维生素D缺乏与儿童神经精神发育障碍研究现况

葛星; 卫红桥

doi:10.19837/j.cnki.ahyf.2020.05.008

PDF(845 KB)

安徽预防医学杂志 ›› 2020, Vol. 26 ›› Issue (5) : 359-363. DOI: 10.19837/j.cnki.ahyf.2020.05.008

综述

维生素D缺乏与儿童神经精神发育障碍研究现况

葛星¹, 卫红桥¹

作者信息 +

Vitamin D deficiency and neuropsychological development disorders in children

GE Xing, WEI Hong-qiao

Author information +

文章历史 +

摘要

随着生活方式的改变、户外活动减少以及营养素摄入不均衡等因素的影响,维生素D(vitamin D,VitD)缺乏症在世界范围内普遍存在,儿童中尤为明显,已经成为全球关注的公共卫生问题。众所周知,VitD作为一种脂溶性维生素与活跃的神经类固醇激素,不仅是促进骨骼代谢和肌肉功能的重要调节因子,还在维持大脑稳态、神经发育和分化等方面发挥着至关重要的作用。近年来,越来越多的研究证据表明,VitD缺乏可能与儿童神经精神发育障碍有关,可增加儿童孤独症谱系障碍(autism spectrum disorder,ASD)、注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)、认知发育障碍和精神分裂症等不良神经精神结局的风险。目前对于VitD缺乏引起儿童神经精神发育障碍的机制仍不清楚,本综述旨在了解VitD缺乏对儿童神经精神发育的影响,同时总结VitD缺乏对儿童5-羟色胺(5-HT)的分布和功能的影响。

Abstract

Vitamin D deficiency is widespread worldwide,especially among children,as a result of changes in lifestyle,lacking of outdoor activities and imbalance in nutrient intake.It has become a global public health concern.As a fat-soluble hormone and an active neurosteroid hormone,vitamin D is not only a key regulator of bone metabolism and muscle function,but also plays a vital role in maintaining brain homeostasis,neurodevelopment and differentiation.Growing body of evidence indicates that vitamin D deficiency may be associated with neurodevelopmental disorders such as autism spectrum disorder,attention deficit hyperactivity disorder,cognitive disorder and schizophrenia in children.The mechanism underlying vitamin D deficiency induced neurodevelopmental disorde,is not clear.This review focuses on the effects of vitamin D deficiency on neurodevelopment in children and the distribution and function of serotonin in children.

导出引用

葛星, 卫红桥. 维生素D缺乏与儿童神经精神发育障碍研究现况[J]. 安徽预防医学杂志. 2020, 26(5): 359-363 https://doi.org/10.19837/j.cnki.ahyf.2020.05.008

GE Xing, WEI Hong-qiao. Vitamin D deficiency and neuropsychological development disorders in children[J]. Anhui Journal of Preventive Medicine. 2020, 26(5): 359-363 https://doi.org/10.19837/j.cnki.ahyf.2020.05.008

