文章摘要
程红,李海波,侯冬青,朱忠信,郁兆仓,王宏健,高爱钰,赵小元,肖培,米杰.学龄儿童维生素D营养状况与身体肌肉量关系的研究[J].中华流行病学杂志,2021,42(3):455-461
学龄儿童维生素D营养状况与身体肌肉量关系的研究
Association of vitamin D nutritional status with body muscle mass in school-age children adolescents
收稿日期:2020-11-30  出版日期:2021-03-29
DOI:10.3760/cma.j.cn112338-20201130-01360
中文关键词: 儿童;维生素D;肌肉质量;队列研究
英文关键词: Children;Vitamin D;Muscle mass;Cohort study
基金项目:国家重点研发计划(2016YFC1300101)
作者单位E-mail
程红 首都儿科研究所流行病学研究室, 北京 100020  
李海波 福建省妇幼保健院出生队列研究室, 福州 350001  
侯冬青 首都儿科研究所流行病学研究室, 北京 100020  
朱忠信 北京市密云区中小学卫生保健所 101500  
郁兆仓 北京市通州区中小学卫生保健所 101100  
王宏健 北京市房山区中小学卫生保健所 102400  
高爱钰 北京市东城区中小学卫生保健所 100009  
赵小元 首都儿科研究所流行病学研究室, 北京 100020  
肖培 国家儿童医学中心儿童慢病管理中心, 首都医科大学附属北京儿童医院, 北京 100045  
米杰 国家儿童医学中心儿童慢病管理中心, 首都医科大学附属北京儿童医院, 北京 100045 jiemi12@vip.sina.com 
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中文摘要:
      目的 探讨学龄儿童维生素D营养状况与身体肌肉量的关系。方法 研究对象来自“儿童青少年心血管与骨健康促进项目”,于2017年采用分层整群抽样的方法在北京市对15 391名6~16岁儿童开展基线调查,2019年对其进行随访调查。进行问卷调查和检测血清25(OH)D,使用生物电阻抗法测定机体肌肉量,并计算全身肌肉质量指数(MMI)。采用多因素线性回归分析维生素D营养状况与基线和随访期MMI的关系。结果 纳入分析的10 890名儿童的年龄为(11.5±3.3)岁,男童占49.6%,基线25(OH)D水平为(35.4±12.0)nmol/L,充足率为11.1%。多因素线性回归校正年龄、性别、体脂肪量、吸烟、饮酒、奶制品摄入、维生素D补充、钙剂补充、体力活动、青春期发育状态后,未观察到维生素D营养状况与基线MMI水平关联有统计学意义(P>0.05)。而对于随访时点MMI,25(OH)D每增加10 nmol/L,其Z值增加0.008(P=0.058);相比于维生素D缺乏,维生素D不足和充足的儿童分别增高0.002(P=0.815)和0.037(P=0.031),趋势P=0.089。亚组分析显示,在BMI正常组中,25(OH)D每增加10 nmol/L,维生素D充足的儿童基线MMI和随访时点MMI Z值分别增高0.019和0.014,均P<0.05。结论 儿童维生素D营养状况与身体肌肉量有关,维生素D充足的儿童倾向于在未来获得更高的肌肉量。倡导儿童青少年维持充足的维生素D水平,加强营养与运动,提升身体素质。
英文摘要:
      Objective To investigate the association between vitamin D nutritional status and the body muscle mass in children. Methods Data were obtained from School-based Cardiovascular and Bone Health Promotion Program. In 2017, a total of 15 391 children aged 6-16 years in Beijing were selected through stratified cluster sampling in baseline survey. A follow-up investigation was conducted in 2019. The questionnaire survey and the detection of serum 25-hydroxyvitamin D[25(OH)D] level were conducted. The bioelectrical impedance analysis (BIA) apparatus was used to measure body muscle mass, and muscle mass index (MMI) was calculated. Multivariable linear models were used to analyze the association of vitamin D nutritional status with the baseline and follow-up MMI measures. Results A total of 10 890 children aged (11.5±3.3) years(boys accounting for 49.6%) were included in the analysis. The average 25(OH)D level was (35.4±12.0) nmol/L, with an adequacy ratio of 11.1%. After multivariate linear regression adjustment for age, sex, body fat mass, smoking status, alcohol use status, dairy supplement, calcium supplement, physical activity, and pubertal development, no statistically significant association between vitamin D nutritional status and baseline MMI level was observed (P>0.05). For the follow-up MMI, the Z-score increased by 0.008 (P=0.058) for per 10 nmol/L increase in 25(OH)D, which were 0.002 (P=0.815) and 0.037 (P=0.031) higher in children with insufficient and adequate vitamin D than those with vitamin D deficiency, respectively (P for trend=0.089). Subgroup analysis showed that in the normal BMI group, for per 10 nmol/L increase in 25 (OH) D, the MMI at baseline survey and MMI Z-score at follow-up of children with adequate vitamin D and increased by 0.019 and 0.014, respectively (both P<0.05). Conclusions Vitamin D nutritional status was related to muscle mass in children, and children with adequate vitamin D tended to obtain higher MMI. Children and adolescents are encouraged to maintain sufficient vitamin D levels, strengthen nutrition and exercise to promote body health.
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