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Zhang Y, Ni P, Miao Y, Chen H, Tang L, Song H, Li W, Li X. Vitamin D 3 improves glucose metabolism and attenuates inflammation in prediabetic human and mice. J Nutr Biochem 2024; 130:109659. [PMID: 38685284 DOI: 10.1016/j.jnutbio.2024.109659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 04/08/2024] [Accepted: 04/22/2024] [Indexed: 05/02/2024]
Abstract
Prediabetes is a crucial stage for prevention and treatment of diabetes, and vitamin D (VD) has been found to be linked to the development of prediabetes and diabetes. Thus, we aimed to identify the effect of VD supplementation on glucose metabolism in prediabetic participants and mice. A 1:1 paired design of randomized, placebo-controlled trial with 1600 IU/day VD3 or placebo was administered to individuals with prediabetes, two-way repeated-measures ANCOVA was used to analyze glycolipid and inflammatory factors. A high-fat diet induced prediabetic KKay mice were utilized to evaluate the effects of VD3 with 16 weeks supplementation. Generalized estimation equation, one way ANOVA were used to analyze continuous monitoring indexes and terminal indexes, respectively. Exercise capacity, skeletal muscle pathological features and relevant proteins were examined. The clinical results showed that VD3 could improve insulin secretion and decrease inflammation. Results of KKay mice exhibited that VD3 not only ameliorate glycolipid metabolism and inflammatory indicators, but also regulated pathological changes of skeletal muscle and exercise capacity. Mechanistically, our results demonstrated that VD3 could inhibit the TLR4/NFκB and activate PI3K/AKT signaling pathway. Collectively, the study indicated that VD3 exerts its beneficial effects by inhibiting TLR4/NFκB to decrease inflammatory response, and activating PI3K/AKT signaling pathway to regulate glucose homeostasis.
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Affiliation(s)
- Yujing Zhang
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Peng Ni
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Yufan Miao
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Hao Chen
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Lulu Tang
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Hanlu Song
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Wenjie Li
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China.
| | - Xing Li
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China.
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Meiyun L, Li X, Xiaoyi L, Dan D. Epidemiologic and clinical differences between early-onset and later-onset childhood vitiligo: A retrospective cohort study. J Am Acad Dermatol 2024; 91:125-127. [PMID: 38467306 DOI: 10.1016/j.jaad.2024.02.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 12/09/2023] [Accepted: 02/27/2024] [Indexed: 03/13/2024]
Affiliation(s)
- Li Meiyun
- Department of Dermatology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xie Li
- Clinical Research Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liu Xiaoyi
- Department of Dermatology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Deng Dan
- Department of Dermatology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Zhang Y, Zhou L, Ren Y, Zhang H, Qiu W, Wang H. Assessment of serum vitamin D levels in children aged 0-17 years old in a Chinese population: a comprehensive study. Sci Rep 2024; 14:12562. [PMID: 38821990 PMCID: PMC11143243 DOI: 10.1038/s41598-024-62305-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 05/15/2024] [Indexed: 06/02/2024] Open
Abstract
Vitamin D deficiency and insufficiency pose global public health challenges, yet research on serum vitamin D levels in the 0-17-year-old age group in southeastern China remains limited. This study aimed to fill this gap by investigating serum 25(OH)D levels in children in the region aged 0-17 years, contributing crucial data for understanding vitamin D nutritional status. Liquid chromatography‒mass spectrometry/mass spectrometry (LC‒MS/MS) technology was used. Vitamin D testing was integrated into routine diagnostic procedures for 11,116 children in Wujiang District, Suzhou City. Among the 0-17-year age group, comprising 6348 boys and 4768 girls, the prevalence of serum 25(OH)D deficiency and insufficiency was 21.4% and 31.0%, respectively. The median serum 25(OH)D concentration was 29.72 ng/mL (21.84-39.84 ng/mL) in boys compared to 28.48 ng/mL (20.65-39.23 ng/mL) in girls. Seasonal variations were observed, with median serum 25(OH)D concentrations of 29.02 ng/mL (20.73-39.72 ng/mL) in spring, 28.79 ng/mL (21.53-39.37 ng/mL) in summer, 30.12 ng/mL (22.00-39.70 ng/mL) in autumn, and 28.58 ng/mL (19.97-39.46 ng/mL) in winter. Statistically significant differences were noted in the serum 25(OH)D levels during autumn and winter. In conclusion, the rate of adequate vitamin D levels in local children was 47.5%, revealing a relatively high prevalence of vitamin D deficiency (21.4%) and insufficiency (31.0%), especially during the post-preschool period. Advocating for vitamin D supplementation in children is crucial for ensuring adequate vitamin D support.
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Affiliation(s)
- Yuan Zhang
- Laboratory of Pediatric Research, Children's Hospital of Wujiang District, Suzhou, 215234, Jiangsu, People's Republic of China
| | - Lijun Zhou
- Laboratory of Pediatric Research, Children's Hospital of Wujiang District, Suzhou, 215234, Jiangsu, People's Republic of China
- Department of Clinical Laboratory, Children's Hospital of Wujiang District, Suzhou, 215234, Jiangsu, People's Republic of China
| | - Yaqiong Ren
- Laboratory of Pediatric Research, Children's Hospital of Wujiang District, Suzhou, 215234, Jiangsu, People's Republic of China
| | - Hongyan Zhang
- Laboratory of Pediatric Research, Children's Hospital of Wujiang District, Suzhou, 215234, Jiangsu, People's Republic of China
- Department of Clinical Laboratory, Children's Hospital of Wujiang District, Suzhou, 215234, Jiangsu, People's Republic of China
| | - Wenna Qiu
- Laboratory of Pediatric Research, Children's Hospital of Wujiang District, Suzhou, 215234, Jiangsu, People's Republic of China.
- Department of Clinical Laboratory, Children's Hospital of Wujiang District, Suzhou, 215234, Jiangsu, People's Republic of China.
| | - Hongying Wang
- Laboratory of Pediatric Research, Children's Hospital of Wujiang District, Suzhou, 215234, Jiangsu, People's Republic of China.
- Department of Clinical Laboratory, Children's Hospital of Wujiang District, Suzhou, 215234, Jiangsu, People's Republic of China.
- Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, 215025, Jiangsu, People's Republic of China.
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Zhou DY, Wei SM, Zhu CL, Wei YH, Wang XM, Yi LL, Yang ST, Peng QL. Age-, season- and gender-specific reference intervals of serum 25-hydroxyvitamin D 3 for healthy children (0 ~ 18 years old) in Nanning area of China. J Physiol Sci 2024; 74:2. [PMID: 38166513 PMCID: PMC10763313 DOI: 10.1186/s12576-023-00895-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/14/2023] [Indexed: 01/04/2024]
Abstract
Establishing specific reference intervals (RIs) of serum 25-hydroxyvitamin D3 [25(OH)D] for children is essential for improving the accuracy of diagnosis and prognosis monitoring of diseases such as rickets and growth retardation. The study including 6,627 healthy children was conducted to establish specific RIs of 25(OH)D for children in Nanning area of China. The results showed that there were statistically significant differences among age, season, and gender of serum 25(OH)D levels, and the age-specific RIs of serum 25(OH)D were 20.3 ~ 53.6 ng/mL for 0 ~ ≤ 1 year and 18.9 ~ 49.6 ng/mL for 2 ~ ≤ 3 years. The age-, season-specific RIs of serum 25(OH)D for 4 ~ ≤ 6 years in spring-summer and autumn-winter were 15.8 ~ 42.6 ng/mL and 15.2 ~ 37.7 ng/mL, respectively. The age-, gender-specific RIs of serum 25(OH)D for 7 ~ ≤ 18 years for males and females were 12.1 ~ 36.1 ng/mL and 10.8 ~ 35.3 ng/mL, respectively. This study successfully established the RIs of serum 25(OH)D, which may help to improve disease diagnosis and monitoring for children in the Nanning area of China.
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Affiliation(s)
- Dong-Yi Zhou
- Department of Clinical Laboratory, Guangxi International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, 530201, Guangxi, China
| | - Shang-Mou Wei
- Department of Clinical Laboratory, Guangxi International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, 530201, Guangxi, China
| | - Chun-Ling Zhu
- Department of Clinical Laboratory, Guangxi International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, 530201, Guangxi, China
| | - Yu-Hong Wei
- Department of Clinical Laboratory, Guangxi International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, 530201, Guangxi, China
| | - Xiao-Mei Wang
- Department of Clinical Laboratory, Guangxi International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, 530201, Guangxi, China
| | - Li-Ling Yi
- Department of Clinical Laboratory, Guangxi International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, 530201, Guangxi, China
| | - Si-Tao Yang
- Department of Clinical Laboratory, Guangxi International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, 530201, Guangxi, China
| | - Qi-Liu Peng
- Department of Clinical Laboratory, Guangxi International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, 530201, Guangxi, China.
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Xu L, Li P, Yuan D. Confirming the association between low serum 25OHD levels in girls with central precocious puberty and its severity. BMC Pediatr 2023; 23:624. [PMID: 38071297 PMCID: PMC10709894 DOI: 10.1186/s12887-023-04447-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 11/28/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND To assess the differences in vitamin D levels in girls with rapidly progressive (RP) or slowly progressive (SP) central precocious puberty (CPP) and to compare whether the factors related to RP-CPP influenced the vitamin D status. A cross-sectional study was performed among girls with CPP classified as RP-CPP or SP-CPP. METHODS The baseline data, gonadotropin-releasing hormone (GnRH) stimulation test results, serum 25-hydroxyvitamin D (25OHD) levels, and season of sample collection were analyzed. RESULTS The mean 25OHD level in 340 girls was 15.89 ± 6.87 ng/mL, of whom only 10 (2.9%) had normal levels (≥ 30 ng/mL). A total of 114 girls in the SP-CPP group and 226 in the RP-CPP group had similar chronological age, disease course, height SDS, bone mineral density, baseline follicle-stimulating hormone (FSH), peak FSH, and 25OHD levels. Developmental age, body mass index (BMI), BMI SDS, peak luteinizing hormone (LH)/FSH, insulin-like growth factor 1 (IGF-1), and IGF-1 SDS were independent risk factors for RP-CPP. Significant differences were observed among the different serum 25OHD levels in terms of season, disease course, IGF1 level, and BMI SDS (P < 0.05). Moreover, the sampling season was strongly correlated with serum 25OHD levels (r = 0.402, P < 0.001). CONCLUSION The vitamin D levels were generally deficient or insufficient in girls with CPP, but were not related to the different types of CPP. High BMI levels, IGF1 levels, or peak LH/FSH ratio, but not vitamin D levels, could promote the progression of RP-CPP. Seasonal factors mainly influenced the vitamin D levels.
