indexes of observation group and normal group were detected. Biosynthetic Human Insulin Injection were given to the patients in the control group. The patients in the observation group were supplemented with vitamin D drops on the basis of the treatment of control group. The level of insulin resistance, adipokines and TNF-α were detected in the 2 groups.Results:FBG, PBG, FINS, TG, Visfatin, TNF-α and HOMA-IR in GDM group were higher compared with that in normal group. 25(OH)D3 and APN in GDM group decreased significantly compared with that in normal group. The comparison of TC, HDL-C and LDL-C in the two groups were not statistically significant. PBG, FINS, HOMA-IR, Visfatin and TNF-α in both groups after treatment significantly decreased compared with that before treatment. PBG, Visfatin and TNF-α in treatment group after treatment decreased more significantly than that in control group. FINS, HOMA-IR in treatment group after treatment increased more significantly than that in control group. The decrease of FBG was not obvious and there was no significant difference between the two groups after treatment. APN and 25(OH)D3 in both groups after treatment significantly increased compared with that before treatment. And they in treatment group after treatment increased more significantly than that in control group. In the correlation analysis, 25(OH) D3in serum was positively correlated to the the level of APN. Also, it was negatively correlated to HOMA-IR, Visfatin and TNF-α.Conclusion:Vitamin D levels in patients with gestational diabetes mellitus decreased more significantly compared with that in healthy pregnant women. And the patients with vitamin D deficiency have higher risk to get GDM. Vitamin D can treat GDM by regulating the degree of insulin resistance and the level of adipokines. And it has clinical value in the treatment of GDM.

四君子汤加减联合维生素D治疗维生素D缺乏性佝偻病的效果及对骨代谢指标的影响

目的探讨四君子汤加减联合维生素D治疗维生素D缺乏性佝偻病的效果及对骨代谢指标的影响。方法回顾性分析2021年1月至2024年5月于郑州大学第一附属医院儿童保健门诊治疗的106例维生素D缺乏性佝偻病患儿的病历资料,根据治疗方法的不同分为对照组(n=56)和研究组(n=50),对照组患儿采用维生素D治疗,研究组患儿在对照组治疗的基础上采用四君子汤加减治疗,两组患儿均治疗6个月。治疗6个月后,比较两组患儿的临床效果,以及治疗前、治疗6个月后的骨代谢指标[尿脱氧吡啶啉(DPD)、骨钙素(BGP)、骨特异性碱性磷酸酶(BALP)]、尺骨和桡骨的骨密度,并比较两组患儿治疗期间的不良反应发生情况。结果研究组患儿治疗后的临床总有效率为96.00%,明显高于对照组的82.14%,差异有统计学意义(P<0.05);治疗前,两组患儿的DPD、BGP、BALP比较差异均无统计学意义(P>0.05);治疗6个月后,两组患儿的DPD、BGP、BALP均明显升高,且研究组患儿的DPD、BGP、BALP分别为(30.47±2.12)nmol/mmol、(15.50±1.40)μg/L、(176.17±15.73)U/L,明显高于对照组的(26.61±1.78)nmol/mmol、(11.69±1.23)μg/L、(143.62±13.77)U/L,差异均有统计学意义(P<0.05);治疗前,两组患儿的尺骨、桡骨骨密度比较差异均无统计学意义(P>0.05);治疗6个月后,两组患儿的尺骨、桡骨骨密度水平均升高,且研究组患儿的尺骨、桡骨骨密度分别为(0.54±0.10)g/cm^(2)、(0.60±0.13)g/cm^(2),明显高于对照组的(0.42±0.08)g/cm^(2)、(0.45±0.10)g/cm^(2),差异均有统计学意义(P<0.05);研究组患儿治疗期间的不良反应总发生率为12.00%,略高于对照组的7.14%,但差异无统计学意义(P>0.05)。结论四君子汤加减联合维生素D治疗维生素D缺乏性佝偻病可改善患儿的骨代谢指标水平,增强骨密度,临床应用效果显著且安全性较好。

葡萄糖酸钙锌联合维生素D治疗维生素D缺乏性佝偻病患儿的效果

目的:观察葡萄糖酸钙锌联合维生素D治疗维生素D缺乏性佝偻病患儿的效果。方法:选取2021年4月至2023年3月郑州市金水区总医院收治的72例维生素D缺乏性佝偻病患儿进行前瞻性研究,按照随机数字表法分为观察组与对照组各36例。对照组采用维生素D治疗,观察组在对照组基础上联合葡萄糖酸钙锌治疗,比较两组生长指标{血清骨碱性磷酸酶(BALP)、血清25-羟维生素D3[25-(OH)D3]、身高}水平、骨代谢指标[血清硬骨素(SOST)、抗酒石酸酸性磷酸酶5b(TRAP-5b)、Ⅰ型胶原交联羧基端肽(CTX-Ⅰ)、成纤维细胞生长因子23(FGF23)、粒细胞集落刺激因子(G-CSF)]和不良反应发生率。结果:治疗3、6个月后,观察组身高及25-(OH)D3、SOST、TRAP-5b、CTX-Ⅰ水平高于对照组,BALP、FGF-23、G-CSF水平低于对照组,差异均有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:葡萄糖酸钙锌联合维生素D治疗维生素D缺乏性佝偻病患儿可改善其生长指标和骨代谢指标水平,效果优于单纯维生素D治疗。

