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中国大陆儿童维生素D营养状况的Meta分析 被引量:13

Meta-analysis of Vitamin D Nutritional Status of Children in Chinese Mainland
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摘要 背景近几年来全球维生素D营养状况备受关注,不同国家和地区的维生素D营养状况可能存在差异,我国关于儿童维生素D营养状况多中心大样本量的相关研究较少。目的分析中国大陆地区儿童维生素D水平的营养状况。方法检索PubMed、EMBase、The Cochrane Library、万方数据知识服务平台、中国知网、中国生物医学文献数据库、维普网等数据库,收集第一作者、发表时间、地区(南/北)、样本量、性别、年龄、结局指标{血清25羟维生素D〔25(OH)D〕水平、血清25(OH)D水平缺乏(<20μg/L)率}等信息,检索时间为建库至2020-04-08。两名研究者独立提取资料并评价文献偏倚风险。采用RevMan 5.2以及Stata 14.0软件进行Meta分析。结果共纳入29篇文献,133441例健康儿童青少年,平均血清25(OH)D水平为(29.62±12.45)μg/L。Meta分析结果显示,我国大陆儿童维生素D缺乏率为21.4%〔95%CI(17.5%,25.4%)〕,南方地区儿童维生素D缺乏率为17.5%〔95%CI(13.1%,22.0%)〕,北方地区儿童维生素D缺乏率为29.0%〔95%CI(19.4%,38.6%)〕。不同性别儿童维生素D缺乏率〔OR=0.99,95%CI(0.95,1.03),P=0.71〕、血清25(OH)D水平〔SMD=0.01,95%CI(-0.24,0.26),P=0.95〕比较,差异均无统计学意义。婴儿组血清25(OH)D水平高于幼儿组〔SMD=0.16,95%CI(0.06,0.27),P=0.002〕、学龄前组〔SMD=0.77,95%CI(0.55,1.00),P<0.00001〕、学龄儿童青少年组〔SMD=0.65,95%CI(0.27,1.04),P=0.0001〕,南方地区婴儿组血清25(OH)D水平高于幼儿组〔SMD=1.51,95%CI(0.31,2.72),P=0.01〕、学龄前组〔SMD=6.22,95%CI(3.97,8.47),P<0.00001〕、学龄儿童青少年组〔SMD=6.80,95%CI(2.95,10.65),P<0.0005〕,北方地区婴儿组血清25(OH)D水平高于幼儿组〔SMD=1.23,95%CI(0.33,2.12),P=0.007〕、学龄前组〔SMD=8.41,95%CI(2.04,14.79),P=0.01〕。幼儿组血清25(OH)D水平高于学龄前组〔SMD=0.61,95%CI(0.43,0.80),P<0.00001〕、学龄儿童青少年组〔SMD=0.65,95%CI(0.27,1.04),P=0.001〕,南方地区幼儿组血清25(OH)D水平高于学龄前组〔SMD=5.53,95%CI(3.57,7.49),P<0.00001〕、学龄儿童青少年组〔SMD=6.07,95%CI(3.04,9.10),P<0.0001〕,北方地区幼儿组血清25(OH)D水平高于学龄前组〔SMD=6.56,95%CI(1.19,11.92),P=0.02〕。学龄前组血清25(OH)D水平高于学龄儿童青少年组〔SMD=0.33,95%CI(0.15,0.51),P=0.0004〕,南方地区学龄前组血清25(OH)D水平高于学龄儿童青少年组〔SMD=1.89,95%CI(0.58,3.21),P<0.005〕,北方地区学龄前组血清25(OH)D水平高于学龄儿童青少年组〔SMD=4.94,95%CI(1.51,8.38),P=0.005〕。结论中国大陆儿童维生素D缺乏仍较严峻,不同性别儿童维生素D水平对比无明显差异,儿童维生素D水平和年龄密切相关,但是仍需进一步研究证实。 Background The global vitamin D nutritional status has attracted much attention recently.Vitamin D nutritional status may differ by country or region.There are few multicenter studies with a large sample size on vitamin D nutritional status in Chinese children.Objective To analyze the vitamin D nutritional status in children in Chinese mainland.Methods Studies regarding vitamin D nutritional status in children in Chinese mainland were collected by searching databases of PubMed,Embase,The Cochrane Library,Wanfang Data,CNKI,SinoMed and CQVIP from database inception to 2020-04-08.Two researchers separately extracted information from the eligible studies,encompassing the first author,publication time,the region(northern or southern China)where participants live,size,sex ratio,age of the sample,and outcome indicators〔serum 25(OH)D level,rate of vitamin D deficiency serum 25(OH)D level <20 μg/L〕,and assessed the publication bias.Meta-analysis was carried out using RevMan 5.2 and Stata 14.0.Results A total of 29 studies with 133 441 healthy children and adolescents were enrolled.The average serum 25(OH)D level was (29.62±12.45)μg/L for all participants.Meta-analysis indicated that the prevalence of vitamin D deficiency in all participants,participants from