0～14岁儿童骨骼发育与维生素K的关联研究

doi:10.11852/zgetbjzz2022-1274

摘要/Abstract

摘要： 目的探讨儿童骨骼发育与维生素K的关联性,为日后临床及时干预儿童时期异常骨骼发育提供理论依据。方法以2020年1月—2022年4月到四川省内数家妇幼保健机构儿童保健门诊进行健康体检的6 335名0～14岁儿童为研究对象,采用液相串联质谱法检测维生素K₁、K₂的水平,同时记录其骨骼发育情况。以是否存在骨骼发育异常分为正常组(n=5 040例)和异常组(n=1 295例),对两组指标进行差异性分析,并通过Logistic回归分析儿童骨骼发育的影响因素,尤其是维生素K与儿童骨骼发育异常的关联性。结果骨骼发育正常组和异常组儿童性别、年龄、身高、体质量、血清维生素D、K₁、K₂比较差异有统计学意义(χ²=6.03,Z=14.32、16.35、16.70、8.26、5.70,χ²=13.88,P＜0.05)。不同年龄组儿童骨骼发育异常检出率比较,差异有统计学意义(χ²=158.66,P＜0.05);异常组各年龄段维生素K₂＜0.10ng/mL占比情况比较,差异无统计学意义(P＞0.05),维生素K₁水平比较,差异有统计学意义(Z=36.5,P＜0.05);正常组中各年龄段儿童维生素K₂、K₁水平比较,差异有统计学意义(χ²=47.58、Z=582.65,P＜0.05)。多因素Logistic回归分析结果提示:女性(OR=0.857, 95%CI:0.755～0.973,P＜0.05)、体质量(OR=0.949, 95%CI:0.931～0.968)是儿童骨骼发育异常的保护因素(P＜0.05),身高(OR=1.044, 95%CI:1.034～1.054)、维生素K₂＜0.1ng/mL(OR=1.153, 95%CI:1.006～1.320)均是儿童骨骼发育异常的危险因素(P＜0.05)。结论儿童骨骼发育受多种因素影响;在维生素K中,主要是维生素K₂影响儿童骨骼发育,且维生素K₂＜0.1ng/mL儿童较维生素K₂≥0.1ng/mL儿童更易出现骨骼发育异常,监测及干预儿童维生素K₂水平,对骨骼发育异常疾病早期预防,有一定临床意义。

关键词: 骨骼发育, 维生素K, 儿童

Abstract: Objective To explore the association between bone development and vitamin K in 6 335 children aged 0 to 14 years, in order to provide a theoretical basis for future clinical intervention of abnormal bone development in children. Methods From January 2020 to April 2022, 6 335 children aged 0 to 14 years who took physical examination in the child health department of several maternal and child health hospitals in Sichuan Province were selected in this study. Serum levels of vitaminK₁ and K₂ were tested by liquid tandem mass spectrometry, meanwhile, the conditions of bone development was recorded. The children were divided into normal group (n=5 040) and abnormal group (n=1 295) according to the bone development result. Then the differences between the two groups were analyzed, andthe influencing factors of bone development in children,especillythe relationship between abnormal bone development and vitamin K was analyzed by Logistic regression. Results There were significant differences in gender(χ²=6.03), age(Z=14.32), height(Z=16.35), weight(Z=16.70), serum vitamin D(Z=8.26),K₁(Z=5.70) and K₂(χ²=13.88) between normal bone development group and abnormal bone development (P＜0.05). The detection rate of skeletal dysplasia in children at different age groups was statistically significant (χ²=158.66, P<0.05). There was no significant difference in the proportion of vitamin K₂<0.10ng/mL among different age groups (P>0.05), but the level of vitamin K1 among different age groups was statistically significant (Z=36.5, P<0.05). The levels of vitamin K₂ and K₁ in children among different ages in the normal group were compared, and the difference was statistically significant (χ²=47.58, Z=582.65, P<0.05).Logistic regression analysis showed that female(OR=0.857,95%CI:0.755-0.973) and weight (OR=0.949,95%CI:0.931-0.968) were protective factors of bone development in children (P<0.05) , height (OR=1.044,95%CI:1.034-1.054) , and vitamin K₂<0.1ng/mL(OR=1.153,95%CI:1.006-1.320) were risk factors for bone development in children(P<0.05). Conclusions The development of children's bones is influenced by various factors.Among vitamin K, it is mainly vitamin K₂ that affects children′s bone development, and children with vitamin K₂< 0.1ng/mL are more likely to have abnormal bone development than children with vitamin K₂≥0.1ng/mL. Monitoring and intervening vitamin K₂ level in children is of certain clinical significance for the early prevention of abnormal bone development diseases.

Key words: bone development, vitamin K, children

中图分类号:

R179

杨钰儒, 王红, 许树红, 曹艳梅, 孟仙, 葛冬梅. 0～14岁儿童骨骼发育与维生素K的关联研究[J]. 中国儿童保健杂志, 2023, 31(7): 746-750.

YANG Yuru, WANG Hong, XU Shuhong, CAO Yanmei, MENG Xian, GE Dongmei. Association between bone development and vitamin K in children aged 0 to 14 years[J]. Chinese Journal of Child Health Care, 2023, 31(7): 746-750.

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