惠州地区儿童血清维生素D水平及与疾病的相关性分析

Analysis of Serum Vitamin D Levels and Correlation with Diseases in Children in Huizhou Area

摘要: 目的：维生素D缺乏是一个全球性的公共卫生问题，了解儿童的维生素D水平及营养状况，对其当下的健康状况以及成年后的健康均有裨益。方法：采用液相色谱串联质谱(LC-MS/MS)法对2022年9月~2024年12月在惠州市第二妇幼保健院就诊的儿童进行血清维生素D测定，比较分析不同年龄段、不同性别、不同季节、不同临床诊断(症状)以及未来是否患病住院儿童血清维生素D水平及营养状况。结果：3719名儿童血清25(OH)D水平为69.0 (51.25, 92.25) nmol/L，维生素D缺乏和不足率为22.5%，男女童之间25(OH)D水平及营养状况无统计学差异。夏秋季25(OH)D水平高于春冬季。25(OH)D水平低于对照组(同时段入学体检儿童)且有统计学差异的临床诊断包括矮小症、抽动障碍、活动与注意失调、生长发育迟缓、童年情绪障碍、注意缺陷与多动障碍(ADHD)。维生素D营养状况低于对照组儿童且具有统计学差异的包括活动与注意失调、SMA、性早熟、言语和语言发育障碍、ADHD。疑似患过敏性疾病儿童维生素D水平及营养状况明显低于过敏原特异性IgE检测阴性的儿童。维生素D水平及营养状况与未来是否住院无关。结论：儿童在不同年龄、不同季节均存在维生素D不足和缺乏情况，维生素D不足和缺乏与多种疾病相关，提示家长需密切关注，合理补充。

Abstract: Objective: Vitamin D deficiency is a global public health issue. Understanding the Vitamin D levels and nutritional status of children is beneficial for their current health as well as their health in adulthood. Methods: Serum vitamin D levels were measured using liquid chromatography-tandem mass spectrometry (LC-MS/MS) in children visiting the Second Maternal and Child Health Hospital of Huizhou City between September 2022 and December 2024. Comparative analyses were conducted to assess vitamin D levels and nutritional status across different age groups, sexes, seasons, clinical diagnoses (symptoms), and future hospitalization status. Results: The serum 25(OH)D level in 3719 children was 69.0 (51.25, 92.25) nmol/L, with a vitamin D deficiency and insufficiency rate of 22.5%. There was no statistically significant difference in 25(OH)D levels and nutritional status between boys and girls. The 25(OH)D levels were higher in summer and autumn compared to spring and winter. The 25(OH)D levels were lower than the control group (children undergoing physical examinations during the same period) and showed statistically significant differences in clinical diagnoses including short stature, tic disorder, activity and attention disorders, growth retardation, childhood emotional disorders, and attention deficit hyperactivity disorder (ADHD). The vitamin D nutritional status was lower than that of the control group and showed statistically significant differences in children with activity and attention disorders, SMA, precocious puberty, speech and language developmental disorders, and ADHD. Children with suspected allergic diseases had significantly lower vitamin D levels and poorer nutritional status compared to those with negative allergen-specific IgE test results. Vitamin D levels and nutritional status are unrelated to future hospitalization. Conclusion: Children have vitamin D deficiencies and deficiencies at different ages and seasons. Vitamin D deficiencies are related to a variety of diseases, prompting parents to pay close attention and supplement rationally.