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Affiliation(s)
- Liya Xu
- Department of Pediatric Endocrinology, Shanghai Children's Hospital, School of medicine, Shanghai Jiao Tong University, Shanghai, 200062, China
| | - Pin Li
- Department of Pediatric Endocrinology, Shanghai Children's Hospital, School of medicine, Shanghai Jiao Tong University, Shanghai, 200062, China.
| | - Dandan Yuan
- Department of Pediatric Endocrinology, Shanghai Children's Hospital, School of medicine, Shanghai Jiao Tong University, Shanghai, 200062, China
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Tung JYL, So HK, Tung KTS, Wong RSM, Tsang HW, Chan B, Tso WWY, Wong ICK, Yam JCS, Lee SLK, Pang G, Wong WHS, Cheung KW, Leung WC, Ip P. Natural history of infants with vitamin D deficiency in Hong Kong. Asia Pac J Clin Nutr 2023; 32:401-407. [PMID: 38135475 PMCID: PMC11090382 DOI: 10.6133/apjcn.202312_32(4).0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 10/27/2023] [Accepted: 07/12/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND AND OBJECTIVES The usual recommended intake of vitamin D for healthy infants is 400 international unit (IU) daily. However, a high dose of vitamin D at 2000-3000 IU daily is needed for those with vitamin D deficiency (VDD). This study aimed to assess the natural history of a group of healthy infants with VDD and the associated factors for persistent VDD. METHODS AND STUDY DESIGN Healthy infants detected to have VDD (25OHD <25 nmol/L) in a population study were followed, and their demographics and clinical data were collected. RESULTS One hundred and thirty-one subjects (boys = 66%) were included. Their first serum 25OHD was taken at a median age of 87.5 days. None were treated with high-dose vitamin D supplements, but some have been given vitamin D at 400 IU daily. They were assessed again at the median age of 252.5 days when 15 remained to have VDD and 26 were in the insufficient range (25 - 49.9nmol/L). All persistent VDD children were on exclusive breastfeeding. Exclusive breastfeeding and no vitamin D supplementation were significant risk factors for persistent vitamin D insufficiency (<50nmol/L). CONCLUSIONS Persistent VDD is common among infants exclusively breastfeeding and those who did not receive vitamin D supplementation.
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Affiliation(s)
- Joanna Yuet-Ling Tung
- Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong SAR, China
| | - Hung-Kwan So
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Keith Tsz-Suen Tung
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Rosa Sze-Man Wong
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
- Department of Special Education and Counselling, The Education University of Hong Kong, Hong Kong SAR, China
| | - Hing-Wai Tsang
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Bianca Chan
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Winnie Wan-Yee Tso
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Ian Chi-Kei Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong SAR, China
| | - Jason Cheuk-Sing Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Samantha Lai-Ka Lee
- Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong SAR, China
| | - Gloria Pang
- Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong SAR, China
| | - Wilfred Hing-Sang Wong
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Ka-Wang Cheung
- Department of Obstetrics and Gynaecology. The University of Hong Kong, Hong Kong SAR, China
| | - Wing-Cheong Leung
- Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Hong Kong SAR, China
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong SAR, China.
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
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Liu J, Liu J, Zhang J, Liu C, Qu C, Na L. Vitamin D deficiency in early life regulates gut microbiome composition and leads to impaired glucose tolerance in adult and offspring rats. Food Funct 2023. [PMID: 37285306 DOI: 10.1039/d3fo00503h] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Vitamin D has been found to be involved in glucose metabolism in recent years. Its deficiency is very common, especially in children. Whether vitamin D deficiency in early life affects adult diabetes risk is unknown. In this study, a rat model of early life vitamin D deficiency (F1 Early-VDD) was established by depriving it of vitamin D from the 0 to the 8th week. Further, some rats were switched to normal feeding conditions and sacrificed at the 18th week. Other rats were mated randomly to generate offspring rats (F2 Early-VDD), and F2 rats were fed under normal conditions and sacrificed at the 8th week. Serum 25(OH)D3 level decreased in F1 Early-VDD at the 8th week and returned to normal at the 18th week. Serum 25(OH)D3 level in F2 Early-VDD at the 8th week was also lower than that in control rats. Impaired glucose tolerance was observed in F1 Early-VDD at the 8th week and 18th week and also in F2 Early-VDD at the 8th week. The gut microbiota composition in F1 Early-VDD at the 8th week significantly changed. Among the top ten genera with a rich difference, Desulfovibrio, Roseburia, Ruminiclostridium, Lachnoclostridium, A2, GCA-900066575, Peptococcus, Lachnospiraceae_FCS020_ group, and Bilophila increased owing to vitamin D deficiency, whereas Blautia decreased. There were 108 significantly changed metabolites in F1 Early-VDD at the 8th week, of which 63 were enriched in known metabolic pathways. Correlations between gut microbiota and metabolites were analyzed. Blautia was positively related to 2-picolinic acid, whereas Bilophila was negatively related to indoleacetic acid. Moreover, some of the changes in microbiota, metabolites, and enriched metabolic pathways still existed in F1 Early-VDD rats at the 18th week and F2 Early-VDD rats at the 8th week. In conclusion, vitamin D deficiency in early life leads to impaired glucose tolerance in adult and offspring rats. This effect may be partly achieved by regulating gut microbiota and their co-metabolites.
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Affiliation(s)
- Jing Liu
- The College of Medical Technology, Shanghai University of Medicine and Health Sciences, Shanghai, China
- Department of Research, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Junyi Liu
- Department of Clinical Nutrition, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Jingyi Zhang
- College of Public Health, Shanghai University of Medicine and Health Sciences, Shanghai, China.
| | - Chunyan Liu
- College of Public Health, Shanghai University of Medicine and Health Sciences, Shanghai, China.
| | - Chunbo Qu
- College of Public Health, Shanghai University of Medicine and Health Sciences, Shanghai, China.
| | - Lixin Na
- College of Public Health, Shanghai University of Medicine and Health Sciences, Shanghai, China.
- Collaborative Innovation Center of Shanghai University of Medicine and Health Sciences, Shanghai, China
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Wu Y, Wang F, Li A, Gao J, Li B, Sheng H, Ma J, Liao X. Vitamin D status among infants and children in Shanghai, China: A hospital-based study. Food Sci Nutr 2023; 11:3111-3120. [PMID: 37324927 PMCID: PMC10261785 DOI: 10.1002/fsn3.3292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 01/20/2023] [Accepted: 02/24/2023] [Indexed: 09/20/2023] Open
Abstract
The variation in vitamin D status is still unclear. We aim to describe the vitamin D status among healthy infants and children in Shanghai (31° N latitude), one of the largest cities in China. We conducted a hospital-based, 2-year retrospective observational study and recruited children for health examination at the Tongren Hospital affiliated with Shanghai Jiao Tong University School of Medicine from January 2019 to December 2020. Serum 25-hydroxyvitamin D (25(OH)D) levels were measured using an enzyme-linked immunosorbent assay. A total of 6164 children aged 0-11 years were included. Of these, 94.4% of the serum 25(OH)D measurements at first assessment were within the range of 12-50 ng/mL. The median 25(OH)D level was 31.3 (IQR 25.6, 38.1) ng/mL, the percentages of 25(OH)D < 20 ng/mL and 25(OH)D < 30 ng/mL were 10.0% and 43.8%, respectively. Low vitamin D status (deficiency and insufficiency) differed significantly by age group (infants, toddlers, preschoolers, and schoolers) and seasonality (all p < .001), but not by gender. For the sub-group (n = 855) of children with repeated assessments, their low 25(OH)D levels increased significantly whether after about a 7-month (n = 351) or 12-month (n = 504) interval, and the increments of median 25(OH)D levels were 8.1 ng/mL and 2.1 ng/mL respectively (p < .001). This study documents the vitamin D status in Shanghai, showing that low vitamin D status is common in infants and children and suggesting that the assessment of 25(OH)D level is necessary for individuals who are at risk for deficiency or excess.