中图分类号： R179

参考文献

[1] Norris JM.Can the sunshine vitamin shed light on type 1 diabetes?[J].Lancet,2001,358(9292): 1476-1478.
[2] Motti H,Richard K.Vitamin D defciency/insuffciency from childhood to adulthood: Insights from a sunny country[J].World J Clin Pediatr,2017,6(1): 1-9.
[3] Munns CF,Shaw N,Kiely M,et al.Global Consensus Recommendations on Prevention and Management of Nutritional Rickets[J].J Clin Endocrinol Metab,2016,101(2):394-415.
[4] Bouillon R,Marcocci C,Carmeliet G,et al.Skeletal andextraskeletal actions of vitamin D: Current evidence and outstanding questions[J].Endocr Rev,2019,40(4): 1109-1151.
[5] Gessner BD,Plotnik J,Muth PT.25-Hydroxyvitamin D levels among healthy children in Alaska[J].J Pediatr,2003,143(4):434-437.
[6] Chu F,Ohinmaa A,Klarenbach S,et al.Serum 25-hydroxyvitamin D concentrations and indicators of mental health: an analysis of the Canadian Health Measures Survey[J].Nutrients,2017,9(10): 1-8.
[7] Choi HS,Oh HJ,Choi H,et al.Vitamin D insufficiency in Korea-a greater threat to younger generation: the Korea National Health and Nutrition Examination Survey (KNHANES) 2008[J].J Clin Endocrinol Metab,2011,96(3):643-651.
[8] Yu X,Wang W,Wei Z,et al.Vitamin D status and related factors in newborns in Shanghai,China[J].Nutrients,2014,6(12):5600-5610.
[9] Liang GY,Qin R,Li J,et al.Optimal level of 25-(OH)D in children in Nanjing (32 degrees N Lat) during winter[J].Pediatr Int,2011,53(4):541-545.
[10] Guo Y,Ke HJ,Liu Y,et al.Prevalence of vitamin D insufficiency among children in southern china: A cross-sectional survey[J].Medicine (Baltimore),2018,97(25):1-5.
[11] Zhao X,Xiao J,Liao X,et al.Vitamin D status among young children aged 1-3 years: a cross-sectional study in Wuxi,China[J].PLoS ONE,2015,10(10):1-11.
[12] Wang S,Shen G,Jiang S,et al.Nutrient status of vitamin D among Chinese children[J].Nutrients,2017,9(4):1-10.
[13] Zhu Z,Zhan J,Shao J,et al.High prevalence of vitamin D deficiency among children aged 1 month to 16 years in Hangzhou,China[J].BMC Public Health,2012,12:126.1-7.
[14] Wang J,Wang H,Chang S,et al.The influence of malnutrition and micronutrient status on anemic risk in children under 3 years old in poor areas in China[J].PLoS ONE,2015,10(10):1-13.
[15] Wu F,Laslett LL,Zhang Q.Threshold effects of vitamin D status on bone health in Chinese adolescents with low calcium intake[J].J Clin Endocrinol Metab,2015,100(12):4481-4489.
[16] Moon RJ,Davies JH,Cooper C,et al.Vitamin D,and maternal and child health[J].Calcif Tissue Int,2019,1-17.
[17] Alonso MA,Mantecón L,Santos F.Vitamin D deficiency in children: a challenging diagnosis![J].Pediatr Res,2019,85(5):596-601.
[18] Gould JF,Anderson AJ,Yelland LN,et al.Association of cord blood vitamin D with early childhood growth and neurodevelopment[J].J Paediatr Child Health,2017,53(1): 75-83.
[19] Francis EC,Hinkle SN,Song Y,et al.Longitudinal maternal vitamin D status during pregnancy is associated with neonatal anthropometric measures[J].Nutrients,2018,10(11):1-12.
[20] Kremer R,Campbell PP,Reinhardt T,et al.Vitamin D status and its relationship to body fat,fnalheight,and peak bone mass in young women[J].J Clin Endocrinol Metab,2009,94(1): 67-73.
[21] Rafiq S,Jeppesen PB.Body mass index,vitamin D,and type 2 diabetes: a systematic review and meta-Analysis[J].Nutrients,2018,10(9):1-20.
[22] Gutiérrez Medina S,Gavela-Pérez T,Domínguez-Garrido MN,et al.The influence of puberty on vitamin D status in obese children and the possible relation between vitamin D deficiency and insulin resistance[J].J Pediatr Endocrinol Metab,2015,28(1-2): 105-110.
[23] Eyles DW,Burne TH,McGrath JJ.Vitamin D,effects on brain development,adult brain function and the links between low levels of vitamin D and neuropsychiatric disease[J].Front Neuroendocrinol,2013,34(1):47-64.
[24] Garcion E,Wion-Barbot N,Montero-Menei CN,et al.New clues about vitamin D functions in the nervous system[J].Trends Endocrinol Metab,2002,13(3):100-105.
[25] O’Loan J,Eyles DW,Kesby J,et al.Vitamin-D status during various stages of pregnancy in the rat;its impact on development and behaviour in adult offspring[J].Psychoneuroendocrinology,2007,32(3):227-234.
[26] Eyles D,Brown J,Mackay-Sim A,et al.Vitamin-D3 and brain development[J].Neuroscience,2003,118(3):641-653.
[27] Bivona G,Gambino CM,Iacolino G,et al.Vitamin D and nervous system[J].Neurol Res,2019,41(9):827-835.
[28] Wang T,Shan L,Du L,et al.Serum concentration of 25-hydroxyvitamin D in autism spectrum disorder: a systematic review and meta-analysis[J].Eur Child Adolesc Psychiatry,2016,25(4):341-50.
[29] Fernell E,Bejerot S,Westerlund J,et al.Autism spectrum disorder and low vitamin D at birth: a sibling control study[J].Mol Autism,2015,6(3):1-9.
[30] Wu DM,Wen X,Han XR,et al.Relationship between neonatal vitamin D at birth and risk of autism spectrum disorders: the NBSIB Study[J].J Bone Miner Res,2018,33(3):458-466.
[31] Feng J,Shan L,Du L,et al.Clinical improvement following vitamin D3 supplementation in autism spectrum disorder[J].Nutr Neurosci,2017,20(5):284-290.
