Association of vitamin D nutritional status with calcaneal bone mineral density in school-age children: a prospective cohort study
10.3760/cma.j.cn112338-20200809-01048
- VernacularTitle:学龄儿童维生素D营养状况与跟骨骨密度关系的前瞻性队列研究
- Author:
Haibo LI
1
;
Xiaoyuan ZHAO
;
Wei HONG
;
Dongqing HOU
;
Zhongxin ZHU
;
Zhaocang YU
;
Hongjian WANG
;
Aiyu GAO
;
Hong CHENG
;
Jie MI
Author Information
1. 福建省妇幼保健院出生队列研究室，福州 350001
- Keywords:
Children;
Vitamin D;
Bone mineral density;
Cohort study
- From:
Chinese Journal of Epidemiology
2021;42(3):462-468
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relationships between vitamin D nutritional status and the calcaneal bone mineral density (BMD) in children.Methods:Data were obtained from School-based Cardiovascular and Bone Health Promotion Program. In 2017, a total of 15 391 children aged 6-16 years in Beijing selected through stratified cluster sampling were included in the baseline survey. A follow-up investigation was conducted in 2019. The questionnaire survey, detection of serum 25-hydroxyvitamin D [25(OH)D] level and ultrasound measurement of calcaneal BMD were conducted. Multivariable linear and logistic regression models were used to analyze the relationships between baseline vitamin D nutritional status and the follow-up calcaneal BMD.Results:A total of 10 914 children aged (11.5±3.3) years (boys accounting for 49.6%) were included in the analysis. The average 25(OH)D level was (35.4±12.0) nmol/L, and the deficiency rate was 36.1%. After the adjustment for age, gender, body mass index, smoking status, alcohol use status, dairy products intake, vitamin D supplement, calcium supplement, physical activity, pubertal development, and baseline calcaneal BMD Z-score, for per 10 nmol/L increase in 25(OH)D, the follow-up calcaneal BMD Z-score increased by 0.01( P=0.041), and the OR(95% CI) of decreased calcaneal BMD Z-score after 2 years was 0.96 (0.93-1.00)( P=0.030). Compared with vitamin D adequacy, the follow-up calcaneal BMD Z-score of children with vitamin D insufficiency and deficiency decreased by 0.03( P=0.307) and 0.06 ( P=0.046), and the risk of decreased calcaneal BMD Z-score after 2 years increased by 15%( P=0.037) and 21%( P=0.006), respectively ( P for trend<0.05). Conclusions:Vitamin D nutritional status was closely related to calcaneal BMD, and children with adequate vitamin D nutritional status tended to obtain higher BMD. Children and adolescents are encouraged to maintain sufficient vitamin D levels, strengthen nutrition and exercise to promote bone health.