southern and northern China,was 21.4%〔95%CI(17.5%,25.4%)〕,17.5%〔95%CI(13.1%,22.0%)〕,and 29.0%〔95%CI(19.4%,38.6%)〕,respectively.No significant sex-based differences were found in the prevalence of vitamin D deficiency 〔OR=0.99,95%CI(0.95,1.03),P=0.71〕,and average serum 25(OH)D level〔SMD=0.01,95%CI(-0.24,0.26),P=0.95〕.Infants had higher average serum 25(OH)D level than young children〔SMD=0.16,95%CI(0.06,0.27),P=0.002〕,preschool children〔SMD=0.77,95%CI(0.55,1.00),P<0.000 01〕,and school-age children and adolescents〔SMD=0.65,95%CI(0.27,1.04),P=0.000 1〕.In participants from southern China,infants had higher average serum 25(OH)D level than young children〔SMD=1.51,95%CI(0.31,2.72),P=0.01〕,preschool children〔SMD=6.22,95%CI(3.97,8.47),P<0.000 01〕,and school-age children and adolescents〔SMD=6.80,95%CI(2.95,10.65),P<0.000 5〕.In those from northern China,infants had higher average serum 25(OH)D level than young children〔SMD=1.23,95%CI(0.33,2.12),P=0.007〕and preschool children〔SMD=8.41,95%CI(2.04,14.79),P=0.01〕.Young children had higher average serum 25(OH)D level than preschool children〔SMD=0.61,95%CI(0.43,0.80),P<0.000 01〕,and school-age children and adolescents〔SMD=0.65,95%CI(0.27,1.04),P=0.001〕.In those from southern China,young children had higher average serum 25(OH)D level than preschool children〔SMD=5.53,95%CI(3.57,7.49),P<0.000 01〕,and school-age children and adolescents〔SMD=6.07,95%CI(3.04,9.10),P<0.000 1〕.In those from northern China,young children had higher average serum 25(OH)D level than preschool children 〔SMD=6.56,95%CI(1.19,11.92),P=0.02〕.Preschool children had higher average serum 25(OH)D level than school-age children and adolescents〔SMD=0.33,95%CI(0.15,0.51),P=0.000 4〕.In those from southern China,the average serum 25(OH)D level in preschool children was higher than that in school-age children and adolescents〔SMD=1.89,95%CI(0.58,3.21),P<0.005〕.In those from northern China,the average serum 25(OH)D level in preschool children was higher than that in school-age children and adolescents with no statistical difference〔SMD=4.94,95%CI(1.51,8.38),P=0.005〕.Conclusion In Chinese mainland,the prevalence of vitamin D deficiency in children was relatively high.The vitamin D level was not associated with sex,but may be closely related to age.However,our conclusion still needs to be verified by further research.
作者 苏晶莹 陈先睿 林刚曦 SU Jingying;CHEN Xianrui;LIN Gangxi(School of Clinical Medicine,Fujian Medical University,Fuzhou 350122,China;Department of Pediatrics,Xinglin Branch of the First Affiliated Hospital of Xiamen University,Xiamen 361022,China;Department of Pediatrics,the First Affiliated Hospital of Xiamen University/Pediatric Key Laboratory of Xiamen/Institute of Pediatrics,School of Medicine,Xiamen University,Xiamen 361003,China)
出处 《中国全科医学》 CAS 北大核心 2021年第32期4126-4136,共11页 Chinese General Practice
关键词 营养状况 维生素D 25羟维生素D 25(OH)D 儿童 META分析 中国 Nutritional status Vitamin D 25 hydroxy vitamin D 25(OH)D Child Meta-analysis China
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