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Vitamin A Nutritional Status Is a Key Determinant of Bone Mass in Children
Xuanrui Zhang1, Jiapeng Huang1, Yingyu Zhou1
1Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, China.
Insights
Optimal vitamin A (VA) levels are crucial for children's bone health. This study found an inverted U-shaped link between plasma retinol and bone density, suggesting appropriate VA intake supports bone mineral status in young children.
Area of Science:
- Pediatric Nutrition
- Bone Metabolism
- Nutritional Biochemistry
Background:
- Childhood bone mass accrual is vital for adult peak bone mass and osteoporosis prevention.
- Vitamin A (VA) is known to influence adult bone health, but its role in children requires further investigation.
- Limited research exists on the association between vitamin A status and bone health specifically in pediatric populations.
Purpose of the Study:
- To investigate the relationship between plasma retinol concentration, dietary vitamin A (VA) and carotenoid intake, and bone mineral status in children aged 6-9 years.
- To determine if there is an association between vitamin A status and bone mineral content (BMC) and bone mineral density (BMD) in this age group.
Main Methods:
- Cross-sectional study of 426 children aged 6-9 years.
- Plasma retinol concentration measured using liquid chromatography-mass spectrometry.
- Dietary intake assessed via a structured Food Frequency Questionnaire (FFQ).
- Bone mineral content (BMC) and bone mineral density (BMD) measured using dual-energy X-ray absorptiometry (DXA).
Main Results:
- An inverted U-shaped association was observed between plasma retinol concentration and total bone mineral density (TBLH BMD) after adjusting for confounders (p-for-non-linearity = 0.046).
- Higher plasma retinol concentrations were associated with increased TBLH BMC (β = 1.89, p = 0.032).
- The optimal range for plasma retinol concentration appeared to be around 1.24 μmol/L for maximizing BMD.
Conclusions:
- Appropriate plasma retinol concentration is associated with better bone mineral status in children aged 6-9 years.
- Adequate dietary intake of vitamin A (VA) and beta-carotene may contribute to enhanced bone mineral status in this pediatric population.
- Further research is warranted to confirm these findings and establish optimal vitamin A intake recommendations for children's bone health.
Abstract:
The bone mass increases that occur during the period of childhood are of great significance for maximizing the peak bone mass in adults and preventing for osteoporosis. Studies have reported that VA can improve the bone health in adults. Moreover, limited studies have assessed such associations in children. In this cross-sectional study including 426 children, we assessed the children's plasma retinol concentration by liquid chromatography-mass spectrometry and the dietary intake of VA and carotenoids using a structured Food Frequency Questionnaire. Their bone mineral content and bone mineral density (BMD) were measured using dual-energy X-ray absorptiometry. After adjusting for potential confounders, the restricted cubic spline revealed an inverted U-shaped association between plasma retinol concentration and BMD; the estimated effects on the TBLH BMD per μmol/L increase in the plasma retinol concentration were 1.79 × 10-2 g/cm2 below 1.24 μmol/L and -5.78 × 10-3 g/cm2 above this point (p for non-linearity = 0.046). A multiple linear regression analysis revealed a positive association between the plasma retinol concentration and the TBLH BMC (β = 1.89, 95% CI: 1.64 × 10-1-3.62, p = 0.032). In conclusion, an appropriate plasma retinol concentration and greater intakes of dietary VA and β-carotene may enhance the bone mineral status of children who are aged 6-9 years.
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