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

作　　者：程红[1] 李海波 侯冬青[1] 朱忠信 郁兆仓 王宏健 高爱钰 赵小元[1] 肖培 米杰 Cheng Hong;Li Haibo;Hou Dongqing;Zhu Zhongxin;Yu Zhaocang;Wang Hongjian;Gao Aiyu;Zhao Xiaoyuan;Xiao Pei;Mi Jie(Department of Epidemiology,Capital Institute of Pediatrics,Beijing 100020,China;Division of Birth Cohort Study,Fujian Provincial Maternal and Child Health Hospital,Fuzhou 350001,China;Beijing Miyun Primary and Secondary School Health Center,Beijing 101500,China;Beijing Tongzhou Primary and Secondary School Health Center,Beijing 101100,China;Beijing Fangshan Primary and Secondary School Health Center,Beijing 102400,China;Beijing Dongcheng Primary and Secondary School Health Center,Beijing 100009,China;Department of Non-communicable Disease Management,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,Beijing 100045,China)

机构地区：[1]首都儿科研究所流行病学研究室,北京100020 [2]福建省妇幼保健院出生队列研究室,福州350001 [3]北京市密云区中小学卫生保健所,101500 [4]北京市通州区中小学卫生保健所,101100 [5]北京市房山区中小学卫生保健所,102400 [6]北京市东城区中小学卫生保健所,100009 [7]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

出　　处：《中华流行病学杂志》2021年第3期455-461,共7页Chinese Journal of Epidemiology

基　　金：国家重点研发计划(2016YFC1300101)。

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15391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10890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。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 15391 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 10890 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

关 键 词：儿童 维生素D 肌肉质量 队列研究 

分 类 号：R153.2[医药卫生—营养与食品卫生学]