Two-phase linear relationship of Vitamin D and Vitamin A among children aged 0–14 years: a cross-sectional study

BackgroundVitamin D and Vitamin A are crucial for children’s immune function, bone health, and cellular growth, but their interrelationship and the impact of various factors remain poorly understood.ObjectiveTo explore the relationship between Vitamin D and Vitamin A levels in children and identify...

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Main Authors: Wenyuan Liu, Qiao Wang, Bibo Mao, Fei Xu, Yefang Ke, Shengying Zhang, Chenbo Zhou, Chunyan Liu, Wenbo Lu, Jishan Zheng
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Nutrition
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Online Access:https://www.frontiersin.org/articles/10.3389/fnut.2025.1539590/full
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author Wenyuan Liu
Qiao Wang
Bibo Mao
Fei Xu
Yefang Ke
Shengying Zhang
Chenbo Zhou
Chunyan Liu
Wenbo Lu
Jishan Zheng
author_facet Wenyuan Liu
Qiao Wang
Bibo Mao
Fei Xu
Yefang Ke
Shengying Zhang
Chenbo Zhou
Chunyan Liu
Wenbo Lu
Jishan Zheng
author_sort Wenyuan Liu
collection DOAJ
description BackgroundVitamin D and Vitamin A are crucial for children’s immune function, bone health, and cellular growth, but their interrelationship and the impact of various factors remain poorly understood.ObjectiveTo explore the relationship between Vitamin D and Vitamin A levels in children and identify any critical thresholds.MethodsA cross-sectional study was conducted from 2018 to 2021 in Ningbo, Zhejiang, China. Participants were children aged 0 to 14 years attending community health service centers for routine health check-ups. Multivariate linear regression analysis was conducted to ascertain the association between serum Vitamin D and Vitamin A levels. A smooth curve fitting approach was employed to analyze the dose–response relationship between Vitamin D and Vitamin A.ResultsA total of 4,752 participants were included. The study revealed significant variations in baseline Vitamin D and Vitamin A levels across different deficiency categories. Mean Vitamin D levels were lowest in the severe deficiency group (4.9 ng/mL) and highest in the normal group (34.8 ± 9.8 ng/mL), while mean Vitamin A levels were lowest in the deficiency group (226.6 ± 72.2 ng/mL) and highest in the normal group (263.3 ± 74.0 ng/mL). The study revealed a two-phase linear relationship with a significant threshold effect at a Vitamin D level of 28.289 ng/mL. Below this threshold, the association between Vitamin D and Vitamin A was strong (β = 2.935, 95% CI: 2.173, 3.696), while above the threshold, the association was significantly weaker (β = 0.737, 95% CI: 0.413, 1.061). The likelihood ratio test confirmed the significance of this threshold effect (p < 0.001).ConclusionThe study concludes that a significant threshold at 28.289 ng/mL Vitamin D marks a point beyond which the association with Vitamin A levels plateaus, highlighting the importance of this threshold for optimizing vitamin status in children.