维生素D在儿童支气管哮喘中的作用研究进展

支气管哮喘是儿童最常见的慢性呼吸道疾病之一,近年来儿童支气管哮喘的患病率呈上升趋势,严重影响儿童的健康和生长发育。维生素D作为重要的脂溶性维生素,不仅参与钙磷代谢以维持骨骼健康,还通过免疫调节等功能在儿童哮喘中发挥作用。本文综述了维生素D在儿童支气管哮喘中的作用研究进展,包括维生素D的生理功能,维生素D通过免疫调节、参与气道重塑、缓解激素抵抗、影响肺发育和肺功能等作用参与哮喘的发生发展,以及补充维生素D在预防和治疗儿童哮喘中的作用,旨在为儿童支气管哮喘的临床防治工作提供新的思路和方法。

钙剂联合维生素D治疗儿童营养性维生素D缺乏性佝偻病合并缺铁性贫血的临床效果分析

目的:分析儿童营养性维生素D缺乏性佝偻病合并缺铁性贫血采取钙剂联合维生素D治疗的临床效果。方法:选取2021年1月—2022年12月惠民县卫生健康保障中心门诊收治的儿童营养性维生素D缺乏性佝偻病合并缺铁性贫血患儿150例作为研究对象,以抽签法随机分为对照组和观察组,各75例。对照组采取常规补充维生素D和铁剂治疗,观察组在对照组基础上给予碳酸钙D3治疗。比较两组患者临床疗效、血红蛋白水平、营养指标、缺铁性贫血纠正时间、不良反应发生情况。结果:治疗后,观察组总有效率高于对照组,差异有统计学意义(P<0.05)。两组白蛋白、总蛋白和血红蛋白高于治疗前,观察组高于对照组,差异有统计学意义(P<0.05)。观察组缺铁性贫血纠正时间短于对照组,差异有统计学意义(P<0.001)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:在儿童营养性维生素D缺乏性佝偻病合并缺铁性贫血患儿的临床治疗中,采取综合治疗具有较高的应用价值,能够改善患儿的营养指标,促进病情恢复,且具有较高的安全性。

维生素D在儿童肥胖中的应用效果及对瘦素、胰岛素抵抗水平的影响

【目的】探讨维生素D在儿童肥胖中的应用效果及对瘦素、胰岛素抵抗水平的影响。【方法】回顾性分析2022年1月至2023年1月本院收治的150例肥胖患儿的临床资料,根据治疗方法不同将其分为观察组(在对照组的基础上给予维生素D治疗)和对照组(采用常规治疗),每组75例。比较两组体重指数(BMI)、25羟基维生素D[25(OH)D]、瘦素、胰岛素抵抗指数(HOMA-IR)、炎症因子[白介素-8(IL-8)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)、活性氧(ROS)]。【结果】两组患儿治疗前后身高比较,差异无统计学意义(P>0.05);治疗后,两组患儿BMI低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组25(OH)D均高于治疗前,瘦素、HOMA-IR低于治疗前,且观察组25(OH)D高于对照组,瘦素、HOMA-IR低于对照组,差异有统计学意义(P<0.05)。治疗后,两组血清IL-8、IL-6、TNF-α、SOD、MDA、ROS水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。【结论】维生素D能够降低肥胖患儿BMI,减轻患儿机体炎症反应及氧化应激反应,提高瘦素水平,降低HOMA-IR,应用效果良好。

健脾补肺法联合西药治疗肺脾气虚型维生素D缺乏性佝偻病疗效观察

目的:维生素D缺乏性佝偻病是以骨骼病变为主的慢性营养缺乏性疾病,主要特征是形成骨基质钙化障碍,常伴有反复呼吸道感染、肌肉松弛、食欲降低、便溏、囟门迟闭、夜惊、出汗等症状,若不及时进行治疗,将会发生骨骼异常,严重影响患儿的生长发育。西医目前治疗该病多通过补充维生素D促进钙磷吸收,但长期连续口服维生素D存在一定的不良反应,可导致软组织钙沉着、肾功能损害。近年来中医中药在防治维生素D缺乏性佝偻病中表现出了良好的技术优势,本研究主要观察健脾补肺法联合西药治疗肺脾气虚型维生素D缺乏性佝偻病疗效。方法:将90例患儿随机分为治疗组45例、对照组45例。对照组予以骨化三醇及葡萄糖酸钙,治疗组在对照组基础上口服以健脾益气、补肺固表为基础的中药颗粒剂,服药3个月后,观察两组的综合疗效及比较治疗前后症状(精神、毛发情况、食量状况、出汗、面色、大便性状、患感冒次数)的中医证候总积分。结果:治疗组总有效率为95.24%(40/42),对照组总有效率为78.05%(32/41),两组差异有统计学意义(P <0.05);治疗后两组中医证候总积分比较,差异有统计学意义(P <0.05)。结论:健脾补肺法联合西药治疗肺脾气虚型维生素D缺乏性佝偻病疗效确切,可显著降低患者中医证候评分,值得临床推广。