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Affiliation(s)
- Ying Wu
- Department of Pediatrics, Tongren HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Fang Wang
- Department of Pediatrics, Tongren HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Aiguo Li
- Department of Pediatrics, Tongren HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Jiangfang Gao
- Department of Pediatrics, Tongren HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Bosheng Li
- Department of Laboratory Medicine, Tongren HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Huiming Sheng
- Department of Laboratory Medicine, Tongren HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Jun Ma
- Center for Community Health CareShanghai Jiao Tong University China Hospital Development InstituteShanghaiChina
| | - Xiang‐Peng Liao
- Department of Pediatrics, Tongren HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
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Bai K, Dong H, Liu L, She X, Liu C, Yu M, Liang Z, Lin H, Ke P, Huang X, Wu X, Zhang Q, Zhao B. Serum 25-hydroxyvitamin D status of a large Chinese population from 30 provinces by LC-MS/MS measurement for consecutive 3 years: differences by age, sex, season and province. Eur J Nutr 2023; 62:1503-1516. [PMID: 36692589 DOI: 10.1007/s00394-023-03094-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 01/12/2023] [Indexed: 01/25/2023]
Abstract
PURPOSE We aimed to describe the vitamin D status and its distribution in different age groups, sexes, seasons, and provinces of a large Chinese population. METHODS This study retrospectively analyzed 1,528,685 results of serum 25-hydroxyvitamin D (25(OH)D) in the central laboratory of KingMed Diagnostics. The samples were from the individuals aged 0-119 years old in 30 provinces of China. Serum 25(OH)D was measured by an accurate commercial liquid chromatography-tandem mass spectrometry (LC-MS/MS) method from January 2017 to December 2019. The subjects were stratified by age, sex, the season of blood collection, and the province of residence. RESULTS The median 25(OH)D concentration was 25.5 ng/mL (interquartile range (IQR) 18.7-32.7 ng/mL) in males and 20.8 ng/mL (IQR 14.4-28.2 ng/mL) in females. Overall, the median 25(OH)D concentration decreased with age in both males and females. Males had a 0.2-2.4 ng/mL higher median 25(OH)D concentration than females in different age groups. Vitamin D deficiency (25(OH)D < 15 ng/mL for the individuals under 14 years old; < 20 ng/mL for the individuals over 14 years old) was found in 21.3% of males and 43.6% of females. Significant seasonal variation of serum 25(OH)D concentrations was repeatedly observed in 3 years, with median concentration higher in summer (25.3 ng/mL (IQR 19.3-31.9 ng/mL)) and lower in winter (18.5 ng/mL (IQR 12.3-26.6 ng/mL)). Vitamin D status varied by province. The median 25(OH)D concentration was the highest in Hainan (31.0 ng/mL (IQR 24.9-39.2 ng/mL)) and the lowest in Qinghai (14.4 ng/mL (IQR 9.6-20.0 ng/mL)). 25(OH)D2 was detected in 12.2% of the results, and no significant seasonal variation was observed. CONCLUSION In China, vitamin D deficiency is prevalent in the population participating in clinical vitamin D measurement. Age and sex differences in vitamin D levels were observed in our study. Seasonal variation and provincial differences are important aspects of serum vitamin D status. 25(OH)D2 cannot be ignored entirely in clinical measurement practice in China.
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Affiliation(s)
- Kai Bai
- Department of Laboratory Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, 510120, China
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
| | - Heng Dong
- Guangzhou KingMed Center for Clinical Laboratory Co., Ltd., Guangzhou, 510120, China
- KingMed College of Laboratory Medical of Guangzhou Medical University, Guangzhou, 510120, China
| | - Ling Liu
- Department of Paediatrics, The Third Affiliated Hospital of Guangdong Medical University (Longjiang Hospital of Shunde District Foshan City), Foshan, 528318, China
| | - Xuhui She
- Guangzhou KingMed Center for Clinical Laboratory Co., Ltd., Guangzhou, 510120, China
- KingMed College of Laboratory Medical of Guangzhou Medical University, Guangzhou, 510120, China
| | - Chang Liu
- Guangzhou KingMed Center for Clinical Laboratory Co., Ltd., Guangzhou, 510120, China
| | - Mujun Yu
- Guangzhou KingMed Center for Clinical Laboratory Co., Ltd., Guangzhou, 510120, China
| | - Zhihui Liang
- Guangzhou KingMed Center for Clinical Laboratory Co., Ltd., Guangzhou, 510120, China
| | - Haibiao Lin
- Department of Laboratory Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, 510120, China
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
| | - Peifeng Ke
- Department of Laboratory Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, 510120, China
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
| | - Xianzhang Huang
- Department of Laboratory Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, 510120, China
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
| | - Xinzhong Wu
- Department of Laboratory Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, 510120, China.
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, 510120, China.
| | - Qiaoxuan Zhang
- Department of Laboratory Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, 510120, China.
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, 510120, China.
| | - Beibei Zhao
- Guangzhou KingMed Center for Clinical Laboratory Co., Ltd., Guangzhou, 510120, China.
- KingMed College of Laboratory Medical of Guangzhou Medical University, Guangzhou, 510120, China.
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Welser L, Pfeiffer KA, Silveira JFDC, Valim ARDM, Renner JDP, Reuter CP. Incidence of Arterial Hypertension is Associated with Adiposity in Children and Adolescents. Arq Bras Cardiol 2023; 120:e20220070. [PMID: 36888776 DOI: 10.36660/abc.20220070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 10/05/2022] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND The increase of hypertension in children and adolescents has attracted the attention of the scientific community largely due to its association with the obesity epidemic. OBJECTIVES To describe the incidence of hypertension and its relationship with the cardiometabolic and genetic profile in children and adolescents from a city in southern Brazil in a three-year period. METHODS This longitudinal study followed 469 children and adolescents, aged 7-17 years old (43.1% boys), assessed at two-time points. We evaluated systolic and diastolic blood pressures (SBP and DBP), waist circumference (WC), body mass index (BMI), body fat percentage (%BF), lipid profile, glucose, cardiorespiratory fitness (CRF), and rs9939609 Polymorphism ( FTO ). Cumulative incidence of hypertension was calculated, and multinomial logistic regression was conducted. The statistical significance was established as p < 0.05. RESULTS After three years, the incidence of hypertension was 11.5%. Overweight or obese individuals were more likely to become borderline hypertensive (overweight OR: 3.22, 95% CI: 1.08-9.55; obesity OR: 4.05, 95% CI: 1.68-9.75), and obese individuals were more likely to become hypertensive (obesity OR: 4.84, 95% CI: 1.57-14.95). High-risk WC and %BF values were associated with hypertension development (OR: 3.41, 95% CI: 1.26-9.19; OR: 2.49, 95% CI: 1.08-5.75, respectively). CONCLUSIONS We found a higher incidence of hypertension in children and adolescents as compared with previous studies. Individuals with higher values of BMI, WC and %BF at baseline were more likely to develop hypertension, suggesting the importance of adiposity in the development of hypertension even in such a young population.
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Affiliation(s)
- Letícia Welser
- Universidade de Santa Cruz do Sul, Santa Cruz do Sul, RS - Brasil
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11
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Liu J, Fu L, Jin S, Jia Y, Zhang J, Sun C, Na L. Vitamin D status in children and its association with glucose metabolism in northern China: a combination of a cross-sectional and retrospective study. BMJ Open 2022; 12:e061146. [PMID: 36446458 PMCID: PMC9710338 DOI: 10.1136/bmjopen-2022-061146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES This study aimed to explore the vitamin D status of children in northern China and the association between vitamin D and glucose metabolism. DESIGN Cross-sectional study was conducted among child participants and retrospective study designs were conducted among adult participants. SETTING AND PARTICIPANTS Both studies were recruited from Harbin, 326 children were included in children's study, 8469 adults were included in adult study. PRIMARY AND SECONDARY OUTCOME MEASURES Physical examination, lifestyle and dietary habit data were recorded in all the participants. Serum insulin, glucose, 25(OH)D3 concentrations in children and serum glucose and lipids levels in adults were measured. Rickets history was also investigated in adults, which was used to define vitamin D deficiency in childhood. The associations were tested by linear regression and binary logistic regression. RESULT In the children's study, only 10.7% of participants were vitamin D sufficient (≥30 ng/mL). Inverse correlations between serum 25(OH)D3 concentration and fasting insulin and homeostasis model assessment - insulin resistance (HOMA-IR) were found, and children with lower serum 25(OH)D3 concentrations were likely to have insulin resistance (IR) (OR: 0.955, 95% CI: 0.917 to 0.995, p value: 0.027). In an adult study, rickets in childhood increased the risk of type 2 diabetes in male participants (OR=1.414, 95% CI=1.013 to 1.972; p value=0.042), but this result was not observed in female participants. CONCLUSION Our findings suggest that vitamin D deficiency is widespread in northern China. Vitamin D deficiency in childhood was associated with IR and increased the risk of type 2 diabetes in male adults.
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Affiliation(s)
- Junyi Liu
- Department of Clinical Nutrition, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
- Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Liqun Fu
- Department of Clinical Nutrition, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Shanshan Jin
- Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yubing Jia
- Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Jingyi Zhang
- Department of Nutrition and food hygiene, College of Public Health, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Changhao Sun
- Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Lixin Na
- Department of Nutrition and food hygiene, College of Public Health, Shanghai University of Medicine and Health Sciences, Shanghai, China
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12
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Chen C, Zhou C, Liu S, Jiao X, Wang X, Zhang Y, Yu X. Association between Suboptimal 25-Hydroxyvitamin D Status and Overweight/Obesity in Infants: A Prospective Cohort Study in China. Nutrients 2022; 14:nu14224897. [PMID: 36432582 PMCID: PMC9698418 DOI: 10.3390/nu14224897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 11/22/2022] Open
Abstract
This study aimed to investigate whether 25-hydroxyvitamin D (25(OH)D) concentrations are correlated to overweight/obesity in infants and to explore a threshold of 25(OH)D. A total of 1205 six-month-old infants from two community hospitals in Shanghai were randomly recruited, and 925 of them were followed up at 12 months. Concentration of 25(OH)D, weight, and length were measured at two time points. Overweight/obesity was defined as a weight-for-length Z-score >97th percentile. The prevalence of overweight/obesity at 6 and 12 months was 6.88% and 5.26%, respectively. The occurrence of vitamin D (VitD) deficiency (<20 ng/mL) at 6 and 12 months was 6.56% and 2.05%, respectively. Concentration of 25(OH)D at the corresponding age was negatively associated with weight-for-length percentile (WLP) at both 6 (adjusted β: −0.14; 95% CI: −0.27, −0.02; p = 0.02) and 12 months (adjusted β: −0.22; 95% CI: −0.41, −0.02; p = 0.03), while the relationship between 25(OH)D at 6 months and WLP at 12 months was nonlinear, where 35 ng/mL was identified as an inflection point. Those with a concentration of 25(OH)D <35 ng/mL at 6 months had a higher risk of overweight/obesity (adjusted OR: 1.42; 95% CI: 1.06, 1.91; p = 0.02) compared to the group with a concentration of 25(OH)D ≥35 ng/mL. Moreover, a concentration of 25(OH)D <35 ng/mL at two time points significantly increased the risk of overweight/obesity at 12 months compared to the group with 25(OH)D concentration ≥35 ng/mL at two time points (adjusted OR: 2.91; 95% CI: 1.13, 7.46; p = 0.03). A suboptimal 25(OH)D concentration <35 ng/mL significantly increases the risk of overweight/obesity in infants.
