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Association of Vitamin D and Weight Status With Neurodevelopmental Outcomes in a Large Pediatric Population:
Ying Shen1, Meiying Gao1, Lejing Guan1
1Children's Health Management Center, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases, Hangzhou, China.
Insights
Vitamin D deficiency is linked to neurodevelopmental issues in children, particularly in normal-weight girls. These findings highlight the need for sex-specific pediatric care strategies.
Area of Science:
- Pediatric Health
- Neurodevelopmental Science
- Nutritional Biochemistry
Background:
- Vitamin D status and weight are crucial for children's neurodevelopment.
- The interplay between vitamin D, weight, and neurodevelopment requires further investigation in pediatric populations.
Purpose of the Study:
- To assess the independent links of vitamin D and weight status with neurodevelopmental outcomes in a large pediatric cohort.
- To examine how age and sex influence these associations.
Main Methods:
- Retrospective analysis of 19,283 children's health records.
- Neurodevelopmental assessment using ASQ-3 (<6 years) and CPRS (≥6 years).
- Logistic regression to evaluate independent and interactive effects of vitamin D and weight status.
Main Results:
- Vitamin D insufficiency/deficiency correlated with poorer neurodevelopment in both younger and older children.
- In normal-weight girls under 6, vitamin D deficiency increased neurodevelopmental delay risk (OR 2.24).
- In normal-weight children aged 6-18, vitamin D deficiency was linked to behavioral challenges in girls (OR 1.61) and boys (OR 1.64).
Conclusions:
- Vitamin D insufficiency/deficiency impacts neurodevelopment in a sex-specific manner, influenced by weight status.
- Current "one-size-fits-all" clinical approaches may be inadequate.
- Personalized pediatric care with sex-specific screening for vitamin D is recommended.
Background:
Vitamin D and weight status are key determinants for neurodevelopmental outcomes in children. However, their independent and interactive associations with neurodevelopmental outcomes represent a critical yet insufficiently explored issue in pediatric health.
Objective:
This study aims to evaluate the independent associations of vitamin D status and weight status with neurodevelopmental outcomes in a large pediatric cohort and to explore how these relationships are stratified by age and sex.
Methods:
This retrospective study analyzed the electronic health records of 19,283 healthy children who visited a health management center in a tertiary children's hospital. Neurodevelopmental outcomes were assessed using the Ages and Stages Questionnaire, Third Edition (ASQ-3) (<6 years) and Conners Parent Rating Scale (CPRS) (≥6 years). Logistic regression analyses were applied to assess the independent and interactive impacts of vitamin D and weight status on neurodevelopmental outcomes.
Results:
The study included 19,283 children, 10,065 (52.2%) of whom were under 6 years old and 9218 (47.8%) who were between 6 and 18 years old. Among them, 1275 (12.67%) children under 6 were at risk for neurodevelopmental delay, and 1483 (16.09%) children aged between 6 and 18 years had behavioral challenges. Multivariable logistic regression revealed that vitamin D insufficiency/deficiency was significantly associated with suboptimal neurodevelopment in both the younger (odds ratio [OR] 1.48, 95% CI 1.23-1.79; P<.001) and older cohorts (OR 1.56, 95% CI 1.39-1.74; P<.001. A subgroup analysis revealed that vitamin D insufficiency/deficiency significantly increased the risk of neurodevelopmental delay among normal-weight girls under 6 years (OR 2.24, 95% CI 1.60-3.15; P<.001; q<.006) after the Benjamini-Hochberg false discovery rate correction. In the 6-to-18-year-old cohort, similar robust associations with behavioral challenges were observed in normal-weight girls (OR 1.61, 95% CI 1.30-2.00; P<.001; q<.006) and boys (OR 1.64, 95% CI 1.36-1.96; P<.001; q<.006).
Conclusions:
Vitamin D insufficiency/deficiency is associated with suboptimal neurodevelopmental outcomes in a sex-dependent manner modulated by weight status, challenging "one-size-fits-all" clinical models. We advocate for stratified, sex-specific screening and personalized pediatric care strategies.
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