Objective: To investigate the relationships between vitamin D nutritional status and the risks of cardiometabolic abnormities in children. Methods: Data were obtained from the School-based Cardiovascular and Bone Health Promotion Program. In 2017, a total of 15 391 children aged 6-16 years in Beijing were selected by using a stratified cluster sampling method in the baseline survey. A Follow-up investigation was conducted in 2019. Log-binomial regression was used to analyze the relationships between baseline vitamin D nutritional status and the risks of cardiometabolic abnormities (obesity, hypertension, hyperglycemia, and dyslipidemia). Results: A total of 10 482 participants were involved in the study. The average vitamin D level was (35.6 ± 12.0) nmol/L, and the deficiency rate was 35.1%. The 2-year cumulative incidence rates of obesity, hypertension, hyperglycemia, high TC, high LDL-C, low HDL-C, high TG, and high non-HDL-C were 4.3%, 10.8%, 8.5%, 3.1%, 2.5%, 3.4%, 2.5%, and 3.9% respectively. After the adjustment of potential confounding factors, children with vitamin D inadequacy or deficiency had higher risks of high TC [RR (95%CI): inadequacy, 2.06 (1.19-3.58); deficiency, 2.80 (1.61-4.89)], high LDL-C [RR (95%CI): inadequacy, 1.67 (1.02-2.73); deficiency, 1.99 (1.19-3.33)], and high non-HDL-C [RR (95%CI): inadequacy, 2.00 (1.26-3.17); deficiency, 2.45 (1.53-3.92)] compared with children with adequate vitamin D, and the risks of them increased with the decrease of vitamin D level (trend P<0.05). The gender-stratified analysis showed that vitamin D deficiency was remained associated with high TC [RR (95%CI): boy, 2.64 (1.19-5.87); girl, 3.13 (1.43-6.83)] and high non-HDL-C [RR (95%CI): boy, 2.58(1.40-4.77); girl, 2.31 (1.10-4.84)]. Conclusions: The risks of abnormal TC, LDL-C, and non-HDL-C were inversely associated with vitamin D level. Maintenance of adequate vitamin D status in children may contribute to the early prevention of cardiovascular diseases.
目的： 探讨儿童中维生素D营养状况与心血管代谢异常发生的关系。 方法： 研究对象来自"儿童青少年心血管与骨健康促进项目"，于2017年采用分层整群抽样的方法在北京市对15 391名6~16岁儿童开展基线调查，2019年对其进行随访调查。采用log-binomial回归分析基线维生素D营养状况与随访期心血管代谢异常（肥胖、高血压、FPG升高和血脂异常）发病风险的关系。 结果： 共纳入10 482名研究对象，维生素D平均水平为（35.6±12.0）nmol/L，缺乏率为35.1%。随访期肥胖、高血压、FPG升高、高TC、高LDL-C、低HDL-C、高TG和高非HDL-C的2年累计发病率分别为4.3%、10.8%、8.5%、3.1%、2.5%、3.4%、2.5%和3.9%。控制相关潜在混杂因素后，与维生素D充足的儿童相比，维生素D缺乏和不足的儿童高TC[RR值（95%CI）：缺乏，2.06（1.19~3.58）；不足，2.80（1.61~4.89）]、高LDL-C[RR值（95%CI）：缺乏，1.67（1.02~2.73）；不足，1.99（1.19~3.33）]和高非HDL-C[RR值（95%CI）：缺乏，2.00（1.26~3.17）；不足，2.45（1.53~3.92）]的发病风险增高，且随着维生素D水平的降低发病风险呈上升趋势（趋势性P<0.05）。按性别分层分析发现，维生素D缺乏与高TC[RR值（95%CI）：男童，2.64（1.19~5.87）；女童，3.13（1.43~6.83）]和高非HDL-C[RR值（95%CI）：男童，2.58（1.40~4.77）；女童，2.31（1.10~4.84）]的发生风险仍相关。 结论： 儿童期维生素D水平越低，TC、LDL-C和非HDL-C异常的发生风险越高。强调儿童维生素D的充足水平可能有助于心血管疾病的早期预防。.
Keywords: Cardiometabolic abnormities; Children; Cohort study; Vitamin D.