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Affiliation(s)
- Chen Chen
- Department of Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Chunyan Zhou
- Translational Medicine Institute, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Shijian Liu
- Department of Clinical Epidemiology and Biostatistics, Children Health Advocacy Institute, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
- School of Public Health, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Xianting Jiao
- Translational Medicine Institute, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
- Department of Pediatric Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Xirui Wang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Yue Zhang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Xiaodan Yu
- Department of Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
- MOE-Shanghai Key Lab of Children’s Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
- Correspondence:
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Wang J, Li X, Gan Y, Fan T, Yang J, Rao F, Yang J. Comparison of the Serum Total 25-Hydroxyvitamin D Concentrations Using Chemiluminescent Immunoassay and Liquid Chromatography-Tandem Mass Spectrometry in Children. J Nutr Sci Vitaminol (Tokyo) 2022; 68:181-188. [PMID: 35768249 DOI: 10.3177/jnsv.68.181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We aimed to assess the difference and agreement between the CL-series Vitamin D Total assay (Mindray), which was a kind of chemiluminescent immunoassay (CLIA) and liquid chromatography-tandem mass spectrometry (LC-MS/MS) in the measurement of serum 25-hydroxyvitamin D [25(OH)D] concentrations in children. We compared the 25(OH)D concentrations of 92 children using the CLIA and LC-MS/MS. Paired samples t-test was used to compare the two groups. Linear regression was used to show the correlation between CLIA and LC-MS/MS. The difference and bias between 2 methods were revealed in Bland-Altman plot. Agreement in classification of deficiency between CLIA and LC-MS/MS was assessed using Cohen's Kappa. p value<0.05 was considered statistically significant. Using Shapiro-Wilk Test to assess whether the data follows a normal distribution. Using 95% children's serum 25(OH)D concentrations by LC-MS/MS as the reference interval. The regression equation was CLIA=1.185×LC-MS/MS-3.328. The fitness adjusted r2 was 0.589. The CLIA showed positive bias compared to LC-MS/MS, p<0.05, bias=(1.94±16.56) ng/mL. Cohen's Kappa=0.53, p<0.001. The agreement of 2 methods in diagnosing "deficiency" was good. According to Shapiro-Wilk Test, the data followed a normal distribution (W=0.99). The reference interval of children's serum 25(OH)D concentrations by LC-MS/MS was 11.35-44.57 ng/mL. In measuring 25(OH)D concentration of children, CLIA represented higher levels than LC-MS/MS. The two methods were consistent in diagnosing vitamin D deficiency. The reference interval of children's serum 25(OH)D concentrations by LC-MS/MS was 11.35-44.57 ng/mL in our area in summer.
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Affiliation(s)
- Jie Wang
- Department of Transfusion, The Affiliated Hospital of Southwest Medical University
| | | | - Yongyi Gan
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province.,Institute of Nuclear Medicine, Southwest Medical University
| | - Tianxing Fan
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province.,Institute of Nuclear Medicine, Southwest Medical University
| | - Jing Yang
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province.,Institute of Nuclear Medicine, Southwest Medical University
| | - Fang Rao
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province.,Institute of Nuclear Medicine, Southwest Medical University
| | - Jianbo Yang
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province.,Institute of Nuclear Medicine, Southwest Medical University
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Multilevel Analysis of the Nutritional and Health Status among Children and Adolescents in Eastern China. Nutrients 2022; 14:nu14040758. [PMID: 35215409 PMCID: PMC8877382 DOI: 10.3390/nu14040758] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 01/31/2022] [Accepted: 02/06/2022] [Indexed: 01/27/2023] Open
Abstract
We aimed to identify multiple nutritional health problems and the relevant factors among children and adolescents aged 7–17 years. This study was part of the China Nutrition and Health Surveillance of Children and Lactating Mothers in 2016–2017, conducted in Jiangsu Province in eastern China. After sampling, 3025 school-age children and adolescents were enrolled into this study. Demographic information collections and anthropometric measurements were conducted by trained local Center for Disease Control and Prevention (CDC) staff. Venous blood in the amount of 6 mL was drawn from each participant in the morning and used for testing biochemical and nutritional indicators. Multivariate logistic regression analysis and Poisson regression analysis were used for overnutrition- and undernutrition-related disorders to test relevant personal, parental, and household factors. The prevalence of wasting, overweight, and obesity was 5.5%, 14.8%, and 12.7%, respectively. Metabolic syndrome (MetS) was prevalent among 5.1% of participants. Among the study participants, 29.5% had hyperuricemia. The overall prevalence of high low-density lipoprotein (LDL) and high total cholesterol (TC) of all participants was 4.8% and 7.4%, respectively. 0.9% of the participants had vitamin A deficiency (VAD) and 14.6% had marginal vitamin A deficiency; 25.1% had vitamin D deficiency (VDD) and 54.5% had inadequate vitamin D levels. Anemia was present in 4.0% of all participants. The prevalence of zinc deficiency was 4.8%. Demographic characteristics, behavioral characteristics, parents’ characteristics, and family characteristics were associated with these multiple malnutrition disorders. The double burdens of malnutrition, which includes overnutrition- and undernutrition-related diseases, were prevalent among the school-age children and adolescents in Jiangsu Province in eastern China. There were various factors related to different nutritional problems. Thus, health education focusing on behavior intervention and nutrition education are necessary in containing nutritional problems among children.
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Effects of Perceived Benefit on Vitamin D Supplementation Intention: A Theory of Planned Behaviour Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19041952. [PMID: 35206141 PMCID: PMC8872502 DOI: 10.3390/ijerph19041952] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 02/03/2022] [Accepted: 02/07/2022] [Indexed: 12/22/2022]
Abstract
There are many factors that affect vitamin D supplementation, including those from the theory of planned behaviour (TPB); however, how the perceived benefit acts in the model remains unknown. In the current study, we tested the efficacy of the TPB and the impacts of the perceived benefit (PBE) in the model. The subjects were 287 customers who purchased vitD from pharmacies in major cities in Taiwan. A structured questionnaire was used to collect the data. t-tests, analysis of variance (ANOVA), regression analyses, and path analysis via SPSS and AMOS were used to analyse the data. The original TPB model explained 47.5% of the variance of intention with the three variables of attitude (β = 0.261), perceived behavioural control (β = 0.183), and subjective norms (β = 0.169). The model that incorporated PBE increased the explained variance to 59.7%, and PBE became the strongest predictor (β = 0.310) and a significant mediator linking attitude, subjective norms, perceived control (ANC) with supplementation intention. PBE and attitude were the two most important variables in predicting vitD supplementation intention. We suggest that updated information regarding dietary sources of vitD and its benefits should be included in health- or nutrition-related courses in education programs for the overall health of the nation.
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Deng YC, Tang XC, Li X, Dong CX. An investigation of vitamin D nutritional status in children after outbreak of coronavirus disease 2019. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2021; 23:1091-1096. [PMID: 34753539 DOI: 10.7499/j.issn.1008-8830.2106155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To investigate vitamin D nutritional status in children after outbreak of coronavirus disease 2019 (COVID-19), as well as the effect of strict epidemic prevention and control measures for the COVID-19 epidemic on vitamin D nutritional status in children. METHODS A total of 7 460 children who underwent routine physical examinations from February to August, 2020 and had normal results were retrospectively enrolled as the observation group, and 10 102 children who underwent routine physical examinations from February to August, 2019 (no epidemic of COVID-19) and had normal results were enrolled as the control group. The serum level of 25-hydroxy vitamin D [25(OH)D] was compared between the two groups. The children in the observation and control groups who underwent physical examinations in March and April were selected as the epidemic prevention subgroup (n=1 710) and non-epidemic subgroup (n=2 877) respectively. The subjects were divided into five age groups (infancy, early childhood, preschool, school age and adolescence), and serum 25(OH)D levels of children of all ages were compared between the epidemic prevention and non-epidemic subgroups. RESULTS The observation group had a lower serum level of 25(OH)D than the control group in March and April (P<0.001). The epidemic prevention subgroup had a lower serum level of 25(OH)D than the non-epidemic subgroup in all age groups (P<0.001). The vitamin D sufficiency rate in early childhood, preschool, school and adolescent children from the epidemic prevention subgroup was lower than the non-epidemic subgroup (P<0.001), with a reduction of 10.71%, 18.76%, 59.63% and 56.29% respectively. CONCLUSIONS Strict prevention and control measures for the COVID-19 epidemic may lead to a significant reduction in vitamin D level in children, especially school-aged and adolescent children. It is recommended to timely monitor vitamin D level in children, take vitamin D supplements, and increase the time of outdoor sunshine as far as possible under the premise of adherence to epidemic prevention regulations.
