A study on the status and intervention effects of vitamin D deficiency in children aged 0-6 years in Chengxian County
成县县域0~6岁儿童维生素D缺乏现状及干预效果研究

摘要

目的 调查甘肃省陇南市成县0~6岁体检儿童维生素D缺乏现状，分析其相关危险因素，探讨儿保科门诊个体化综合干预的临床效果，为县域儿童维生素D缺乏的防治提供科学依据。方法 选取2025年1月-2026年1月于成县人民医院儿保科门诊体检的0~6岁县域儿童100例为研究对象，检测血清25-羟维生素D水平，统计维生素D缺乏、不足发生率；采用单因素及多因素Logistic回归分析维生素D缺乏的危险因素。将50例维生素D缺乏儿童随机分为对照组与干预组，对照组予门诊常规健康指导，干预组实施个体化维生素D补充、户外活动指导、家庭喂养宣教联合随访督导的综合干预，对比两组干预3、6个月血清25-羟维生素D水平及营养状况改善情况。结果 100例儿童中，维生素D缺乏率38.00%，不足率29.00%，正常率33.00%，缺乏与不足总发生率67.00%。多因素Logistic回归分析显示，每日户外活动＜1h、未规律补充维生素D、喂养方式不当为维生素D缺乏的独立危险因素（均P＜0.001）。干预前两组血清25-羟维生素D水平无统计学差异（P＞0.05）；干预3、6个月后，两组水平均显著升高，且干预组各时点水平均高于对照组（均P＜0.001）。干预6个月后，干预组维生素D缺乏率8.00%、正常率76.00%，显著优于对照组的32.00%、32.00%（P＜0.001）。结论 成县县域0~6岁儿童维生素D缺乏及不足发生率较高，户外活动不足、补充不规律、喂养不当是核心危险因素；儿保科门诊个体化综合干预可有效改善儿童维生素D营养状况，适合在基层县域儿童保健机构推广应用。

Abstract

Objective To investigate the status of vitamin D deficiency in children aged 0-6 years undergoing physical examinations in Chengxian County, Longnan City, Gansu Province, analyze related risk factors, and explore the clinical effect of individualized comprehensive intervention in the pediatric outpatient department, providing a scientific basis for the prevention and treatment of vitamin D deficiency in children in the county.
Methods One hundred children aged 0-6 years in the county who underwent physical examinations at the pediatric outpatient department of Chengxian People’s Hospital from January 2025 to January 2026 were selected as the study subjects. Serum 25-hydroxyvitamin D levels were measured, and the incidence of vitamin D deficiency and insufficiency was statistically analyzed. Univariate and multivariate logistic regression analyses were used to analyze the risk factors for vitamin D deficiency. Fifty children with vitamin D deficiency were randomly divided into a control group and an intervention group. The control group received routine outpatient health guidance, while the intervention group received a comprehensive intervention including individualized vitamin D supplementation, outdoor activity guidance, family feeding education, and follow-up supervision. The serum 25-hydroxyvitamin D levels and nutritional status improvement of the two groups were compared at 3 and 6 months after the intervention.
Results Among the 100 children, the vitamin D deficiency rate was 38.00%, the insufficiency rate was 29.00%, and the normal rate was 33.00%, with a total deficiency and insufficiency rate of 67.00%. Multivariate logistic regression analysis showed that daily outdoor activity <1 hour, lack of regular vitamin D supplementation, and improper feeding methods were independent risk factors for vitamin D deficiency (all P < 0.001). Before the intervention, there was no statistically significant difference in serum 25-hydroxyvitamin D levels between the two groups (P > 0.05); after 3 and 6 months of intervention, the levels in both groups increased significantly, and the levels in the intervention group were higher than those in the control group at all time points (all P < 0.001). After 6 months of intervention, the vitamin D deficiency rate in the intervention group was 8.00%, and the normal rate was 76.00%, significantly better than the 32.00% and 32.00% in the control group (P < 0.001).
Conclusion   The incidence of vitamin D deficiency and insufficiency is high among children aged 0-6 years in Chengxian County. Insufficient outdoor activity, irregular supplementation, and improper feeding are the core risk factors. Individualized comprehensive intervention in pediatric outpatient clinics can effectively improve children’s vitamin D nutritional status and is suitable for promotion and application in primary-level county-level child health institutions.