Yuan Li, Wang Huiyu, Luo Yan, Wang Lei
Beijing Haidian District Maternal and Child Health Care Hospital, Beijing, China.
Guiyang Maternal and Child Health Care Hospital, Guiyang, Guizhou, China.
J Pediatr Endocrinol Metab. 2024 Nov 15. doi: 10.1515/jpem-2024-0330.
Previous studies have shown that vitamin D deficiency is a risk factor for obesity in children and adolescents, but most focus on school-age children and adolescents, with little attention paid preschoolers.
To explore the relationship between overweight or obesity in the context of vitamin D intake among preschool children in Beijing, and analyze the correlation.
A total of 51,640 preschoolers (26,775 boys; 24,865 girls), aged 1-6 years, were recruited for physical examination. Overweight or obesity was defined according to the World Health Organization Child Growth and Development Standards (2006 edition). Serum 25-hydroxy (OH) vitamin D levels were determined using standardized liquid chromatography-tandem mass spectrometry (LC-MS/MS), and vitamin D status was evaluated based on the Practice Guide on Clinical Issues Related to Vitamin D Nutrition in Chinese Children (2022).
No significant change was observed in the incidence of overweight (7.72, 7.51, and 7.24 %) or obesity (2.75, 2.63, and 2.40 %) from 2021 to 2023. Among boys, 7.3 % were overweight and 2.8 % were obese. Among girls, 7.6 % were overweight and 2.3 % were obese. Vitamin D deficiency (2.10, 1.70, and 1.01 %) and insufficiency rate (24.09, 18.42, and 15.44 %) showed a decreasing trend. Deficiency or insufficiency was most common in children aged 36-59 months, and serum 25- (OH) vitamin D levels were significantly lower in winter compared to other seasons, with the highest levels in summer. Time spent outdoors was significantly less among children with vitamin D deficiency or insufficiency, and preschoolers who spent more than 2.94 h/day had higher serum vitamin D level. Serum 25- (OH) vitamin D levels were negatively correlated with body mass index (BMI), with overweight or obesity preschoolers showing significantly lower than their normal weight group. After adjusting for age, gender and season, family economic status, guardian educational level and time spent outdoors, the odds of vitamin D deficiency and insufficiency in overweight or obesity in preschoolers were 1.025 (95 % Cl: 1.002-1.174), 1.218 (95 % Cl: 1.099-1.708), respectively.
From 2021 to 2023, there was no significant change in the incidence of overweight or obesity among preschool children in Beijing. Furthermore, the rate of vitamin D deficiency or insufficiency decreased year by year. Vitamin D deficiency or insufficiency associates with factors such as age, season of the year, and time spent outdoors, and there is an association between overweight or obesity and vitamin D status among preschoolers.
以往研究表明，维生素D缺乏是儿童和青少年肥胖的一个风险因素，但大多数研究聚焦于学龄儿童和青少年，对学龄前儿童关注较少。
探讨北京学龄前儿童维生素D摄入情况下超重或肥胖的关系，并分析相关性。
共招募51640名1至6岁学龄前儿童（男孩26775名，女孩24865名）进行体检。超重或肥胖根据世界卫生组织儿童生长发育标准（2006年版）定义。采用标准化液相色谱-串联质谱法（LC-MS/MS）测定血清25-羟基（OH）维生素D水平，并根据《中国儿童维生素D营养相关临床问题实践指南（2022）》评估维生素D状况。
2021年至2023年，超重（7.72%、7.51%和7.24%）或肥胖（2.75%、2.63%和2.40%）发生率无显著变化。男孩中，7.3%超重，2.8%肥胖。女孩中，7.6%超重，2.3%肥胖。维生素D缺乏率（2.10%、1.70%和1.01%）和不足率（24.09%、18.42%和15.44%）呈下降趋势。36至59月龄儿童中缺乏或不足最为常见，冬季血清25-（OH）维生素D水平显著低于其他季节，夏季最高。维生素D缺乏或不足的儿童户外活动时间显著减少，每天户外活动超过2.94小时的学龄前儿童血清维生素D水平较高。血清25-（OH）维生素D水平与体重指数（BMI）呈负相关，超重或肥胖的学龄前儿童显著低于正常体重组。在调整年龄、性别和季节以及家庭经济状况、监护人教育水平和户外活动时间后，学龄前儿童超重或肥胖时维生素D缺乏和不足的比值比分别为1.025（95%Cl：1.002-1.174）、1.218（95%Cl：1.099-1.708）。
2021年至2023年，北京学龄前儿童超重或肥胖发生率无显著变化。此外，维生素D缺乏或不足率逐年下降。维生素D缺乏或不足与年龄、季节和户外活动时间等因素有关，学龄前儿童超重或肥胖与维生素D状况之间存在关联。