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Affiliation(s)
- Yong-Chao Deng
- Center of Clinical Laboratory of Hunan Children's Hospital, Changsha 410007, China (dyc_mail2000@sina. com)
| | - Xi-Chun Tang
- Center of Clinical Laboratory of Hunan Children's Hospital, Changsha 410007, China (dyc_mail2000@sina. com)
| | | | - Cai-Xia Dong
- Center of Clinical Laboratory of Hunan Children's Hospital, Changsha 410007, China (dyc_mail2000@sina. com)
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[Nutrient Status of Vitamin D among Cancer Patients]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2021; 24:345-350. [PMID: 34034458 PMCID: PMC8174108 DOI: 10.3779/j.issn.1009-3419.2021.101.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND There is a certain correlation between vitamin nutritional status and cancer patients. Studies have shown that vitamin deficiency increases the risk of cancer. The purpose of this study is to understand the vitamin D nutritional status of cancer patients and to provide scientific basis for further nutritional intervention. METHODS Cancer patients who visited Shandong Cancer Hospital from July 2017 to June 2019 were included in this retrospective study. Serum 25-hydroxyvitamin D [25(OH)D] concentrations were measured. Univariate analysis and multiple linear regression analysis were carried out using SPSS 20.0. RESULTS A total of 2,487 cancer patients were evaluable for this analysis. Mean 25(OH)D concentration was (12.70±6.82) ng/mL; the prevalence of vitamin D deficiency [25(OH)D concentration less than 20.00 ng/mL] was of 92.20%. In univariate analysis, age, body mass index (BMI), season and types of cancer were associated with 25(OH)D concentrations. In the multivariate analysis, BMI (β=0.71), age (β=-0.56), season (β=-0.99 for winter; β=-0.76 for autumn vs summer) and types of cancer (β=-1.17 for lung cancer; β=-1.45 for esophageal-gastric cancer; β=-1.05 for colorectal cancer vs other types of cancer) were independently and significantly associated with 25(OH)D levels (P<0.05). CONCLUSIONS Vitamin D deficiency was highly prevalent among cancer patients. Age, BMI, season and types of cancer may be associated with 25(OH)D levels, which indicate that monitoring of vitamin D level for cancer survivor should be taken into account.
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Koyama S, Kubota T, Naganuma J, Arisaka O, Ozono K, Yoshihara S. Incidence rate of vitamin D deficiency and FGF23 levels in 12- to 13-year-old adolescents in Japan. J Bone Miner Metab 2021; 39:456-462. [PMID: 33206223 DOI: 10.1007/s00774-020-01173-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 10/21/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The incidence rate of vitamin D deficiency is increasing throughout the world. We measured the incidence rate of vitamin D deficiency and fibroblast growth factor 23 (FGF23) levels in 12- to 13-year-old adolescents in Japan. MATERIALS AND METHODS A total of 492 adolescents (247 boys and 245 girls) from Japanese community enrolled in this study. 25 hydroxyvitamin D (25(OH)D) was measured with radioimmunoassay. In the subjects with low 25(OH)D levels (≦ 20 ng/ml), intact parathyroid hormone (iPTH), calcium (Ca), phosphorus (P), albumin (Alb), alkaline phosphatase (ALP) and FGF23 were measured. RESULTS 25(OH)D levels were significantly lower in girls (20.9 ± 3.1 ng/ml) than in boys (22.2 ± 3.3 ng/ml) (p < 0.0001). Fifty-five boys (22.3%) and 83 (33.9%) girls showed vitamin D deficiency (< 20 ng/ml). One-hundred eighty-six (75.3%) boys and 162 (66.1%) girls showed vitamin D insufficiency (≧ 20 ng/ml, < 30 ng/ml). In the subjects whose 25(OH)D levels were ≦ 20 ng/ml, the levels of iPTH, Ca, P, Alb, ALP and FGF23 were 22.3 ± 9.0 pg/ml, 9.5 ± 0.4 mg/dl, 4.7 ± 0.6 mg/dl, 4.6 ± 0.3 g/dl, 920.8 ± 339.3 U/l and 42.6 ± 26.0 pg/ml, respectively. There was a significant negative association between serum 25(OH)D levels and iPTH [r = - 0.290 (p < 0.0001)]. There was no significant association between serum 25(OH)D levels and FGF23. CONCLUSION We show that 28% of Japanese 12- to 13-year-old early adolescents suffer from vitamin D deficiency. Findings from this study indicate that vitamin D deficiency requires close oversight in public health during adolescence to ensure proper bone health.
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Affiliation(s)
- Satomi Koyama
- Department of Pediatrics, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi, 321-0293, Japan.
| | - Takuo Kubota
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Junko Naganuma
- Department of Pediatrics, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi, 321-0293, Japan
| | - Osamu Arisaka
- Department of Pediatrics, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi, 321-0293, Japan
- Department of Pediatrics, Nasu Red Cross Hospital, Otawara, Tochigi, Japan
| | - Keiichi Ozono
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Shigemi Yoshihara
- Department of Pediatrics, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi, 321-0293, Japan
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Lin S, Jiang L, Zhang Y, Chai J, Li J, Song X, Pei L. Socioeconomic status and vitamin D deficiency among women of childbearing age: a population-based, case-control study in rural northern China. BMJ Open 2021; 11:e042227. [PMID: 33753436 PMCID: PMC7986774 DOI: 10.1136/bmjopen-2020-042227] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To explore the association between socioeconomic status (SES) and vitamin D deficiency/insufficiency of women of childbearing age in rural northern China. DESIGN A population-based, case-control study was conducted. SETTING Four counties of Henan Province, China from 2009 to 2010. PARTICIPANTS 1151 non-pregnant healthy women between 18 and 40 years old. PRIMARY AND SECONDARY OUTCOME MEASURES Serum 25-hydroxyvitamin D (25(OH)D) levels were measured using high-performance liquid chromatography-tandem mass spectrometry. Vitamin D insufficiency was defined as serum 25(OH)D ≥20 ng/mL and <30 ng/mL, deficiency as ≥10 ng/mL and <20 ng/mL, and severe deficiency as <10 ng/mL. SES was measured separately by women's and their husbands' education level and occupation, household income and expenditure, as well as aggregately by SES index constructed with principal component analysis. RESULTS The median serum 25(OH)D level was 20.90 (13.60-34.60) ng/mL, and the prevalence of vitamin D insufficiency, deficiency and severe deficiency was 20.16%, 31.80% and 15.99%, respectively. After adjustment, household annual income <¥10 000 was associated with increased risk of vitamin D insufficiency (adjusted OR (aOR): 2.10, 95% CI 1.41 to 3.14), deficiency (aOR: 1.58, 95% CI 1.09 to 2.29) and severe deficiency (aOR: 2.79, 95% CI 1.78 to 4.38); inadequate household income for expenditure was associated with elevated risk of vitamin D insufficiency (aOR: 1.66, 95% CI 1.08 to 2.54) and deficiency (aOR: 1.81, 95% CI 1.26 to 2.62); low SES index was associated with elevated risk of vitamin D insufficiency (aOR: 2.40, 95% CI 1.52 to 3.80) and deficiency (aOR: 1.64, 95% CI 1.08 to 2.50); and both middle and low SES index were associated with increased risk of vitamin D severe deficiency (aOR: 1.70, 95% CI 1.02 to 2.84; aOR: 2.45, 95% CI 1.45 to 4.14). CONCLUSIONS Lower SES was associated with higher risk of vitamin D deficiency/insufficiency in women of childbearing age in rural northern China. More should be done to explore potential mechanisms and to narrow down SES inequalities in vitamin D status.
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Affiliation(s)
- Shiqi Lin
- Institute of Population Research/China Center on Population Health and Development, Peking University, Beijing, China
| | - Lifang Jiang
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Zhengzhou, Henan, China
| | - Yuan Zhang
- Institute of Population Research/China Center on Population Health and Development, Peking University, Beijing, China
| | - Jian Chai
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Zhengzhou, Henan, China
| | - Jiajia Li
- Institute of Population Research/China Center on Population Health and Development, Peking University, Beijing, China
| | - Xinming Song
- Institute of Population Research/China Center on Population Health and Development, Peking University, Beijing, China
| | - Lijun Pei
- Institute of Population Research/China Center on Population Health and Development, Peking University, Beijing, China
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Zhao Y, Qin R, Hong H, Lv H, Ye K, Wei Y, Zheng W, Qi H, Ni Y, Zhang L, Yang G, Liu G, Wu A. Vitamin D status and its dietary and lifestyle factors in children during the first 5 years of life: A cross-sectional multicentre Jiangsu bone study. J Hum Nutr Diet 2021; 34:792-806. [PMID: 33751685 DOI: 10.1111/jhn.12883] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 03/01/2021] [Accepted: 03/02/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND To explore the vitamin D status with its demographic and lifestyle factors including dietary, supplementation, and physical activity in 0-5 years old children. METHODS This was a large population-based cross-sectional multicentre study in which the children were recruited from 12 Children's Health Care Centers by a stratified cluster random-sampling method in 10 cities in Jiangsu Province, China. RESULTS A total number of 5289 children were investigated. The prevalence of vitamin D deficiency was 30.1%. The concentration of 25 hydroxyvitamin D was 64.0 (46.3-83.0) nmol mL-1 after adjustment for covariates. Children with higher risk of vitamin D deficiency were more likely to be at older age, girls, survey conducted in spring, location in southern Jiangsu province, residence in urban, outdoor activity < 2 h day-1 (all p < 0.05). Moreover, those with lower risk were more likely to be the number of parity ≥ 2 times, vitamin D supplementation from birth to 6 months, the initial time of vitamin D supplementation after birth ≤ 1 months, vitamin D and calcium supplementation in the last 3 months, and dose of vitamin D supplementation > 400 IU day-1 (all p < 0.05). Children with preferences for sweets, meat consumption > 150.0 g day-1 , milk consumption < 250 mL day-1 , time of sleeping < 10 h day-1 had higher risks of vitamin D deficiency. However, these relationships were affected by demographics. CONCLUSIONS Vitamin D status during the first five years of life was suboptimal and was associated with demographic and lifestyle determinants including milk, meat, sweets, vitamin D and calcium supplementation, sleeping and outdoor activity.
