Department of Statistics, Renmin University of China, Beijing, China.
Department of Statistics, Renmin University of China, Beijing, China. Email:
Asia Pac J Clin Nutr. 2020;29(3):566-576. doi: 10.6133/apjcn.202009_29(3).0016.
Vitamin A is involved in immune function, vision, reproduction, and cell differentiation and is essential for child growth. Vitamin A deficiency (VAD) contributes significantly to mortality and morbidity in developing countries. This study assessed the current vitamin A status in Chinese children.
A cross-sectional survey was conducted in 26 provinces in China between 2015 and 2018, and 277,064 children aged 0-14 years were enrolled. Data on sociodemographic factors and dietary supplements were obtained through interviews with their parents. Serum vitamin A concentrations were measured using HPLC. To reduce the sampling error, a weighted distribution was produced to estimate the distribution of serum vitamin A concentration in Chinese children. A new method was used calculate the CI.
The results revealed that 10.4% (23.9 million) (95% CI: 10.1%-10.8%) of Chinese children aged 0-14 years were at risk of suffering from subclinical VAD (SVAD) (<0.2 mg/L). Sick children, especially those with recurrent respiratory infections (21.3%, 95% CI: 20.5%-22.2%), were vulnerable to SVAD. A high prevalence of SVAD was observed in western and northeastern areas in China. Serum vitamin A concentrations in ethnic minority groups were significantly lower than those in Han Chinese children (p<0.01).
VAD is still a moderate public health problem in Chinese children, especially in those with respiratory symptoms. Regular consumption of vitamin A-rich foods should be promoted through nutrition education for parents.
维生素 A 参与免疫功能、视力、生殖和细胞分化，是儿童生长所必需的。维生素 A 缺乏症（VAD）是发展中国家儿童死亡和发病的主要原因。本研究评估了中国儿童目前的维生素 A 状况。
2015 年至 2018 年期间，在中国 26 个省份进行了一项横断面调查，共纳入 277064 名 0-14 岁儿童。通过对其父母的访谈获得社会人口因素和膳食补充剂的数据。使用 HPLC 测量血清维生素 A 浓度。为了减少抽样误差，采用加权分布来估计中国儿童血清维生素 A 浓度的分布。采用新方法计算置信区间。
结果显示，10.4%（2390 万）（95%CI：10.1%-10.8%）的 0-14 岁中国儿童存在亚临床维生素 A 缺乏症（SVAD）（<0.2mg/L）风险。患病儿童，尤其是反复呼吸道感染儿童（21.3%，95%CI：20.5%-22.2%），易患 SVAD。中国西部和东北部地区 SVAD 患病率较高。少数民族儿童的血清维生素 A 浓度明显低于汉族儿童（p<0.01）。
维生素 A 缺乏症仍然是中国儿童的一个中度公共卫生问题，尤其是有呼吸道症状的儿童。应通过对父母进行营养教育，促进定期食用富含维生素 A 的食物。
