Li Hong-Ai, Zou Shao-Qiu, Li Bang-Tao, Wang Teng, Ma Zhi-Chao, Luo Qing, Huang Xiao-Yan, Fan Li-Chun, Xiang Wei
Department of Child Health Care, Hainan Women and Children's Medical Center (Children's Hospital Affiliated to Hainan Medical University), Haikou, China.
Department of Pediatrics, Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.
Transl Pediatr. 2022 Jun;11(6):1010-1017. doi: 10.21037/tp-22-235.
There are limited data regarding the prevalence and risk factors relating to vitamin D deficiency (VDD) in children of Hainan, a tropical city with abundant sunlight in China. To gather and analyze the serum VD levels of healthy children in Hainan, so as to understand their VD nutritional status and improve the representative data of VD nutritional status in south China.
Children who presented to the outpatient clinic for physical examination at 4 hospitals in the Hainan Province from 2012 to 2020 were enrolled in this study. The serum 25-hydroxyvitamin D (25-OHD) levels was analyzed. 25-OHD levels <50 nmol/L is considered VDD, 50-75 nmol/L is vitamin D insufficiency (VDI), and ≥75 nmol/L is VD sufficient (VDS).
The average serum 25-OHD level was 94.63±49.99 nmol/L [95% confidence interval (CI): 93.67-95.60]. VDD was detected in 13.98% of participants (1,435 cases), VDI was detected in 30.60% of participants (3,140 cases), and 55.42% presented with VDS (5,687 cases). The average 25-OHD level of boys was significantly higher than that of girls (t=3.67, P<0.001). The average serum 25-OHD levels in the following age groups 0-1, 1-3, 3-7, 7-14, and 14-18 years were 105.92±57.39, 100.55±53.22, 86.35±39.19, 73.61±34.21, and 54.97±19.19 nmol/L, respectively. These results suggested that with an increase in age, the 25-OHD levels decreased. The average 25-OHD levels of children with a body mass index (BMI) <85 percentile were significantly higher than that of children in the overweight and obese group (F=7.393, P=0.001).
A certain proportion of all age groups showed vitamin D deficiency and insufficiency in Hainan. A formal recommendation for vitamin D supplementation should be considered, especially in autumn and winter seasons for children over 7 years old, and in those with BMI ≥85 percentile or BMI ≥95 percentile.
关于中国阳光充足的热带城市海南儿童维生素D缺乏（VDD）的患病率及危险因素的数据有限。收集并分析海南健康儿童的血清维生素D水平，以了解其维生素D营养状况，完善中国南方维生素D营养状况的代表性数据。
纳入2012年至2020年在海南省4家医院门诊进行体检的儿童。分析血清25-羟基维生素D（25-OHD）水平。25-OHD水平<50 nmol/L被视为VDD，50-75 nmol/L为维生素D不足（VDI），≥75 nmol/L为维生素D充足（VDS）。
血清25-OHD平均水平为94.63±49.99 nmol/L [95%置信区间（CI）：93.67-95.60]。13.98%的参与者（1435例）检测出VDD，30.60%的参与者（3140例）检测出VDI，55.42%的参与者（5687例）表现为VDS。男孩的平均25-OHD水平显著高于女孩（t=3.67，P<0.001）。0-1岁、1-3岁、3-7岁、7-14岁和14-18岁年龄组的血清25-OHD平均水平分别为105.92±57.39、100.55±53.22、86.35±39.19、73.61±34.21和54.97±19.19 nmol/L。这些结果表明，随着年龄增长，25-OHD水平下降。体重指数（BMI）<第85百分位数的儿童的平均25-OHD水平显著高于超重和肥胖组儿童（F=7.393，P=0.001）。
海南各年龄组均有一定比例的儿童存在维生素D缺乏和不足。应考虑正式推荐补充维生素D，尤其是7岁以上儿童在秋冬季节，以及BMI≥第85百分位数或BMI≥第95百分位数的儿童。