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Affiliation(s)
- Yan Zhao
- Department of Clinical Nutrition, Jiangsu Province Hospital, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Rui Qin
- Department of Child Health Care, Jiangsu Women and Children Health Hospital, Women and Child Branch Hospital of Jiangsu Province Hospital, the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Hong Hong
- Department of Child Health Care, Drum Tower Maternity and Child Health Care Institute, Nanjing, China
| | - Heyu Lv
- Department of Child Health Care, Jiangning Maternity and Child Health Care Institute, Nanjing, China
| | - Kan Ye
- Department of Child Health Care, Suzhou Municipal Hospital, Suzhou, China
| | - Yarong Wei
- Department of Child Health Care, Wuxi Maternity and Child Health Care Hospital, Wuxi, China
| | - Wen Zheng
- Department of Child Health Care, Yancheng Maternity and Child Health Care Institute, Yancheng, China
| | - Hongxia Qi
- Department of Child Health Care, Xuzhou Children's Hospital, Xuzhou, China
| | - Yufei Ni
- Department of Child Health Care, Nantong Maternity and Child Health Care Hospital, Nantong, China
| | - Li Zhang
- Department of Child Health Care, Huai'an Maternity and Child Health Care Hospital, Huai'an, China
| | - Guoqiang Yang
- Department of Child Health Care, Kunshan Maternity and Child Health Care Institute, Kunshan, China
| | - Guoqin Liu
- Department of Child Health Care, Dafeng Maternity and Child Health Care Hospital, Dafeng, China
| | - Aiping Wu
- Department of Child Health Care, Xinghua Maternity and Child Health Care Hospital, Xinghua, China
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21
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Zhang X, Chen Y, Jin S, Bi X, Chen D, Zhang D, Liu L, Jing H, Na L. Association of serum 25-Hydroxyvitamin D with Vitamin D intervention and outdoor activity among children in North China: an observational study. BMC Pediatr 2020; 20:542. [PMID: 33267851 PMCID: PMC7709348 DOI: 10.1186/s12887-020-02435-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 11/17/2020] [Indexed: 11/10/2022] Open
Abstract
Background Living at high latitudes is one of the risk factors for vitamin D deficiency in children. However, evidence on vitamin D improvement for this pediatric population to date is limited. This study aims at evaluating the association of different vitamin D intervention methods and outdoor activity on the vitamin D status of children in North China. Methods In this observational study, a total of 55,925 children aged 1 month to 18 years old were recruited from pediatric outpatient departments from July 2016 to June 2017. Data on demographics, anthropometric measurements, vitamin D intervention (either prescribed by physicians or given by parents) and outdoor activity were recorded. The serum levels of 25-hydroxycholecalciferol (25(OH)D) were determined by high performance liquid chromatography tandem–mass spectrometry. Logistic regression analysis was performed to assess the association of vitamin D intervention or outdoor activity with blood vitamin D status, adjusted for age, gender, BMI for age, and seasons. Results The overall rate of hypovitaminosis D was 65.60%. Of the children’s outdoor activity, 35.63, 31.95, and 32.42% were below 30 min/d, 30–60 min/d and over 60 min/d, respectively. Furthermore, the proportion of therapeutic intervention, supplementation intervention and no vitamin D intervention among the children was 16.48, 32.87, and 50.65%, respectively. After adjusted for confounding factors, vitamin D intervention was associated with a lower risk of hypovitaminosis D, with OR (95% CI) of 0.191 (0.180, 0.202) in children with therapeutic doses and 0.423 (0.404, 0.443) in those with supplementation doses, compared with children without vitamin D intervention. In addition, longer outdoor time was associated with a lower risk of hypovitaminosis D [0.479 (0.456, 0.504) for 60 min/d, 0.737 (0.701, 0.776) for 30–60 min/d], independent of vitamin D intervention. Conclusions High prevalence of vitamin D deficiency was found in children living at high latitudes. Vitamin D intervention and outdoor activity are all negatively associated with children’s vitamin D deficiency. Routine vitamin D intervention combined with increased outdoor time might be an effective approach to prevent hypovitaminosis D among children, especially those at school, living at high latitudes. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-020-02435-9.
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Affiliation(s)
- Xuguang Zhang
- Department of Child Healthcare, Harbin Children's Hospital, Harbin, 150010, China
| | - Yanping Chen
- Department of Child Healthcare, Harbin Children's Hospital, Harbin, 150010, China
| | - Shanshan Jin
- Collaborative Innovation Center for Biomedicine, Medical Technology College, Shanghai University of Medicine & Health Sciences, Shanghai, 201318, China
| | - Xinxin Bi
- Health Supervision Institute of Harbin Municipal Health Bureau, Harbin, 150010, China
| | - Dongkai Chen
- Department of Child Healthcare, Harbin Children's Hospital, Harbin, 150010, China
| | - Dongmei Zhang
- Department of Child Healthcare, Harbin Children's Hospital, Harbin, 150010, China
| | - Li Liu
- Department of Child Healthcare, Harbin Children's Hospital, Harbin, 150010, China
| | - Hong Jing
- Department of Child Healthcare, Harbin Children's Hospital, Harbin, 150010, China
| | - Lixin Na
- Collaborative Innovation Center for Biomedicine, Medical Technology College, Shanghai University of Medicine & Health Sciences, Shanghai, 201318, China.
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22
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Associations between Vitamin D and Liver Function and Liver Fibrosis in Patients with Biliary Atresia. Gastroenterol Res Pract 2019; 2019:4621372. [PMID: 31781188 PMCID: PMC6875370 DOI: 10.1155/2019/4621372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 08/19/2019] [Accepted: 09/13/2019] [Indexed: 02/06/2023] Open
Abstract
Objectives To detail the effects of vitamin D (VD) deficiency and assess the relationships between VD deficiency and liver function and liver fibrosis in patients with biliary atresia (BA). Methods In this study, BA patients confirmed by intraoperative cholangiography were enrolled between January 2017 and February 2019. Preoperative serum 25-(OH)D level, liver function, serum biomarker levels of liver fibrosis, and histopathologic features were recorded. Deficiency, insufficiency, and sufficiency of VD were defined as serum 25-(OH)D concentrations of <10, 10-20, and >20 ng/ml, respectively. Associations between serum 25-(OH)D level and liver function and liver fibrosis were analyzed. Results A total of 161 BA infants were included. The median (interquartile range (IQR)) serum 25-(OH)D level in all patients was 7.56 (IQR: 4.48–11.40) ng/ml. The rates of 25-(OH)D deficiency, insufficiency, and sufficiency were 67.1% (108/161), 29.2% (47/161), and 3.7% (6/161), respectively. Serum 25-(OH)D level was negatively correlated with alkaline phosphatase (r = ‐0.232, P = 0.003). After adjusting for age, a decrease in serum 25-(OH)D level was correlated with the increase of the Batts-Ludwig stage score (odds ratio (OR): 0.94, 95% confidence interval (CI): 0.88–0.99; P = 0.028). Serum 25-(OH)D level was also correlated with the N-terminal propeptide of type III procollagen (PIIINP) (r = ‐0.246, P = 0.002). Additionally, PIIINP (P = 0.038) and ALP (P = 0.031) were independently associated with serum 25-(OH)D level. Conclusions VD deficiency was common and inversely correlated with liver fibrosis in BA patients. Furthermore, VD was not correlated with liver function except alkaline phosphatase.
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Vitamin D Food Fortification and Nutritional Status in Children: A Systematic Review of Randomized Controlled Trials. Nutrients 2019; 11:nu11112766. [PMID: 31739503 PMCID: PMC6893768 DOI: 10.3390/nu11112766] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 11/04/2019] [Accepted: 11/12/2019] [Indexed: 12/29/2022] Open
Abstract
Children are in the risk group for developing hypovitaminosis D. Several strategies are used to reduce this risk. Among these, fortification of foods with vitamin D (25(OH)D) has contributed to the achievement of nutritional needs. This systematic review aims to discuss food fortification as a strategy for maintenance or recovery of nutritional status related to vitamin D in children. The work was developed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and registered in the International prospective register of systematic reviews (PROSPERO) database (CRD42018052974). Randomized clinical trials with children up to 11 years old, who were offered vitamin D-fortified foods, and who presented 25(OH)D concentrations were used as eligibility criteria. After the selection stages, five studies were included, totaling 792 children of both sexes and aged between two and 11 years. Interventions offered 300-880 IU of vitamin D per day, for a period of 1.6-9 months, using fortified dairy products. In four of the five studies, there was an increase in the serum concentrations of 25(OH)D with the consumption of these foods; additionally, most children reached or maintained sufficiency status. Moreover, the consumption of vitamin D-fortified foods proved to be safe, with no concentrations of 25(OH)D > 250 nmol/L. Based on the above, the fortification of foods with vitamin D can help maintain or recover the nutritional status of this vitamin in children aged 2-11 years. However, it is necessary to perform additional randomized clinical trials in order to establish optimal doses of fortification, according to the peculiarities of each region.
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Li H, Huang T, Xiao P, Zhao X, Liu J, Cheng H, Dong H, Morris HA, Mi J. Widespread vitamin D deficiency and its sex-specific association with adiposity in Chinese children and adolescents. Nutrition 2019; 71:110646. [PMID: 31896064 DOI: 10.1016/j.nut.2019.110646] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 05/31/2019] [Accepted: 11/01/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Vitamin D is involved in various physiologic and pathologic processes in the human body. The aim of this study was to determine the prevalence of vitamin D deficiency and the association of adiposity indicators with 25-hydroxyvitamin D (25[OH]D) in Chinese children and adolescents. METHODS This was a population-based, nationwide, multicenter cross-sectional study involving 10 696 participants (51.2% boys) 6 to 18 y of age. Total body fat mass was assessed by dual-energy x-ray absorptiometry, and measures of body mass index (BMI), fat mass index (FMI), fat mass percentage (FMP), and plasma 25(OH)D concentrations were obtained. RESULTS The adjusted mean of 25(OH)D was 39.3 nmol/L for all participants, 40.7 nmol/L for boys, and 37.9 nmol/L for girls. Of the children, 30% had vitamin D deficiency (25[OH]D <30 nmol/L) and 80% had vitamin D insufficiency (25[OH]D <50 nmol/L). The prevalence rates of vitamin D deficiency and insufficiency were higher in girls (31%, 83.4%, respectively) than in boys (22.8%, 78.7%, respectively). An L-shape relationship between age and 25(OH)D was observed in all children, with a threshold age of 14 y. Also, there was an inverted U-shaped association of BMI with 25(OH)D, and multivariable linear models shown FMI and FMP were inversely associated with 25(OH)D concentrations, particularly in boys (β = -0.86 and -0.83, respectively, all P < 0.05). CONCLUSIONS Vitamin D deficiency was widespread and its sex-specific association with an excess of body fat in Chinese children and adolescents. The findings indicate that targeted screening and treatment guidelines may be useful.
