Zhu Tong,Li Lianyong,Liu Tianjing,et al.Correlations between prematurity and vitamin D and bone metabolic markers in neonates[J].Journal of Clinical Pediatric Surgery,2020,19(05):420-425.[doi:10.3969/j.issn.1671-6353.2020.05.009]
早产儿维生素D及骨代谢指标水平的相关性研究
- Title:
- Correlations between prematurity and vitamin D and bone metabolic markers in neonates
- Keywords:
- Premature Birth; Bone Diseases; Metabolic; Vitamin D; Evaluation Studies
- 分类号:
- R722.6;R681;R591.44
- 摘要:
- 目的 探讨早产、维生素D和骨代谢指标水平的相关性。方法 收集2012年11月至2013年10月于中国医科大学附属盛京医院出生的814例新生儿为研究对象，其中24例为妊娠28~32周的早产儿（重度早产组），134例为妊娠32~36周的早产儿（轻度早产组），656例为妊娠满37周的足月儿（足月产组）。使用25-（OH）-D、骨保护素（osteoprotegerin，OPG）、甲状旁腺激素（parathyroid hormone，PTH）和Ⅰ型胶原C末端肽（C-telopeptides type Ⅰ collagen，CTX）对应的ELISA试剂盒完成25羟基维生素D（25-（OH）-D）血清浓度及骨代谢标志物浓度的测定。结果 足月产组体重、身长、头围、胸围大于重度和轻度早产组（P<0.01）。三组间的维生素D和PTH水平差异有统计学意义（P<0.01）。重度早产组与足月产组、重度早产组与轻度早产组中的OPG水平存在差异，且有统计学意义（P<0.01）。早产组中，25-（OH）-D浓度与OPG、CTX的浓度呈正相关（r=0.563，P<0.01； r=0.581，P<0.001），与PTH浓度呈负相关（r=-0.621，P<0.001），OPG与PTH的浓度呈负相关（r=-0.518，P<0.001），与CTX浓度呈正相关（r=0.653，P<0.001），PTH与CTX浓度呈负相关（r=-0.520，P<0.001）。结论 成骨活动障碍及破骨活动亢进可能是导致早产儿易患代谢性骨病的关键因素，维生素D缺乏可能是代谢性骨病的原因之一。监测血清25-（OH）-D和骨代谢指标水平能较好地反映新生儿（特别是早产儿）的骨代谢状态。
- Abstract:
- Objective To measure the levels of vitamin D and bone metabolic markers and explore the correlation between prematurity,vitamin D and bone metabolic markers in neonates.Methods A total of 1,304 women delivered at Shengjing Hospital,China Medical University from November,2012 to October,2013.Finally 814 neonates including 24 very preterm,134 mildly preterm and 656 term were recruited for analysis.Enzyme-linked immunosorbent assay (ELISA) kit was utilized for measuring the serum levels of 25-hydroxyitamin D(25-(OH)-D) and 25-(OH)-D,osteoprotegerin (OPG),parathyroid hormone (PTH) and C-telopeptides typeⅠcollagen (CTX).Results Significant differences existed in body weight,body length,head circumference and chest circumference between term and very/mildly preterm groups (P<0.01).Significant differences existed in the levels of vitamin D and PTH level between very preterm and mildly preterm,mildly preterm and term and very preterm and term groups (P<0.01).Significant difference existed in the level of OPG between very preterm and term and very preterm and mildly preterm groups (P<0.01).In two preterm groups,25-(OH)-D concentration showed a significant positive correlation with OPG and CTX concentrations (r=0.563,0.581,P<0.001) and a negative correlation with PTH (r=-0.621,P<0.001).There was a negative correlation between concentrations of OPG and PTH (r=0.563,0.581,P<0.001) and a positive correlation between OPG and CTX (r=0.653,P<0.001).PTH concentration had a negative correlation of CTX concentration (r=-0.520,P<0.001).Conclusion Disorder of osteogenesis and hyperactivity of osteoclast in premature may play a key role in their susceptibilities to metabolic bone disease.Vitamin D deficiency may be one of the causes of metabolic bone disease.Measuring the serum levels of 25-(OH)-D and bone metabolic markers can reflect the condition of bone metabolism in premature neonates.
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备注/Memo
收稿日期:2019-04-14。
基金项目:国家自然科学基金（编号：81572095）；国家重点研发计划项目（编号：2016YFC1000505）
通讯作者:赵群,Email:zhaoqunorthopedics@163.com