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spelling doaj-art-b7f86d1d96934f67b9e79e70be0db2402025-08-20T01:50:39ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2025-04-011210.3389/fnut.2025.15395901539590Two-phase linear relationship of Vitamin D and Vitamin A among children aged 0–14 years: a cross-sectional studyWenyuan Liu0Qiao Wang1Bibo Mao2Fei Xu3Yefang Ke4Shengying Zhang5Chenbo Zhou6Chunyan Liu7Wenbo Lu8Jishan Zheng9Laboratory of Medicine, The Affiliated Women and Children’s Hospital of Ningbo University, Ningbo, ChinaLaboratory of Medicine, Qiu’ga Central Health Clinic, Ningbo, ChinaLaboratory of Medicine, The Affiliated Women and Children’s Hospital of Ningbo University, Ningbo, ChinaLaboratory of Medicine, The Affiliated Women and Children’s Hospital of Ningbo University, Ningbo, ChinaLaboratory of Medicine, The Affiliated Women and Children’s Hospital of Ningbo University, Ningbo, ChinaLaboratory of Medicine, The Affiliated Women and Children’s Hospital of Ningbo University, Ningbo, ChinaLaboratory of Medicine, The Affiliated Women and Children’s Hospital of Ningbo University, Ningbo, ChinaLaboratory of Medicine, The Affiliated Women and Children’s Hospital of Ningbo University, Ningbo, ChinaLaboratory of Medicine, The Affiliated Women and Children’s Hospital of Ningbo University, Ningbo, ChinaDepartment of Pediatrics, The Affiliated Women and Children’s Hospital of Ningbo University, Ningbo, ChinaBackgroundVitamin D and Vitamin A are crucial for children’s immune function, bone health, and cellular growth, but their interrelationship and the impact of various factors remain poorly understood.ObjectiveTo explore the relationship between Vitamin D and Vitamin A levels in children and identify any critical thresholds.MethodsA cross-sectional study was conducted from 2018 to 2021 in Ningbo, Zhejiang, China. Participants were children aged 0 to 14 years attending community health service centers for routine health check-ups. Multivariate linear regression analysis was conducted to ascertain the association between serum Vitamin D and Vitamin A levels. A smooth curve fitting approach was employed to analyze the dose–response relationship between Vitamin D and Vitamin A.ResultsA total of 4,752 participants were included. The study revealed significant variations in baseline Vitamin D and Vitamin A levels across different deficiency categories. Mean Vitamin D levels were lowest in the severe deficiency group (4.9 ng/mL) and highest in the normal group (34.8 ± 9.8 ng/mL), while mean Vitamin A levels were lowest in the deficiency group (226.6 ± 72.2 ng/mL) and highest in the normal group (263.3 ± 74.0 ng/mL). The study revealed a two-phase linear relationship with a significant threshold effect at a Vitamin D level of 28.289 ng/mL. Below this threshold, the association between Vitamin D and Vitamin A was strong (β = 2.935, 95% CI: 2.173, 3.696), while above the threshold, the association was significantly weaker (β = 0.737, 95% CI: 0.413, 1.061). The likelihood ratio test confirmed the significance of this threshold effect (p < 0.001).ConclusionThe study concludes that a significant threshold at 28.289 ng/mL Vitamin D marks a point beyond which the association with Vitamin A levels plateaus, highlighting the importance of this threshold for optimizing vitamin status in children.https://www.frontiersin.org/articles/10.3389/fnut.2025.1539590/fullVitamin DVitamin Achildrenmicronutrientsdose–response relationshippublic health intervention
spellingShingle Wenyuan Liu
Qiao Wang
Bibo Mao
Fei Xu
Yefang Ke
Shengying Zhang
Chenbo Zhou
Chunyan Liu
Wenbo Lu
Jishan Zheng
Two-phase linear relationship of Vitamin D and Vitamin A among children aged 0–14 years: a cross-sectional study
Frontiers in Nutrition
Vitamin D
Vitamin A
children
micronutrients
dose–response relationship
public health intervention
title Two-phase linear relationship of Vitamin D and Vitamin A among children aged 0–14 years: a cross-sectional study
title_full Two-phase linear relationship of Vitamin D and Vitamin A among children aged 0–14 years: a cross-sectional study
title_fullStr Two-phase linear relationship of Vitamin D and Vitamin A among children aged 0–14 years: a cross-sectional study
title_full_unstemmed Two-phase linear relationship of Vitamin D and Vitamin A among children aged 0–14 years: a cross-sectional study
title_short Two-phase linear relationship of Vitamin D and Vitamin A among children aged 0–14 years: a cross-sectional study
title_sort two phase linear relationship of vitamin d and vitamin a among children aged 0 14 years a cross sectional study
topic Vitamin D
Vitamin A
children
micronutrients
dose–response relationship
public health intervention
url https://www.frontiersin.org/articles/10.3389/fnut.2025.1539590/full
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