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Affiliation(s)
- Haibo Li
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Tao Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Pei Xiao
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Xiaoyuan Zhao
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Junting Liu
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Hong Cheng
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Hongbo Dong
- Department of Non-Communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Howard A Morris
- School of Pharmacy and Medical Sciences, University of South Australia, North Terrace, Adelaide, South Australia, Australia
| | - Jie Mi
- Department of Non-Communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
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25
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A systematic review and meta-analysis of the response of serum 25-hydroxyvitamin D concentration to vitamin D supplementation from RCTs from around the globe. Eur J Clin Nutr 2019; 73:816-834. [PMID: 30872787 DOI: 10.1038/s41430-019-0417-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 02/10/2019] [Accepted: 02/18/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND/OBJECTIVES Optimal doses of vitamin D (VitD) supplement in different populations are unclear. We aim to evaluate the relationship between VitD supplementation and post-intervention serum 25-hydroxyvitamin D [25(OH)D] concentration, to provide a recommended dosage of VitD for achieving an optimal 25(OH)D concentration for different populations. SUBJECTS/METHODS Literature search was conducted in Embase, etc. Randomized controlled trials about VitD supplemental intakes and their effect on 25(OH)D concentration were enrolled. The effect on 25(OH)D concentration between different supplementation doses in each population group was compared by meta-analysis. Multivariate meta-regression model is utilized to establish reference intake dosage of VitD. RESULTS A total of 136 articles were included about children (3-17 years), adults (18-64 years), postmenopausal women, the elderly ( >64 years), pregnant, or lactating women. Overall, intervention groups obtained higher 25(OH)D concentration than controls and there was obvious dose-response effect between intake dose and 25(OH)D concentration. Baseline 25(OH)D concentration and age were significant indicators for 25(OH)D concentration. To reach sufficient 25(OH)D concentration (75 nmol/L), the recommended VitD supplemental intakes was 1340 and 2250 IU/day for children and pregnant women, 2519 and 797 IU/day for European adults aged 18-64 and 65-85 years, 729, 2026, and 1229 IU/day for adults in North America, Asia and Middle East and Africa, respectively. CONCLUSIONS Regional- and age-specific recommended dosages of VitD supplements for population to achieve optimal 25(OH)D concentrations have been suggested.
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26
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Guo Y, Ke HJ, Liu Y, Fu M, Ning J, Yu L, Xiao Y, Che D, Chen XY, Deng YH, Wu JL. Prevalence of vitamin D insufficiency among children in southern china: A cross-sectional survey. Medicine (Baltimore) 2018; 97:e11030. [PMID: 29923990 PMCID: PMC6023856 DOI: 10.1097/md.0000000000011030] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Vitamin D deficiency is associated with numerous public health issues. Limited data are available for children in southern China, a region that receives abundant sunlight. We aimed to estimate the 25-hydroxyvitamin D (25(OH)D) levels in children in that area, and to determine seasonal variations in serum 25(OH)D levels. A total of 16,755 children aged 0 to 6 years, who visited the Guangdong Women and Children's Hospital for health examination between January 2016 and May 2017, were included in the present study. The serum 25(OH)D levels ranged from 10.5 to 307.4 nmol/L (mean ± standard deviation: 78.5 ± 26.3 nmol/L). The prevalence of vitamin D deficiency and insufficiency were 10.8% and 39.0%, respectively. The mean serum 25(OH)D level in spring (71.8 ± 24.9 nmol/L) was lower than that in other seasons. From January to April, we found a relatively high prevalence of vitamin D deficiency or insufficiency, both of which were also found to increase with age. Logistic regression analysis revealed that vitamin D deficiency and insufficiency were significantly associated with age and season. Deficiency and insufficiency of vitamin D are common among children in southern China, despite the area receiving sufficient sunlight.
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Affiliation(s)
- Yong Guo
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University
| | - Hai-Jin Ke
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University
| | - Ying Liu
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University
| | - Min Fu
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University
| | - Jing Ning
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University
| | - Li Yu
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University
| | - Yu Xiao
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University
| | - Di Che
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University
| | - Xiao-Yan Chen
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University
| | - Yu-Hong Deng
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Jie-Ling Wu
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University
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27
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Zhang X, Wang W, Li Y, Wang H, Liu R, Zhu L. Serum 25-hydroxyvitamin D status in chinese children with vitiligo: a case-control study. Clin Pediatr (Phila) 2018; 57:802-805. [PMID: 28990433 DOI: 10.1177/0009922817734362] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Vitamin D can play a vital role in autoimmune diseases. Epidemiologic evidence demonstrates vitamin D deficiency excited in adult patients with vitiligo. OBJECTIVES To investigate 25-hydroxyvitamin D (25(OH)D) levels in children with vitiligo and explore possible relevant factors. METHODS A total of 114 patients and 100 controls were included in our case-control study. We analyzed the required data collected by the questionnaire and examination to reveal the correlation with 25(OH)D levels. RESULTS The mean serum 25(OH)D levels in patients and controls were 43.62 ± 19.23 and 67.87 ± 19.45 nmol/L, respectively. The rate of deficient in patients and controls are 14.9% and 2%, respectively. There was significant difference between the 2 groups. Significant differences also existed on different ages comparing serum vitamin D levels of patients with controls ( P < .001). Age was an independent factor affecting 25(OH)D level ( P = .032). Two (1.8%) and 4 (3.5%) of children with vitiligo have comorbid autoimmune diseases and family history, respectively. There was no correlation between sex, duration of disease, type of vitiligo, skin lesion location, stage, family history, and comorbid autoimmune diseases with 25(OH)D levels. CONCLUSION Serum vitamin D level was associated with onset vitiligo children. More sunshine and vitamin D fortified foods are necessary among children with age. The rates of children vitiligo with family history has decreased in China.
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Affiliation(s)
- Xianhui Zhang
- 1 Department of Laboratory Medicine, Children's Hospital of Shanxi Province, Tai'yuan, China
| | - Wei Wang
- 2 Department of Laboratory Medicine, Shanxi Provincial People's Hospital, Taiyuan, China
| | - Yuanjun Li
- 3 Department of Dermatology, Children's Hospital of Shanxi Province, Taiyuan, China
| | - Hui Wang
- 3 Department of Dermatology, Children's Hospital of Shanxi Province, Taiyuan, China
| | - Runtao Liu
- 3 Department of Dermatology, Children's Hospital of Shanxi Province, Taiyuan, China
| | - Lei Zhu
- 1 Department of Laboratory Medicine, Children's Hospital of Shanxi Province, Tai'yuan, China
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28
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Zhao X, Yuan Y, Lin Y, Zhang T, Ma J, Kang W, Bai Y, Wang Y, Shao H, Dlodlo RA, Harries AD. Vitamin D status in tuberculosis patients with diabetes, prediabetes and normal blood glucose in China: a cross-sectional study. BMJ Open 2017; 7:e017557. [PMID: 28951414 PMCID: PMC5623489 DOI: 10.1136/bmjopen-2017-017557] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE The association between tuberculosis (TB), diabetes mellitus (DM) and vitamin D status is poorly characterised. We therefore: (1) determined vitamin D status in patients with TB in relation to whether they had normal fasting blood glucose (FBG), pre-DM or DM and (2) assessed whether baseline characteristics in patients with TB, including their DM status, were associated with vitamin D deficiency. METHODS In patients with TB consecutively attending six clinics or hospitals in China, we measured 25-hydroxycholecalciferol (25-(OH)D3) at the time of registration using electrochemiluminescence in a COBASE 601 Roche analyser by chemiluminescence immunoassay. Data analysis was performed using the χ2 test, ORs and multivariate logistic regression. RESULTS There were 306 eligible patients with TB, including 96 with smear positive pulmonary TB, 187 with smear negative pulmonary TB and 23 with extrapulmonary TB. Of these, 95 (31%) had normal blood glucose, 83 (27%) had pre-DM and 128 (42%) had DM. Median serum vitamin D levels were 16.1 ng/mL in patients with TB with normal FBG, 12.6 ng/mL in patients with TB with pre-DM and 12.1 ng/mL in patients with TB with DM (p<0.001). The study highlighted certain baseline characteristics associated with vitamin D deficiency (25-(OH)D3<20 ng/mL). After adjusting for confounders, serum vitamin D deficiency was significantly more common in patients being registered in the cold season (November to April) (p=0.006) and in those with DM (p=0.003). CONCLUSION Vitamin D levels are lower in patients with TB with pre-DM and DM and are also affected by certain baseline characteristics that include being registered in the cold season and having DM. TB programmes need to pay more attention to vitamin D status in their patients, especially if there is coexisting pre-DM or DM.
