不同地理区域(北纬48-52°)7-8岁儿童维生素D补充的横断面研究

O. Senkevich, Maria A. Chernobrovkina, Yu. G. Kovalsky
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摘要

背景。儿童中维生素D缺乏症的流行程度根据其居住的地理纬度需要进行后续研究。这对于预防措施的实施是至关重要的,这些措施可以减少与维生素D缺乏相关的病理状况的发生风险。本研究的目的是研究生活在俄罗斯联邦不同地理纬度的7-8岁儿童维生素D的补充情况。该研究包括生活在一个地区(哈巴罗夫斯克边疆区)的三个地理区域(北部- 52°,中部- 50°,南部- 48°)的相对健康的儿童。通过酶联免疫吸附法测定血清25(OH)D浓度来评估维生素D的补充情况。25(OH)D浓度为21-30 ng/ml时诊断为维生素D不足,缺乏- 10 - 20 ng/ml,严重缺乏- < 10 ng/ml;25(OH)D的最佳浓度为30 ~ 100 ng/ml。在同一地区生活的7-8岁儿童中,维生素D缺乏和不足的患病率逐渐从南部(57%)增加到中部(73%)和北部(83%)。北部地区儿童维生素D缺乏和不足(25(OH)D≤30 ng/mL)的患病率是南部地区儿童的3.8倍(95%可信区间为1.2 ~ 12.7)。影响该地区儿童25(OH)D血清浓度的因素之一是居住地地理纬度决定的日照水平。4°N的差异在确定相对高纬度地区居民的维生素D状况方面具有重要意义。需要进一步研究不同纬度地区儿童25(OH)D浓度的相关因素(日照水平、每年日照天数、家庭食物和家庭特征)。
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Vitamin D Supplementation of 7–8 Years Old Children from Different Geographical Areas (48–52° North Latitude): Cross Sectional Study
Background. The prevalence of vitamin D deficiency in children by their geographic latitude of residence requires follow-up study. This is crucial for implementation of preventive measures that can reduce the risk of developing pathological conditions associated with vitamin D deficiency.Objective. The aim of the study is to study the vitamin D supplementation of 7–8 years old children living in different geographical latitudes of one subject of Russian Federation.Methods. The study included relatively healthy children living in three geographical areas (northern — 52°, central — 50°, southern — 48°) of one region (Khabarovsk Krai). Vitamin D supplementation was evaluated by 25(OH)D serum concentration via enzyme-linked immunosorbent assay. Vitamin D insufficiency was diagnosed at 25(OH)D concentration of 21–30 ng/ml, deficiency — 10–20 ng/ml, severe deficiency — < 10 ng/ml; optimal 25(OH)D concentration was considered as 30–100 ng/ml.Results. The increase in prevalence of vitamin D deficiency and insufficiency has been revealed with gradual increase from southern (57%) to central (73%) and northern (83%) geographic areas in 7–8 years old children living in the same region. The prevalence of vitamin D deficiency and insufficiency (25(OH)D ≤ 30 ng/mL) among children living in the northern geographic area was greater by 3.8-fold (95% confidence interval 1.2–12.7) then among peers living in the southern areas.Conclusion. One factor affecting 25(OH)D serum concentration in children of this region is the insolation level determined by the geographical latitude of residence. The 4°N difference is significant in determining vitamin D status in residents of relatively high latitudes. Further studies of factors associated with 25(OH)D concentration in children living in different latitudes are required (insolation level, number of sunny days per year, food and household characteristics in families).
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