婴幼儿维生素D营养状况及影响因素分析

耿立蒙 耿立军 高文婷 王鑫 吕攀攀 刘聪聪 刘芳

[摘要] 目的 分析嬰幼儿维生素D营养状况及其影响因素。 方法 选取2018年12月～2020年2月在滨州医学院附属医院儿童保健科健康体检的2771例婴幼儿为研究对象，采用荧光免疫层析法检测血清25-羟基维生素D[25（OH）D]水平，并应用单因素及多因素Logistic回归探讨影响维生素D的高危因素。 结果 2771例婴幼儿25（OH）D水平为（36.27±9.09）ng/mL，缺乏、不足比率分别为4.5%、20.9%。不同性别、年龄组婴幼儿25（OH）D差异无统计学意义（P=0.946，P=0.255），夏秋季节婴幼儿血清维生素D水平明显高于春冬季节（P<0.001）。多因素Logistic回归分析显示春冬季、纯母乳喂养、户外活动时间<2 h及未规律补充维生素D是婴幼儿维生素缺乏的高危因素。 结论 滨州地区健康婴幼儿的维生素D营养状况良好，婴幼儿维生素D营养状况与性别、年龄无关，与季节变化有关;应加强维生素D制剂的补充并合理安排户外活动时间，尤其是纯母乳喂养的婴幼儿。

[关键词] 婴幼儿;营养状况;维生素D;危险因素

[中图分类号] R723.2          [文献标识码] A          [文章编号] 1673-9701（2020）16-0013-04

Analysis of nutritional status and influencing factors of infant vitamin D

GENG Limeng1   GENG Lijun2   GAO Wenting1   WANG Xin1   LV Panpan1    LIU Congcong1    LIU Fang1

1.Department of Children's Health， Affiliated Hospital of Binzhou Medical College， Binzhou 256603， China; 2.Intravenous Drug Preparation Room， Binzhou People's Hospital in Shandong Province， Binzhou   256603， China

[Abstract] Objective To analyze the nutritional status of infant vitamin D and its influencing factors. Methods 2771 infants who were examined in the Department of Child Health Care of the Affiliated Hospital of Binzhou Medical College from December 2018 to February 2020 were selected as the research subjects. The serum 25-hydroxyvitamin D[25（OH）D]level was detected by fluorescence immunochromatography. The high-risk factors affecting vitamin D were explored by Univariate and multivariate logistic regression. Results The 25（OH）D level of 2771 infants was （36.27±9.09） ng/mL， and the rates of deficiency and insufficiency were 4.5% and 20.9%， respectively. There was no statistically significant difference in the 25（OH）D of infants of different gender and age groups（P=0.946， P=0.255）. The serum vitamin D level of infants in summer and autumn was significantly higher than that in spring and winter（P<0.001）. Multivariate Logistic regression analysis showed that spring and winter， exclusive breastfeeding， outdoor activity time<2 h， and irregular vitamin D supplementation were high-risk factors for vitamin deficiency in infants. Conclusion Vitamin D nutrition status of healthy infants in Binzhou area is good. Vitamin D nutrition status of infants has nothing to do with gender and age， and is related to seasonal changes. Vitamin D preparations should be strengthened and outdoor activities should be reasonably arranged， especially for exclusive breastfeeding infants.

[Key words] Infants; Nutritional status; Vitamin D; Risk factors

维生素D是全球居民最易缺乏的营养素之一，不仅能促进钙磷吸收，还与肿瘤、自身免疫性疾病、感染、心血管疾病以及抑郁症有关[1-3]。据有关资料估计，全世界约有10亿人维生素D缺乏或不足。全球儿童普遍存在维生素D的缺乏[4]，维生素D缺乏不仅影响儿童当前的生长发育，更与成人后的身体健康息息相关，所以我们更应关注儿童维生素D的营养状况，尤其是生长发育迅速的婴幼儿。

国内外有关婴幼儿维生素D营养状况的大样本调查较少，且目前山东省婴幼儿维生素D的检测数据不足，无法有效预防婴幼儿维生素D缺乏。血清25-羟基维生素D[25（OH）D]是反映人体维生素 D 营养状态的金指标[5-8]，本研究通过对滨州市婴幼儿25（OH）D的调查，了解本地区健康婴幼儿维生素D的营养状况，探讨影响维生素D的高危因素，为婴幼儿维生素D的合理补充提供理论指导和依据。……