【摘要】 目的探讨儿童血清25羟维生素D[25(OH) D]水平与血清甲状旁腺素(PTH)、钙水平的相关性。方法选择2018年1月至2019年12月于新乡医学院第三附属医院进行体检的200例儿童为研究对象,其中男102例,女98例;年龄1～10(7.37±1.52)岁。采用化学发光法检测受试者血清25(OH)D及PTH水平,采用生物化学法检测血清钙水平。比较不同性别、不同年龄段儿童血清25(OH)D、PTH及钙水平;并根据25(OH)D水平评估儿童维生素D营养状况,比较不同营养状况儿童血清25(OH)D、PTH及钙水平;分析血清25(OH)D水平与PTH及钙水平相关性。结果男童与女童血清25(OH) D、PTH及钙水平比较差异无统计学意义(P>0.05)。1～3岁组儿童血清25(OH)D水平显著高于4～6岁组和7～10岁组,4～6岁组儿童血清25(OH) D水平显著高于7～10岁组(P<0.05)。1～3岁组、4～6岁组、7～10岁组儿童血清PTH及钙水平比较差异无统计学意义(P>0.05)。200例儿童中维生素D重度缺乏5例(2.5%)、中度缺乏11例(5.5%)、轻度缺乏105例(52.5%)、正常79例(39.5%)。维生素D正常组儿童血清25(OH)D水平显著高于维生素D轻度缺乏组、维生素D中度缺乏组、维生素D重度缺乏组(P<0.05),维生素D轻度缺乏组儿童血清25(OH)D水平显著高于维生素D中度缺乏组、维生素D重度缺乏组(P<0.05),维生素D中度缺乏组儿童血清25(OH)D水平显著高于维生素D重度缺乏组(P<0.05)。维生素D正常组与维生素D轻度缺乏组儿童血清PTH及钙水平比较差异无统计学意义(P>0.05);维生素D正常组和维生素D轻度缺乏组儿童血清PTH水平显著低于维生素D中度缺乏组和维生素D重度缺乏组,血清钙水平显著高于维生素D中度缺乏组和维生素D重度缺乏组(P<0.05);维生素D中度缺乏组儿童血清PTH水平显著低于重度缺乏组,血清钙水平显著高于维生素D重度缺乏组(P<0.05)。受试者血清25(OH)D水平与PTH水平呈负相关(r=-0.705,P<0.05),与钙水平呈正相关(r=0.713,P<0.05)。结论 1～10岁儿童存在维生素D缺乏现象,血清25(OH)D水平与PTH、钙水平密切相关。建议定期联合监测儿童血清25(OH)D、PTH及钙水平,以及时了解体内维生素D营养状况及骨代谢水平。更多还原

【Abstract】 Objective To investigate the correlation between the levels of serum 25-hydroxy vitamin D[25(OH)D]and parathyroid hormone (PTH),calcium (Ca) in children.Methods Two hundred children received medical examination in the Third Affiliated Hospital of Xinxiang Medical University from January 2018 to December 2019 were selected as study subjects,including 102 males and 98 females,with age of 1-10 (7.37±1.52) years old.Electro-chemiluminescence was used to detect the levels of serum 25(OH)D and PTH of all subjects;the biochemical method was used to detect the level of serum Ca;the serum 25(OH)D,PTH,Ca were compared between the children of different genders or ages.Nutritional status of vitamin D of the children were evaluated according to the level of 25(OH)D.Then,the levels of serum 25(OH)D,PTH and Ca of children with different nutritional status were also compared.The correlations of the levels of serum 25(OH)D and PTH,Ca were analyzed.Results There was no significant difference in the levels of serum 25(OH)D,PTH and Ca between the boys and girls (P>0.05).The level of serum 25(OH)D in the 1-3 years old group was significantly higher than that in the4-6 years old group and 7-10 years old group;the level of serum 25(OH)D in the 4-6 years old group was significantly higher than that in the 7-10 years old group (P<0.05).There was no significant difference in the levels of serum PTH and Ca among the 1-3 years old group,4-6 years old group and 7-10 years old group (P>0.05).Among the 200 children,5 cases (2.5%) had severe vitamin D deficiency,11 cases (5.5%) had moderate vitamin D deficiency,105 cases (52.5%)had mild vitamin D deficiency and 79 cases (39.5%) had normal vitamin D.The level of serum 25(OH)D in the normal vitamin D group was significantly higher than that in mild-,moderate-and severe-vitamin D deficiency groups (P<0.05).The level of serum 25(OH)D in the mild-vitamin D deficiency group was significantly higher than that in the moderate-and severe-vitamin D deficiency groups (P<0.05).The level of serum 25(OH)D in the moderate-vitamin D deficiency group was significantly higher than that in the severe-vitamin D deficiency group (P<0.05).There was no significant difference in serum PTH and Ca levels between the normal vitamin D group and the mild-vitamin D deficiency group (P>0.05);the level of serum PTH in the normal vitamin D group and the mild-vitamin D deficiency group was significantly lower than that of the moderate-vitamin D deficiency group and the severe-vitamin D deficiency group (P<0.05),and the level of serum Ca was significantly higher than that in the moderate-vitamin D deficiency group and the severe-vitamin D deficiency group (P<0.05);the level of serum PTH in the moderate-vitamin D deficiency group was significantly higher than that in the moderatevitamin D deficiency group and the severe-vitamin D deficiency group (P<0.05);the level of serum Ca was significantly higher than that in severe vitamin D deficiency group (P<0.05).The level of serum 25(OH)D was negatively correlated with the level of serum PTH(r=-0.705,P<0.05),and it was positively correlated with the level of serum Ca (r=0.713,P<0.05).Conclusion Vitamin D deficiency exists in the children aged 1-10 years old.The level of serum 25(OH)D is closely related to the levels of serum PTH and Ca.The levels of serum 25(OH)D,PTH and Ca should be monitored regularly,in order to timely investigate the vitamin D vitamin D status and bone metabolism.更多还原