Vitamin D levels and its influencing factors in children and adolescents in mainland China: a systematic review and meta-analysis
Objectives Childhood vitamin D deficiency is a public health issue. This study aims to systematically evaluate vitamin D nutritional status among children and adolescents in Mainland China through a quantitative analysis of literature, providing evidence-based strategies for prevention.Design This i...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2025-06-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/6/e094693.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849682873511051264 |
|---|---|
| author | Bo Chen Pengyun Ji Zisheng Li Wenyan Qin Youqing She |
| author_facet | Bo Chen Pengyun Ji Zisheng Li Wenyan Qin Youqing She |
| author_sort | Bo Chen |
| collection | DOAJ |
| description | Objectives Childhood vitamin D deficiency is a public health issue. This study aims to systematically evaluate vitamin D nutritional status among children and adolescents in Mainland China through a quantitative analysis of literature, providing evidence-based strategies for prevention.Design This is a systematic review and meta-analysis, conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data sources A comprehensive search strategy was implemented across eight electronic databases (PubMed, Embase, Web of Science, Cochrane Library, CNKI, VIP, Wanfang and CBM) from inception to February 2024.Eligibility criteria We included cross-sectional studies that measured serum 25-hydroxyvitamin D levels and analysed influencing factors (eg, age, season, region) in healthy children and adolescents aged 0–18 years in Mainland China; studies reporting prevalence data of vitamin D deficiency/insufficiency based on standardised thresholds (deficiency <50 nmol/L, insufficiency 50–75 nmol/L) and using validated detection methods (eg, liquid chromatography-tandem mass spectrometry, chemiluminescence immunoassay, ELISA) were prioritised.Data extraction and synthesis Two independent reviewers systematically searched, screened and extracted data using predefined protocols. Study quality was assessed with the Agency for Healthcare Research and Quality (AHRQ) tool. Meta-analyses were performed using random-effects models in Review Manager V.5.3 and Stata V.16.0, with subgroup analyses by age, season and region. Sensitivity analysis and Egger’s test were applied to evaluate robustness and publication bias. Findings were synthesised through narrative summaries and quantitative pooling.Results The pooled prevalence of vitamin D deficiency among children and adolescents in Mainland China was 48% (95% CI: 40% to 57%), with extreme heterogeneity across studies (I² = 99.98%, p<0.001). Sensitivity analysis confirmed the stability of pooled estimates. Subgroup analyses revealed significant age-related declines (infants: 82.35 nmol/L vs adolescents: 50.98 nmol/L, p<0.05). Study quality assessed by AHRQ criteria showed 16% of included studies were high-quality (scores 8-11/11), 84% moderate (4-7). Evidence of publication bias was detected via Egger’s test (p<0.05) and funnel plot asymmetry.Conclusions The study highlights the widespread nature of vitamin D deficiency among children and adolescents in Mainland China, particularly in older children and during winter months. Effective interventions are necessary to address this issue. Future research should prioritise methodological standardisation to reduce heterogeneity and address potential publication bias.PROSPERO registration number CRD42023479183. |
| format | Article |
| id | doaj-art-9934dff1714042e48c2a7de3737d71fc |
| institution | DOAJ |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-9934dff1714042e48c2a7de3737d71fc2025-08-20T03:24:03ZengBMJ Publishing GroupBMJ Open2044-60552025-06-0115610.1136/bmjopen-2024-094693Vitamin D levels and its influencing factors in children and adolescents in mainland China: a systematic review and meta-analysisBo Chen0Pengyun Ji1Zisheng Li2Wenyan Qin3Youqing She4Department of Nuclear Medicine, Chaohu Hospital of Anhui Medical University, Hefei, Anhui, ChinaDepartment of Pain, Eastern Theater General Hospital, Nanjing, Jiangsu, ChinaDepartment of Nuclear Medicine, Chaohu Hospital of Anhui Medical University, Hefei, Anhui, ChinaDepartment of Nuclear Medicine, Chaohu Hospital of Anhui Medical University, Hefei, Anhui, ChinaDepartment of Nuclear Medicine, Chaohu Hospital of Anhui Medical University, Hefei, Anhui, ChinaObjectives Childhood vitamin D deficiency