学龄儿童维生素D营养状况与身体肌肉量关系的研究

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

Abstract

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].Chinese journal of Epidemiology,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

Received:November 30, 2020

DOI：10.3760/cma.j.cn112338-20201130-01360

KeyWord: 儿童维生素D 肌肉质量队列研究

English Key Word: Children Vitamin D Muscle mass Cohort study

FundProject:国家重点研发计划（2016YFC1300101）

Author Name	Affiliation	E-mail
Cheng Hong	Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100020, China
Li Haibo	Division of Birth Cohort Study, Fujian Provincial Maternal and Child Health Hospital, Fuzhou 350001, China
Hou Dongqing	Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100020, China
Zhu Zhongxin	Beijing Miyun Primary and Secondary School Health Center, Beijing 101500, China
Yu Zhaocang	Beijing Tongzhou Primary and Secondary School Health Center, Beijing 101100, China
Wang Hongjian	Beijing Fangshan Primary and Secondary School Health Center, Beijing 102400, China
Gao Aiyu	Beijing Dongcheng Primary and Secondary School Health Center, Beijing 100009, China
Zhao Xiaoyuan	Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100020, China
Xiao Pei	Department of Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
Mi Jie	Department of Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China	jiemi12@vip.sina.com

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Abstract:

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。

English Abstract:

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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