Li Haibo, Huang Tao, Xiao Pei, Zhao Xiaoyuan, Liu Junting, Cheng Hong, Dong Hongbo, Morris Howard A, Mi Jie
Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China.
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
Nutrition. 2020 Mar;71:110646. doi: 10.1016/j.nut.2019.110646. Epub 2019 Nov 9.
Vitamin D is involved in various physiologic and pathologic processes in the human body. The aim of this study was to determine the prevalence of vitamin D deficiency and the association of adiposity indicators with 25-hydroxyvitamin D (25[OH]D) in Chinese children and adolescents.
This was a population-based, nationwide, multicenter cross-sectional study involving 10 696 participants (51.2% boys) 6 to 18 y of age. Total body fat mass was assessed by dual-energy x-ray absorptiometry, and measures of body mass index (BMI), fat mass index (FMI), fat mass percentage (FMP), and plasma 25(OH)D concentrations were obtained.
The adjusted mean of 25(OH)D was 39.3 nmol/L for all participants, 40.7 nmol/L for boys, and 37.9 nmol/L for girls. Of the children, 30% had vitamin D deficiency (25[OH]D <30 nmol/L) and 80% had vitamin D insufficiency (25[OH]D <50 nmol/L). The prevalence rates of vitamin D deficiency and insufficiency were higher in girls (31%, 83.4%, respectively) than in boys (22.8%, 78.7%, respectively). An L-shape relationship between age and 25(OH)D was observed in all children, with a threshold age of 14 y. Also, there was an inverted U-shaped association of BMI with 25(OH)D, and multivariable linear models shown FMI and FMP were inversely associated with 25(OH)D concentrations, particularly in boys (β = -0.86 and -0.83, respectively, all P < 0.05).
Vitamin D deficiency was widespread and its sex-specific association with an excess of body fat in Chinese children and adolescents. The findings indicate that targeted screening and treatment guidelines may be useful.
维生素D参与人体多种生理和病理过程。本研究旨在确定中国儿童和青少年维生素D缺乏的患病率以及肥胖指标与25-羟基维生素D（25[OH]D）的关联。
这是一项基于人群的全国性多中心横断面研究，纳入了10696名6至18岁的参与者（51.2%为男孩）。通过双能X线吸收法评估全身脂肪量，并测量体重指数（BMI）、脂肪量指数（FMI）、脂肪量百分比（FMP）以及血浆25(OH)D浓度。
所有参与者的25(OH)D校正均值为39.3nmol/L，男孩为40.7nmol/L，女孩为37.9nmol/L。在这些儿童中，30%存在维生素D缺乏（25[OH]D<30nmol/L），80%存在维生素D不足（25[OH]D<50nmol/L）。女孩的维生素D缺乏和不足患病率（分别为31%、83.4%）高于男孩（分别为22.8%、78.7%）。在所有儿童中观察到年龄与25(OH)D呈L形关系，阈值年龄为14岁。此外，BMI与25(OH)D呈倒U形关联，多变量线性模型显示FMI和FMP与25(OH)D浓度呈负相关，尤其是在男孩中（β分别为-0.86和-0.83，均P<0.05）。
维生素D缺乏在中国儿童和青少年中普遍存在，且存在性别特异性，与体脂过多有关。研究结果表明，针对性的筛查和治疗指南可能会有所帮助。
