儿童骨折:维生素D有没有作用?
Alexa J Karkenny1, Jahn Avarello2, Regina Hanstein1
1The Children's Hospital at Montefiore.
Journal of pediatric orthopedics
|June 30, 2023
概括
虽然低维生素D (25-OHD) 在骨折儿童中很常见,但这项研究发现,骨折和非骨折组之间的25-OHD水平没有差异. 副甲状腺激素 (PTH) 水平在骨折的儿童中显著更高.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 整形外科 整形外科 整形外科
- 营养科学 营养科学
背景情况:
- 维生素D (25-OHD) 缺乏症在儿童中很普遍,影响约50%.
- 关于低25-OHD与儿科骨折风险之间的联系的现有研究产生了不一致的结果.
- 这项研究研究了儿科骨折与25-OHD,甲状腺上腺激素 (PTH) 和水平之间的关系.
研究的目的:
- 为了评估儿科骨折与关键生化标志物之间的关联:25-OHD,PTH和.
- 为了确定维生素D状况是否能使患有骨折的儿童与健康对照群区别开来.
- 确定儿童骨折风险的潜在生化预测因素.
主要方法:
- 从2014年到2017年,在两个城市儿科急诊室进行了一项前性病例控制研究.
- 招募了需要静脉注射的1至17岁的参与者,收集了人口统计,营养和活动数据.
- 血液样本分析了25-OHD,和PTH水平.
主要成果:
- 该研究包括123例骨折病例和122例对照病例;79%的所有患者的25-OHD水平不足.
- 虽然下肢骨折在低25-OHD患者中更常见,但整体25-OHD和水平在骨折和对照组之间没有显著差异.
- 骨折的儿童表现出显著更高的PTH水平 (中位数为33比24.5ppg/mL;P<0.0005),其中13%显示过多甲状腺功能,而对照组为2%.
- 多变量分析,调整了维生素D充足度和户外活动,确定PTH是增加骨折几率的唯一独立预测因素 (OR=1.10,P=0.021).
结论:
- 低25-OHD在儿科骨折患者中很常见,但与对照组没有显著差异.
- 偏甲状腺激素 (PTH) 水平升高独立地与儿童骨折风险增加有关.
- 研究结果表明,这可能会对基于证据的维生素D查和骨折后补充的指导方针产生潜在影响,强调PTH的作用.
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