is a public health issue. This study aims to systematically evaluate vitamin D nutritional status among children and adolescents in Mainland China through a quantitative analysis of literature, providing evidence-based strategies for prevention.Design This is a systematic review and meta-analysis, conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data sources A comprehensive search strategy was implemented across eight electronic databases (PubMed, Embase, Web of Science, Cochrane Library, CNKI, VIP, Wanfang and CBM) from inception to February 2024.Eligibility criteria We included cross-sectional studies that measured serum 25-hydroxyvitamin D levels and analysed influencing factors (eg, age, season, region) in healthy children and adolescents aged 0–18 years in Mainland China; studies reporting prevalence data of vitamin D deficiency/insufficiency based on standardised thresholds (deficiency <50 nmol/L, insufficiency 50–75 nmol/L) and using validated detection methods (eg, liquid chromatography-tandem mass spectrometry, chemiluminescence immunoassay, ELISA) were prioritised.Data extraction and synthesis Two independent reviewers systematically searched, screened and extracted data using predefined protocols. Study quality was assessed with the Agency for Healthcare Research and Quality (AHRQ) tool. Meta-analyses were performed using random-effects models in Review Manager V.5.3 and Stata V.16.0, with subgroup analyses by age, season and region. Sensitivity analysis and Egger’s test were applied to evaluate robustness and publication bias. Findings were synthesised through narrative summaries and quantitative pooling.Results The pooled prevalence of vitamin D deficiency among children and adolescents in Mainland China was 48% (95% CI: 40% to 57%), with extreme heterogeneity across studies (I² = 99.98%, p<0.001). Sensitivity analysis confirmed the stability of pooled estimates. Subgroup analyses revealed significant age-related declines (infants: 82.35 nmol/L vs adolescents: 50.98 nmol/L, p<0.05). Study quality assessed by AHRQ criteria showed 16% of included studies were high-quality (scores 8-11/11), 84% moderate (4-7). Evidence of publication bias was detected via Egger’s test (p<0.05) and funnel plot asymmetry.Conclusions The study highlights the widespread nature of vitamin D deficiency among children and adolescents in Mainland China, particularly in older children and during winter months. Effective interventions are necessary to address this issue. Future research should prioritise methodological standardisation to reduce heterogeneity and address potential publication bias.PROSPERO registration number CRD42023479183.https://bmjopen.bmj.com/content/15/6/e094693.full |
| spellingShingle | Bo Chen Pengyun Ji Zisheng Li Wenyan Qin Youqing She Vitamin D levels and its influencing factors in children and adolescents in mainland China: a systematic review and meta-analysis BMJ Open |
| title | Vitamin D levels and its influencing factors in children and adolescents in mainland China: a systematic review and meta-analysis |
| title_full | Vitamin D levels and its influencing factors in children and adolescents in mainland China: a systematic review and meta-analysis |
| title_fullStr | Vitamin D levels and its influencing factors in children and adolescents in mainland China: a systematic review and meta-analysis |
| title_full_unstemmed | Vitamin D levels and its influencing factors in children and adolescents in mainland China: a systematic review and meta-analysis |
| title_short | Vitamin D levels and its influencing factors in children and adolescents in mainland China: a systematic review and meta-analysis |
| title_sort | vitamin d levels and its influencing factors in children and adolescents in mainland china a systematic review and meta analysis |
| url | https://bmjopen.bmj.com/content/15/6/e094693.full |
| work_keys_str_mv | AT bochen vitamindlevelsanditsinfluencingfactorsinchildrenandadolescentsinmainlandchinaasystematicreviewandmetaanalysis AT pengyunji vitamindlevelsanditsinfluencingfactorsinchildrenandadolescentsinmainlandchinaasystematicreviewandmetaanalysis AT zishengli vitamindlevelsanditsinfluencingfactorsinchildrenandadolescentsinmainlandchinaasystematicreviewandmetaanalysis AT wenyanqin vitamindlevelsanditsinfluencingfactorsinchildrenandadolescentsinmainlandchinaasystematicreviewandmetaanalysis AT youqingshe vitamindlevelsanditsinfluencingfactorsinchildrenandadolescentsinmainlandchinaasystematicreviewandmetaanalysis |