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【摘要】 目的：了解广东省东莞地区6～10岁性早熟女童血清25羟维生素D[25-（OH）D]水平及营养状况，为性早熟儿童能够合理补充维生素D及性早熟治疗提供科学依据。方法：回顾性分析2015年3月1日-2018年12月31日到本院儿童保健科及儿科门诊就诊的性早熟6～10岁女童354例的血清25-（OH）D水平资料。按照年龄不同将其分为6～8岁组及9～10岁组，分析不同年龄段的维生素D营养状况。结果：本研究共纳入6～10岁性早熟女童354例，血清25-（OH）D水平为（52.05±13.56）nmol/L，其中缺乏53例（14.97%）、不足105例（29.66%）、充足196例（55.37%），过量及中毒均为0例;6～8岁组血清25-（OH）D水平高于9～10岁组（P<0.05），且两组血清25-（OH）D缺乏率、不足率比较，差异均有统计学意义（P<0.05）。结论：东莞地区6～10岁性早熟儿童维生素D水平比较低，不能达到理想水平，维生素D缺乏或不足普遍存在。
【关键词】 性早熟; 维生素D; 女童
【Abstract】 Objective：To investigate the serum 25-hydroxyvitamin D[25-（OH）D]level and nutritional status of precocious puberty girls aged 6-10 in Dongguan，Guangdong Province，and to provide scientific basis for reasonable supplementation of vitamin D and treatment of precocious puberty.Method：The serum 25-（OH）D levels of precocious puberty girls aged 6 to 10 years were retrospectively analyzed from March 1，2015 to December 31，2018 in the Department of Child Health and Pediatric Clinic of our hospital.According to age，they were divided into 6-8 years old group and 9-10 years old group.The nutritional status of vitamin D in different age groups was analyzed.Result：A total of 354 girls aged 6-10 years with precocious puberty were enrolled in this study，the serum 25-（OH）D level was（52.05±13.56）nmol/L，among them，53 cases（14.97%）were deficient，105 cases（29.66%）were insufficient，196 cases（55.37%）were sufficient，0 case were overdose and poisoning.The serum 25-（OH）D level in 6-8 years old group was higher than that of 9-10 years old group（P<0.05）.The deficiency and insufficiency rate of serum 25-（OH）D in two groups were compared，the differences were statistically significant（P<0.05）.Conclusion：The level of vitamin D in precocious puberty children aged 6 to 10 in Dongguan is insufficiency rate relatively low，which can not reach the ideal level，vitamin D deficiency or insufficiency is widespread.
【Key words】 Sexual precocity; Vitamin D; Girls First-author’s address：Dongguan Maternity and Child Health Care Hospital，Dongguan 523000，China
doi：10.3969/j.issn.1674-4985.2019.17.019
兒童性早熟是一种异常的生长发育状况，表现为青春期特征提前，女童在8岁以前出现性腺增大和第二性征，或者在10岁之前出现月经。据有关临床统计资料表明，儿童性早熟发病率正呈现不断上升的趋势[1-2]。维生素D缺乏和不足日益严重，已成为影响儿童健康的全球性问题[3]，维生素D缺乏可导致钙磷代谢异常，引起鸡胸、漏斗胸等骨骼畸形，甚至生长发育迟缓等情况，同时增加成人后骨质疏松及骨折的风险。维生素D缺乏引起的佝偻病是我国儿童保健科和儿科重点防治的四大疾病之一。随着研究的深入，人们对维生素D的认识不仅局限于骨代谢方面，还发现维生素D在对人体认知功能、循环系统、呼吸系统、内分泌系统、自身免疫系统及肿瘤发生有关[4-5]。血清25羟维生素D[25-（OH）D]在体内浓度高、稳定性强且半衰期较长，是反映机体维生素D代谢的重要指标[6]。本研究通过回顾性分析本院就诊的354例性早熟表现的女童血清25-（OH）D的水平，探讨本地区性早熟儿童维生素D水平及营养状况，为本地区性早熟儿童合理补充维生素D及性早熟治疗提供科学依据。现报道如下。
【关键词】 性早熟; 维生素D; 女童
【Abstract】 Objective：To investigate the serum 25-hydroxyvitamin D[25-（OH）D]level and nutritional status of precocious puberty girls aged 6-10 in Dongguan，Guangdong Province，and to provide scientific basis for reasonable supplementation of vitamin D and treatment of precocious puberty.Method：The serum 25-（OH）D levels of precocious puberty girls aged 6 to 10 years were retrospectively analyzed from March 1，2015 to December 31，2018 in the Department of Child Health and Pediatric Clinic of our hospital.According to age，they were divided into 6-8 years old group and 9-10 years old group.The nutritional status of vitamin D in different age groups was analyzed.Result：A total of 354 girls aged 6-10 years with precocious puberty were enrolled in this study，the serum 25-（OH）D level was（52.05±13.56）nmol/L，among them，53 cases（14.97%）were deficient，105 cases（29.66%）were insufficient，196 cases（55.37%）were sufficient，0 case were overdose and poisoning.The serum 25-（OH）D level in 6-8 years old group was higher than that of 9-10 years old group（P<0.05）.The deficiency and insufficiency rate of serum 25-（OH）D in two groups were compared，the differences were statistically significant（P<0.05）.Conclusion：The level of vitamin D in precocious puberty children aged 6 to 10 in Dongguan is insufficiency rate relatively low，which can not reach the ideal level，vitamin D deficiency or insufficiency is widespread.
【Key words】 Sexual precocity; Vitamin D; Girls First-author’s address：Dongguan Maternity and Child Health Care Hospital，Dongguan 523000，China
doi：10.3969/j.issn.1674-4985.2019.17.019
兒童性早熟是一种异常的生长发育状况，表现为青春期特征提前，女童在8岁以前出现性腺增大和第二性征，或者在10岁之前出现月经。据有关临床统计资料表明，儿童性早熟发病率正呈现不断上升的趋势[1-2]。维生素D缺乏和不足日益严重，已成为影响儿童健康的全球性问题[3]，维生素D缺乏可导致钙磷代谢异常，引起鸡胸、漏斗胸等骨骼畸形，甚至生长发育迟缓等情况，同时增加成人后骨质疏松及骨折的风险。维生素D缺乏引起的佝偻病是我国儿童保健科和儿科重点防治的四大疾病之一。随着研究的深入，人们对维生素D的认识不仅局限于骨代谢方面，还发现维生素D在对人体认知功能、循环系统、呼吸系统、内分泌系统、自身免疫系统及肿瘤发生有关[4-5]。血清25羟维生素D[25-（OH）D]在体内浓度高、稳定性强且半衰期较长，是反映机体维生素D代谢的重要指标[6]。本研究通过回顾性分析本院就诊的354例性早熟表现的女童血清25-（OH）D的水平，探讨本地区性早熟儿童维生素D水平及营养状况，为本地区性早熟儿童合理补充维生素D及性早熟治疗提供科学依据。现报道如下。