Vitamin D Status and Its Influence on the Health of Preschool Children in Hangzhou

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Abstract

Objective: Vitamin D deficiency and insufficiency in children are global public health problems. However, few studies have focused on vitamin D status in healthy preschool children, especially in Asia. This study aimed to investigate vitamin D status and host-related factors in healthy preschool children in Hangzhou to analyze the impact of low vitamin D levels (<30 ng/mL) on health outcomes (obesity, early childhood caries, and respiratory tract infections).

Methods: A total of 1,510 healthy children aged 24–72 months from 15 kindergartens in Hangzhou were included. Data on the children's gender, age, body mass index (BMI), caries, and blood samples available for vitamin D analysis were collected from June to August 2018. A total of 325 children aged 36–48 months took part in a survey on the frequency of respiratory tract infections in the last year.

Results: The children's mean 25(OH)D level was 28.01 ± 7.29 ng/mL. A total of 11.4% of the children had vitamin D deficiency, and 52.6% had vitamin D insufficiency. Only 36.0% had vitamin D sufficiency. No significant difference was found by gender or BMI group. However, children in the obesity group had the highest prevalence of vitamin D deficiency and the lowest 25(OH)D levels. A significant negative correlation was found between the 25(OH)D level and child age ( r = −0.144, p < 0.001). Regression analysis showed that the children’s 25(OH)D levels decreased by 0.17 ng/mL per month with age. In addition, children with low vitamin D levels might increase the risk of obesity and early childhood caries. Multiple linear regression indicated that the number of caries in children increased by 0.08 per 1-ng/mL decrease in the 25(OH)D level ( β = −0.08, p < 0.001).

Conclusion: Vitamin D deficiency/insufficiency is a serious problem among healthy preschool children in Hangzhou. Public health policies or interventions should be implemented to ensure that preschool children have adequate vitamin D to reduce the risk of related diseases.

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Most cited references 37

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Global prevalence and disease burden of vitamin D deficiency: a roadmap for action in low‐ and middle‐income countries

Daniel E. Roth, Steven A. Abrams, John F. Aloia … (2018)

Vitamin D is an essential nutrient for bone health and may influence the risks of respiratory illness, adverse pregnancy outcomes, and chronic diseases of adulthood. Because many countries have a relatively low supply of foods rich in vitamin D and inadequate exposure to natural ultraviolet B (UVB) radiation from sunlight, an important proportion of the global population is at risk of vitamin D deficiency. There is general agreement that the minimum serum/plasma 25-hydroxyvitamin D concentration (25(OH)D) that protects against vitamin D deficiency–related bone disease is approximately 30 nmol/L; therefore, this threshold is suitable to define vitamin D deficiency in population surveys. However, efforts to assess the vitamin D status of populations in low- and middle-income countries have been hampered by limited availability of population-representative 25(OH)D data, particularly among population subgroups most vulnerable to the skeletal and potential extraskeletal consequences of low vitamin D status, namely exclusively breastfed infants, children, adolescents, pregnant and lactating women, and the elderly. In the absence of 25(OH)D data, identification of communities that would benefit from public health interventions to improve vitamin D status may require proxy indicators of the population risk of vitamin D deficiency, such as the prevalence of rickets or metrics of usual UVB exposure. If a high prevalence of vitamin D deficiency is identified ( > 20% prevalence of 25(OH)D 1%), food fortification and/or targeted vitamin D supplementation policies can be implemented to reduce the burden of vitamin D deficiency–related conditions in vulnerable populations.

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Vitamin D Deficiency and Oral Health: A Comprehensive Review

João Botelho, Vanessa Machado, Luis Proença … (2020)

Vitamin D (VD) levels have been gaining growing attention in Oral Health. During growth and adulthood, VD deficiency (VDD) is associated with a wide variety of oral health disorders, and impaired VD synthesis may expedite some of these conditions. In children, severe VDD can induce defective tooth mineralization, resulting in dentin and enamel defects. As a consequence, these defects may increase the risk of the onset and progression of dental caries. Further, VDD has been associated with higher prevalence of periodontitis and gingival inflammation, and several recent preclinical and clinical studies have unveiled potential pathways through which Vitamin D may interact with the periodontium. VDD correction through supplementation may contribute to a successful treatment of periodontitis; however, alveolar bone regeneration procedures performed in baseline VDD patients seem more prone to failure. Vitamin D may also be linked with some oral pathology entities such as certain oral cancers and events of osteonecrosis of the jaw. This review aims to provide comprehensive evidence of how VD levels should be considered to promote good oral health, and to summarize how VDD may hamper oral development and its role in certain oral conditions.