[32] Meyer T,Becker A,Sundermann J,et al.Attention deficit-hyperactivity disorder is associated with reduced blood pressure and serum vitamin D levels: results from the nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS)[J].Eur Child Adolesc Psychiatry,2017,26(2):165-175.
[33] Khoshbakht Y,Bidaki R,Salehi-Abargouei A.Vitamin D status and attention deficit hyperactivity disorder: a systematic review and meta-Analysis of observational studies[J].Adv Nutr,2018,9(1): 9-20.
[34] 王媛媛,崔俊岭,张会丰.儿童25羟维生素D水平与注意缺陷多动障碍关系的系统评价和Meta分析[J].中国循证儿科杂志,2018,13(4):248-252.
[35] Morales E,Julvez J,Torrent M,et al.Vitamin D in pregnancy and attention defcit hyperactivity disorder-like symptoms in childhood[J].Epidemiology,2015,26(4):458-465.
[36] Husmann C,Frank M,Schmidt B,et al.Low 25(OH)-vitamin D concentrations are associated with emotional and behavioral problems in German children and adolescents[J].PLoS ONE,2017,12(8):1-16.
[37] Zhu P,Tong SL,Hao JH,et al.Cord Blood Vitamin D and Neurocognitive Development Are Nonlinearly Related in Toddlers[J].J Nutr,2015,146(6):1232-1238.
[38] Whitehouse AJ,Holt BJ,Serralha M,et al.Maternal serum vitamin D levels during pregnancy and offspring neurocognitive development[J].Pediatrics,2012,129(3):485-493.
[39] Morales E,Guxens M,Llop S,et al.Circulating 25-hydroxyvitamin D3 in pregnancy and infant neuropsychological development[J].Pediatrics,2012,130(4):e913-920.
[40] Davies G,Welham J,Chant D,et al.A systematic review and meta-analysis of Northern Hemisphere season of birth studies in schizophrenia[J].Schizophr Bull,2003,29(3):587-593.
[41] Kinney DK,Teixeira P,Hsu D,et al.Relation of schizophrenia prevalence to latitude,climate,fish consumption,infant mortality,and skin color: a role for prenatal vitamin d deficiency and infections?[J].Schizophr Bull,2009,35(3):582-595.
[42] Bourque F,van der Ven E,Malla A.A meta-analysis of the risk for psychotic disorders among first- and second-generation immigrants[J].Psychol Med,2011,41(5): 897-910.
[43] McGrath JJ,Eyles DW,Pedersen CB,et al.Neonatal vitamin D status and risk of schizophrenia: a population-based case-control study[J].Arch Gen Psychiatry,2010,67(9):889-894.
[44] McGrath JJ,Burne TH,Féron F,et al.Developmental vitamin D deficiency and risk of schizophrenia: a 10-year update[J].Schizophr Bull,2010,36(6): 1073-1078.
[45] Walther DJ,Bader M.A unique central tryptophan hydroxylase isoform[J].Biochem Pharmacol,2003,66(9),1673-1680.
[46] Gutknecht L,Kriegebaum C,Waider J,et al.Spatio-temporal expression of tryptophan hydroxylase isoforms in murine and human brain: convergent data from Tph2 knockout mice[J].Eur Neuropsychopharmacology,2009,19(4),266-282.
[47] Fernstrom JD,Wurtman RJ.Brain serotonin content: physiological regulation by plasma neutral amino acids[J].Science,1972,178(4059),414-416.
[48] Bennett-Clarke CA,Leslie MJ,Lane RD,et al.Effect of serotonin depletion on vibrissa-related patterns of thalamic afferents in the rat's somatosensory cortex[J].J Neurosci,1994,14(12): 7594-607.
[49] Shehabeldin R,Lutz D,Karsak M,et al.Reelin controls the positioning of brainstem serotonergic raphe neurons[J].PLoS One,2018,13(7):1-21.
[50] Eyles DW,Burne TH,McGrath JJ.Vitamin D,effects on brain development,adult brain functionand the links between low levels of vitamin D and neuropsychiatric disease[J].Front Neuroendocrinol,2013,34(1): 47-64.
[51] Veenstra TD,Prüfer K,Koenigsberger C,et al.1,25-Dihydroxyvitamin D3 receptors in the central nervous system of the rat embryo[J].Brain Res,1998,804(2): 193-205.
[52] Patrick RP,Ames BN.Vitamin D hormone regulates serotonin synthesis.Part 1: relevance for autism[J].FASEB J,2014,28(6): 2398-2413.
[53] Zepf FD,Stadler C,Demisch L,et al.Serotonergic functioning and trait-impulsivity in attention-deficit/hyperactivity-disordered boys (ADHD): influence of rapid tryptophan depletion[J].Hum Psychopharmacol,2008,23(1): 43-51.
[54] Chugani DC,Muzik O,Behen M,et al.Developmental changes in brain serotonin synthesis capacity in autistic and nonautistic children[J].Ann Neurol,1999,45(3):287-295.
[55] Zhang X,Beaulieu JM,Sotnikova TD,et al.Tryptophan hydroxylase-2 controls brain serotonin synthesis[J].Science,2004,305(568): 217.
[56] Groves NJ,Kesby JP,Eyles DW,et al.Adult vitamin D defciency leads to behavioural and brain neurochemical alterations in C57BL/6J and BALB/c mice[J].Behav Brain Res,2013,241:120-131.
[57] McGrath J,Eyles D,Mowry B,et al.Low maternal vitamin D as a risk factor for schizophrenia: a pilot study using banked sera[J].Schizophr.Res,2003,63(1-2): 73-78.
[58] Jacquemyn Y,Ajaji M,Karepouan N.Vitamin D levels in maternal serum and umbilical cord blood in a multi-ethnic population in Antwerp,Belgium[J].Facts Views Vis Obgyn,2013,5(1):3-5.
[59] Grant CC,Stewart AW,Scragg R,et al.Vitamin D during pregnancy and infancy and infant serum 25-hydroxyvitamin D concentration[J].Pediatrics,2014,133(1):e143-153.