银川市中小学生维生素D营养状况及影响因素

Vitamin D nutritional status and related factors in primary and secondary school students in Yinchuan

目的了解银川6~18岁儿童青少年的维生素D营养状况及其影响因素,为改善儿童青少年维生素D营养状况提供理论依据。方法采用分层整群随机抽样方法,从银川市抽取小学、初中、高中各2所共36个班1615名学生作为调查对象,进行静脉采血、体格检查和问卷调查。结果学生维生素D缺乏率和适宜率分别为66.9%和33.1%,不同年龄组间维生素D缺乏率差异有统计学意义(χ^2=25.65,P<0.05),6岁组最高(79.2%),其次为13岁组(76.6%)和12岁组(75.3%)。二元Logistic回归分析结果显示,影响儿童青少年维生素D营养状况的因素有年龄(OR=0.95)、每日户外运动时间(OR=0.49)、纯母乳喂养(OR=0.63)和母亲学历(高中及大专、本科及以上的OR值分别为0.73,0.43);决策树QUEST和Logistic回归组合模型结果显示,影响儿童青少年维生素D营养状况的关键因素有每日户外运动时间、年龄、母亲学历、体质量指数(BMI)以及户外运动时间和年龄、户外运动时间和母亲学历、年龄和母亲学历、纯母乳喂养和BMI之间的交互作用。结论银川学生维生素D营养状况不良检出率较高,影响维生素D营养状况的关键因素有每日户外运动时间、年龄、母亲学历、BMI以及户外运动时间和年龄、户外运动时间和母亲学历、年龄和母亲学历、纯母乳喂养和BMI之间的交互作用。

Objective To understand the vitamin D nutritional status and associated factors of children and adolescents aged 6-18 in Yinchuan,so as to provide theoretical basis for improving the vitamin D malnutrition status of children and adolescents.Methods Using stratified cluster sampling method,1615 children and adolescents from 36 classes in 2 primary schools,junior high schools and high schools were randomly selected from Yinchuan,Ningxia.Venous blood sampling,physical examinations and questionnaires were conducted.Results The vitamin D deficiency rate and appropriate rate for students were 66.9%and33.1%,respectively.There was a statistically significant difference in vitamin D deficiency among different age groups(χ^2=25.65,P<0.05).The 6-year-old group had the highest(79.2%),followed by the 13-year-old group(76.6%),and the 12-year-old group(75.3%).The results of binary Logistic regression showed that the factors influencing the vitamin D nutritional status of children and adolescents included age(OR=0.95),daily outdoor exercise time(OR=0.49),exclusive breastfeeding(OR=0.63)and mother’s education(OR=0.73,0.43).The decision tree QUEST and Logistic regression combination model results show that the key factors affecting vitamin D nutrition status include daily outdoor exercise time,age,mother’s education,BMI,and interaction between outdoor exercise time and age,interaction between outdoor exercise time and mother’s education,interaction between age and mother’s education,interaction between exclusive breastfeeding and BMI.Conclusion The detection rate of vitamin D deficiency in children and adolescents aged 6-18 in Yinchuan is high,factors associated with vitamin D nutritional status includes daily outdoor exercise time,age,mother’s education,BMI,and interaction between outdoor exercise time and age,interaction between outdoor exercise time and mother’s education,interaction between age and mother’s education,interaction between exclusive breastfeeding and BMI.