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The association between vitamin D status and infectious diseases of the respiratory system in infancy and childhood

Dimitra Zisi, Anna Challa, Alexandros Makis (2019)

Purpose Respiratory tract infections (RTIs) are a major cause of illness worldwide and the most common cause of hospitalization for pneumonia and bronchiolitis. These two diseases are the leading causes of morbidity and mortality among children under 5 years of age. Vitamin D is believed to have immunomodulatory effects on the innate and adaptive immune systems by modulating the expression of antimicrobial peptides, like cathelicidin, in response to both viral and bacterial stimuli. The aim of this review is to summarize the more recently published data with regard to potential associations of 25-hydroxyvitamin D [25(OH)D] with infectious respiratory tract diseases of childhood and the possible health benefits from vitamin D supplementation. Methods The literature search was conducted by using the PubMed, Scopus, and Google Scholar databases, with the following keywords: vitamin D, respiratory tract infection, tuberculosis, influenza, infancy, and childhood. Results Several studies have identified links between inadequate 25(OH)D concentrations and the development of upper or lower respiratory tract infections in infants and young children. Some of them also suggest that intervention with vitamin D supplements could decrease both child morbidity and mortality from such causes. Conclusions Most studies agree in that decreased vitamin D concentrations are prevalent among most infants and children with RTIs. Also, normal to high-serum 25(OH)D appears to have some beneficial influence on the incidence and severity of some, but not all, types of these infections. However, studies with vitamin D supplementation revealed conflicting results as to whether supplementation may be of benefit, and at what doses.

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Author and article information

Contributors

Zhaojun Chen: URI : http://loop.frontiersin.org/people/424425/overview

Xi Lv: URI : http://loop.frontiersin.org/people/1321630/overview

Xia Qian: URI : http://loop.frontiersin.org/people/1321637/overview

Ting Wu: URI : http://loop.frontiersin.org/people/1321619/overview

Yunxia Zhu: URI : http://loop.frontiersin.org/people/1321623/overview

Journal

Journal ID (nlm-ta): Front Public Health

Journal ID (iso-abbrev): Front Public Health

Journal ID (publisher-id): Front. Public Health

Title: Frontiers in Public Health

Publisher: Frontiers Media S.A.

ISSN (Electronic): 2296-2565

Publication date (Electronic): 17 May 2021

Publication date Collection: 2021

Volume: 9

Electronic Location Identifier: 675403

Affiliations

[1] ¹Department of Child Health Care, Hangzhou Women's Hospital (Hangzhou Maternity and Child Care Hospital) , Hangzhou, China

[2] ²Department of Teaching Office, Hangzhou First People's Hospital , Hangzhou, China

Author notes

Edited by: Pietro Vajro, University of Salerno, Italy

Reviewed by: Nasser M. Al-Daghri, King Saud University, Saudi Arabia; Khaled Saad, Assiut University Hospital, Egypt

*Correspondence: Yunxia Zhu 544039114@ 123456qq.com

This article was submitted to Children and Health, a section of the journal Frontiers in Public Health

†These authors have contributed equally to this work

Article

DOI: 10.3389/fpubh.2021.675403

PMC ID: 8165265

PubMed ID: 34079788

SO-VID: 0a12f091-eca5-4674-aea2-6eda8d3d0dda

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

History

Date received : 03 March 2021

Date accepted : 30 March 2021

Page count

Figures: 2, Tables: 3, Equations: 0, References: 37, Pages: 9, Words: 6516

Funding

Funded by: Basic Public Welfare Research Program of Zhejiang Province 10.13039/501100017577

Funded by: Hangzhou Social Development of Scientific Research 10.13039/100017363

Vitamin D Status and Its Influence on the Health of Preschool Children in Hangzhou

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Most cited references 37

Global prevalence and disease burden of vitamin D deficiency: a roadmap for action in low‐ and middle‐income countries

Vitamin D Deficiency and Oral Health: A Comprehensive Review

The association between vitamin D status and infectious diseases of the respiratory system in infancy and childhood

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