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青岛地区短暂性抽动障碍患儿维生素D水平的回顾性分析
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Abstract:
目的：探讨青岛地区短暂性抽动障碍(provisional tic disorder, PTD)患儿维生素D水平的变化特征。方法：采用病例对照研究设计，连续纳入2017年12月至2025年4月于青岛大学附属医院儿童保健科首次就诊的PTD患儿300例(PTD组)，并匹配同期健康儿童300例(对照组)。通过高效液相色谱–串联质谱法检测血清25(OH)D浓度，比较组间差异；采用χ2检验或t检验分析生活方式因素(户外活动、饮食习惯、睡眠问题)的关联性。结果：1) 维生素D水平：PTD组血清25(OH)D浓度显著低于对照组(18.3 ± 6.7 ng/mL vs. 31.2 ± 8.4 ng/mL; t = 23.86, P < 0.05)，且25(OH)D不足/缺乏程度更高(83% vs. 48%; χ2 = 82.60, P < 0.05)。2) 生活方式：PTD组日均户外活动时间更短(1.6 ± 0.8 h vs. 2.1 ± 0.9 h; t = 4.29, P < 0.05)、饮食习惯不良比例更高(58.7% vs. 45.7%; χ2 = 10.88, P < 0.05)、睡眠障碍发生率更高(72.3% vs. 57.3%; χ2 = 14.8, P < 0.05)。结论：青岛地区PTD患儿普遍存在血清25(OH)D缺乏，且与户外活动不足、饮食失衡及睡眠问题显著相关，提示维生素D可能参与PTD的病理进程。
Objective: To characterize vitamin D status in children with provisional tic disorder (PTD) in Qingdao, China. Methods: A case-control study design was employed, consecutively enrolling 300 children with PTD (PTD group) who visited the Department of Child Health Care at the Affiliated Hospital of Qingdao University for the first time from December 2017 to April 2025, and matching them with 300 healthy children (control group) during the same period. Serum 25(OH)D concentrations were measured using high-performance liquid chromatography-tandem mass spectrometry, and differences between groups were compared. The associations with lifestyle factors (outdoor activities, dietary habits, and sleep problems) were analyzed using χ2 tests or t-tests. Results: 1) Vitamin D level: PTD group showed significantly lower serum 25(OH)D levels (18.3 ± 6.7 ng/mL vs. 31.2 ± 8.4 ng/mL; t = 23.86, P < 0.05) and higher combined vitamin D insufficiency/deficiency rate (83% vs. 48%; χ2 = 82.60, P < 0.05). 2) Lifestyle factors: The PTD group had shorter daily outdoor activity time (1.6 ± 0.8 h vs. 2.1 ± 0.9 h; t = 4.29, P < 0.05), a higher proportion of poor dietary habits (58.7% vs. 45.7%; χ2 = 10.88, P < 0.05), and a higher incidence of sleep disorders (72.3% vs. 57.3%; χ2 = 14.8, P < 0.05). Conclusion: Vitamin D deficiency, indicated by low serum 25(OH)D levels, was prevalent among children with Provisional Tic Disorder (PTD) in Qingdao. This deficiency significantly correlated with decreased outdoor exposure,
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