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Affiliation(s)
- Xin Zhao
- Department of Laboratory Medicine, Beijing Hospital, National Center of Gerontology, Beijing, Beijing, China
| | - Yanli Yuan
- Director Office, Jilin Provincial Academy of Tuberculosis Control and Prevention, Changchun, Jilin, China
| | - Yan Lin
- Department of TB and HIV, International Union Against Tuberculosis and Lung Disease, Paris, Paris, France
- The Union China Office, International Union Against Tuberculosis and Lung Disease, Beijing, Beijing, China
| | - Tiejuan Zhang
- Director Office, Jilin Provincial Academy of Tuberculosis Control and Prevention, Changchun, Jilin, China
| | - Jianjun Ma
- Director Office, Jilin Provincial Academy of Tuberculosis Control and Prevention, Changchun, Jilin, China
| | - Wanli Kang
- Department of Epidemiology, Beijing Chest Hospital, Capital Medical University, Beijing, Beijing, China
- Department of Epidemiology, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, Beijing, China
| | - Yunlong Bai
- Director Office, Jilin Provincial Academy of Tuberculosis Control and Prevention, Changchun, Jilin, China
| | - Yunlong Wang
- Department of Tuberculosis, Meihekou City Tuberculosis Institute, Meihekou, Jilin, China
| | - Hongshan Shao
- Department of Tuberculosis, Dongfeng County Tuberculosis Institute, Dongfeng, Jilin, China
| | - Riitta A Dlodlo
- Department of TB and HIV, International Union Against Tuberculosis and Lung Disease, Paris, Paris, France
- Department of TB and HIV, International Union Against Tuberculosis and Lung Diseases, Bulawayo, Bulawayo, Zimbabwe
| | - Anthony D Harries
- Department of TB and HIV, International Union Against Tuberculosis and Lung Disease, Paris, Paris, France
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, London, UK
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29
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Zhang R, Muyiduli X, Su D, Zhou B, Fang Y, Jiang S, Wang S, Huang L, Mo M, Li M, Shao B, Yu Y. Effect of Low-Dose Vitamin D Supplementation on Serum 25(OH)D in School Children and White-Collar Workers. Nutrients 2017; 9:E505. [PMID: 28513555 PMCID: PMC5452235 DOI: 10.3390/nu9050505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 05/10/2017] [Accepted: 05/10/2017] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE Our study aimed to investigate the nutritional vitamin D status of school children aged 9-15 years and white-collar workers in Zhejiang province, and evaluate the efficacy of low-dose-oral vitamin D supplementation in both populations. METHODS We conducted a prospective controlled trial during March 2014 to November 2015, comparing the efficacy of vitamin D supplements (400 IU/day) with non-intervention for 18 months in school children aged 9-15 years. Meanwhile, a before-after study was conducted among white-collar workers for 1 year. Serum 25(OH)D concentration was measured at baseline and after vitamin D supplementation, respectively. RESULTS At the baseline, 95% of school children and 84% of adult participants had vitamin D deficiency (<20 ng/mL). In school children, no difference was observed between the intervention and control groups with regard to anthropometric data. Serum 25(OH)D concentrations of the school children intervention group, school children control group and white-collar workers were 12.77 ± 3.01 ng/mL, 14.17 ± 3.59 ng/mL and 16.58 ± 3.66 ng/mL at baseline and increased to 17.34 ± 3.78 ng/mL, 18.04 ± 4.01 ng/mL and 17.75 ± 5.36 ng/mL after vitamin D supplementation, respectively. Although, after adjusting for potential confounders, the 400 IU oral vitamin D supplementation increased serum 25(OH)D concentration in school children (β = 0.81, p = 0.0426) as well as in white-collar workers (p = 0.0839), the prevalence of vitamin D deficiency was still very high among school children (79.23% in intervention group and 72.38% in control group) and white-collar workers (76.00%). CONCLUSIONS High prevalence of vitamin D deficiency was common in these two study populations. Daily doses of 400 IU oral vitamin D supplementation was not able to adequately increase serum 25(OH)D concentrations. A suitable recommendation regarding the level of vitamin D supplementation is required for this Chinese population.
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Affiliation(s)
- Ronghua Zhang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, Zhejiang, China.
| | - Xiamusiye Muyiduli
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, Zhejiang, China.
| | - Danting Su
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, Zhejiang, China.
| | - Biao Zhou
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, Zhejiang, China.
| | - Yueqiang Fang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, Zhejiang, China.
| | - Shuying Jiang
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, Zhejiang, China.
| | - Shuojia Wang
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, Zhejiang, China.
| | - Lichun Huang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, Zhejiang, China.
| | - Minjia Mo
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, Zhejiang, China.
| | - Minchao Li
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, Zhejiang, China.
| | - Bule Shao
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, Zhejiang, China.
| | - Yunxian Yu
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, Zhejiang, China.
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Dang HX, Liu CJ, Li J, Chen SJ, Xu F. Clinical Significance and Prognostic Effect of Serum 25-hydroxyvitamin D Concentrations in Critical and Severe Hand, Foot and Mouth Disease. Nutrients 2017; 9:nu9050478. [PMID: 28489032 PMCID: PMC5452208 DOI: 10.3390/nu9050478] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 05/06/2017] [Accepted: 05/08/2017] [Indexed: 12/13/2022] Open
Abstract
Objective: To examine the association of serum 25-hydroxyvitamin D [25(OH)D] concentrations with critical and severe hand, foot and mouth disease (HFMD) and assess the clinical significance and prognostic effect of 25(OH)D concentrations in children with HFMD. Methods: This is a prospective observational study. The 138 children with HFMD were divided into common (49 cases), severe (52 cases), and critical (37 cases) HFMD groups. Another 59 healthy children undergoing outpatient medical examinations during the same period were chosen as the control group. Serum 25(OH)D concentrations were measured in all the subjects, and each group was subdivided by serum 25(OH)D concentration into 25(OH)D normal (≥30 ng/mL); insufficiency (20–29.9 ng/mL), and deficiency (<20 ng/mL) groups. The pediatric critical illness score (PCIS) was recorded for the critical and severe HFMD group upon admission to the pediatric intensive care unit (PICU). Children with critical and severe HFMD were also monitored for blood lactate (LAC), serum calcium ions (Ca++), D-dimer (DD), lactate dehydrogenase (LDH), and creatine kinase-MB (CK-MB) levels; the incidences of brainstem encephalitis, neurogenic pulmonary edema, and circulatory failure; and the 14-day mortality rate. Results: Serum 25(OH)D concentrations were generally low in all groups. The critical HFMD group showed a significantly lower serum 25(OH)D mean concentration (20.0 ± 8.4 ng/mL) and a higher proportion of deficiency (18%) compared with the control group (28.1 ± 6.6 ng/mL, 8%), common (29.5 ± 8.1 ng/mL, 10%) and severe (31.9 ± 9.7 ng/mL, 8%) HFMD groups (p < 0.05). In the critical and severe HFMD groups, the 25(OH)D deficiency group had lower PCISs than the 25(OH)D normal and insufficiency groups (p < 0.05); and had higher values than the latter two groups for LAC, LDH, CK-MB and DD; and the incidences of brainstem encephalitis, neurogenic pulmonary edema, circulatory failure, and mortality (p < 0.05). The death group showed significantly lower serum 25(OH)D concentrations and PCISs than the survival group (p < 0.05) and had higher LAC, LDH, CK-MB and DD levels and higher incidences of brainstem encephalitis, neurogenic pulmonary edema, and circulatory failure (p < 0.05). Logistic regression analysis revealed that the serum 25(OH)D concentration was an independent factor that influenced mortality in children with critical and severe HFMD. Conclusions: In this study, we find the serum 25(OH)D concentrations are substantially reduced in children with critical and severe HFMD and are associated with the severity of HFMD. The serum 25(OH)D concentrations may have clinical value for determining the progression of critical HFMD and predicting the risk of death. Further evidence is needed before it can be stated that 25(OH)D concentrations have clinical value in HMFD diagnosis.
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Affiliation(s)
- Hong-Xing Dang
- Department of PICU, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, 136 Zhongshan No. 2 Road, Yu Zhong District, Chongqing 400014, China.
- China International Science and Technology Cooperation base of Child development and Critical Disorders, 136 Zhongshan No. 2 Road, Yu Zhong District, Chongqing 400014, China.
- Chongqing Engineering Research Center of Stem Cell Therapy, 136 Zhongshan No. 2 Road, Yu Zhong District, Chongqing 400014, China.
| | - Cheng-Jun Liu
- Department of PICU, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, 136 Zhongshan No. 2 Road, Yu Zhong District, Chongqing 400014, China.
- China International Science and Technology Cooperation base of Child development and Critical Disorders, 136 Zhongshan No. 2 Road, Yu Zhong District, Chongqing 400014, China.
- Chongqing Engineering Research Center of Stem Cell Therapy, 136 Zhongshan No. 2 Road, Yu Zhong District, Chongqing 400014, China.
| | - Jing Li
- Department of PICU, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, 136 Zhongshan No. 2 Road, Yu Zhong District, Chongqing 400014, China.
- China International Science and Technology Cooperation base of Child development and Critical Disorders, 136 Zhongshan No. 2 Road, Yu Zhong District, Chongqing 400014, China.
- Chongqing Engineering Research Center of Stem Cell Therapy, 136 Zhongshan No. 2 Road, Yu Zhong District, Chongqing 400014, China.
| | - Shi-Jiao Chen
- Department of PICU, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, 136 Zhongshan No. 2 Road, Yu Zhong District, Chongqing 400014, China.
- China International Science and Technology Cooperation base of Child development and Critical Disorders, 136 Zhongshan No. 2 Road, Yu Zhong District, Chongqing 400014, China.
- Chongqing Engineering Research Center of Stem Cell Therapy, 136 Zhongshan No. 2 Road, Yu Zhong District, Chongqing 400014, China.
| | - Feng Xu
- Department of PICU, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, 136 Zhongshan No. 2 Road, Yu Zhong District, Chongqing 400014, China.
- China International Science and Technology Cooperation base of Child development and Critical Disorders, 136 Zhongshan No. 2 Road, Yu Zhong District, Chongqing 400014, China.
- Chongqing Engineering Research Center of Stem Cell Therapy, 136 Zhongshan No. 2 Road, Yu Zhong District, Chongqing 400014, China.
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