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Different diagnostic criteria influence the determination of Vitamin D nutritional status in children: a
Qingling Zhu1,2, Yueyuan Zhu3, Jiajia Liu2
1The School of Clinical Medicine, Fujian Medical University, Fuzhou, China.
Insights
Vitamin D status in children varies significantly based on diagnostic criteria, impacting deficiency and sufficiency classifications. Tailored interventions considering age and season are crucial for optimal Vitamin D levels.
Area of Science:
- Pediatric Nutrition
- Endocrinology
- Public Health
Background:
- Vitamin D is essential for bone health and immune function in children.
- Assessing Vitamin D status is critical for preventing deficiency-related diseases.
- Prevalence and influencing factors of Vitamin D status in Chinese children require further investigation.
Purpose of the Study:
- To evaluate Vitamin D status in healthy children aged 0-6 years in Quanzhou, China.
- To compare the impact of different diagnostic criteria on Vitamin D deficiency and sufficiency classifications.
- To identify factors influencing Vitamin D levels in this pediatric population.
Main Methods:
- A cross-sectional study involving 1,183 healthy children aged 0-6 years.
- Serum 25(OH)D levels measured by ELISA; anthropometric data collected.
- Analysis of Vitamin D variations by sex, season, age, weight-for-length Z-score (WLZ), body mass index (BMI), and Vitamin A status; evaluation of diagnostic criteria impacts.
Main Results:
- Mean serum 25(OH)D was 73.02 nmol/L, with variations observed across seasons and age groups (infants > toddlers > preschoolers).
- Classification of Vitamin D deficiency/sufficiency varied significantly between two diagnostic criteria (Criterion I vs. Criterion II).
- Poor inter-criteria agreement (Kappa = 0.071) and significant classification discrepancies noted across subgroups (sex, season, age, BMI).
- Age, season, BMI, and Vitamin A status independently predicted Vitamin D sufficiency.
Conclusions:
- Vitamin D classification is highly dependent on diagnostic criteria, highlighting the need for region-specific guidelines and standardized thresholds.
- Targeted interventions, especially increased winter supplementation for young children, should be tailored to age and seasonal variations due to latitude-dependent synthesis.
- Consistent application of standardized diagnostic criteria is essential for accurate Vitamin D status assessment and effective public health strategies in pediatric populations.
Objective:
To assess Vitamin D status in children aged 0-6 years in Quanzhou, China, and compare the impact of diagnostic criteria on deficiency/sufficiency classification.
Methods:
This cross-sectional study enrolled 1,183 healthy children aged 0-6 years (January 2022-March 2023). Serum 25(OH)D levels were measured via ELISA, and anthropometric data were collected. Participants were stratified by sex, season, age, WLZ, BMI, and Vitamin A status to analyze Vitamin D variations. Diagnostic criteria impacts on classification were evaluated.
Results:
Mean serum 25(OH)D was 73.02 nmol/L (IQR: 58.48-89.09), with no sex-based differences (P > 0.05). Levels varied by season (highest in summer: 75.85 nmol/L; lowest in winter: 69.00), and age (infants > toddlers > preschoolers), all P < 0.05. Serum 25(OH)D were observed to decrease with increasing WLZ (Weight-for-Length Z-score) and BMI, though no statistically significant differences were found for either parameter (both P > 0.05) Using Criterion I, 2.46% were deficient, 9.97% insufficient, and 87.57% sufficient (χ2 = 1589.053, P < 0.001). With Criterion II, rates shifted to 12.43, 40.74, and 46.83%, respectively (χ2 = 239.271, P < 0.001). Classification discrepancies were significant across subgroups (sex, season, age, BMI; all P.adj <0.05), with poor inter-criteria agreement (Kappa = 0.071, P < 0.001). Age, season, BMI, and Vitamin A independently predicted sufficiency (P < 0.05).
Conclusion:
This study underscores two critical implications: (1) Vitamin D deficiency/sufficiency classifications are critically dependent on diagnostic criteria, necessitating region-specific guidelines and standardized threshold selection in practice and research. (2) Given the influence of latitude on Vitamin D synthesis, targeted interventions-particularly increased winter dosing for young children-should be tailored to age and seasonal variations.
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