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惠州地区儿童血清维生素A、维生素D水平及与近视的相关性分析
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Abstract:
目的：探讨儿童血清维生素A、维生素D水平与近视的关联性。方法：选取2022年9月至2025年12月在惠州市第二妇幼保健院检测血清维生素A、维生素D的0~15岁儿童，分析其营养状况及与近视的相关性。结果3307名儿童血清维生素A水平为0.43 ± 0.15 mg/L，0~1岁组儿童最低。维生素A缺乏占2.4%，边缘缺乏占12.9%，0~1岁组缺乏和边缘缺乏最为严重(23.2%)。维生素A水平最高的为秋季，最低的为春季。维生素A缺乏最为严重的为春季(17.0%)，与春季缺乏相比有统计学差异的为夏季(χ2 = 14.363, P = 0.001)。不同体重分级、是否近视儿童维生素A水平及营养状况均无统计学差异。4599名儿童血清维生素D水平为72.13 ± 33.88 nmol/L。随着年龄的增加呈明显下降趋势(b = ？0.376, t = 130.475, P < 0.001)。维生素D缺乏和不足率为25.5%，随着年龄的增长有加剧趋势(b = 0.006, t = 5.604, P < 0.001)。春季维生素D营养状况最差，缺乏和不足为29.5%，与春季维生素D营养状况相比，有统计学差异为夏季(χ2 = 31.649, P < 0.001)。与正常体重儿童相比，超重或肥胖儿童25(OH)D水平与营养状况均有统计学差异(t = 3.166, P = 0.002; χ2 = 10.966, P = 0.004)。正常视力儿童维生素D缺乏和不足率高于近视儿童(35.0% vs. 31.1%, P = 0.016)。结论：惠州地区0~15岁儿童普遍存在维生素A与维生素D缺乏或不足的现象。其中，0~1岁婴幼儿维生素A不足问题较为突出，而维生素D不足与缺乏则更为普遍，且其发生率呈现随年龄增长而上升的趋势。两种维生素的营养状况春季最差，夏季相对较好。尽管维生素D缺乏和不足率在正常视力与近视儿童之间存在一定差异，但该差异缺乏临床意义。因此，本研究未能提供维生素A和维生素D水平与近视之间存在具有临床意义关联的证据。
Objective: To investigate the association between serum vitamin A and vitamin D levels and myopia in children from Huizhou. Methods: Children aged 0~15 years who underwent serum vitamin A and vitamin D testing at Huizhou Second Maternal and Child Healthcare Hospital from September 2022 to December 2025 were enrolled. Their nutritional status and its correlation with myopia were analyzed. Results: A total of 3,307 children had a serum vitamin A level of 0.43 ± 0.15 mg/L, with the lowest level observed in the 0~1 year age group. The prevalence of vitamin A deficiency and marginal deficiency was 2.4% and 12.9%, respectively, with the highest rates (23.2%) in the 0~1 year group. Vitamin A levels peaked in autumn and were lowest in spring. The most severe vitamin A deficiency occurred in spring (17.0%), which showed a statistical difference compared to summer (χ2 = 14.363, P = 0.001). No statistically significant differences were found in vitamin A levels or nutritional status across different weight categories or between children with and without myopia. Among 4599 children, the serum vitamin D level was 72.13 ± 33.88 nmol/L, demonstrating a significant decreasing trend with age (b = ？0.376, t = 130.475, P < 0.001). The prevalence of vitamin D deficiency and insufficiency was 25.5%, showing an increasing trend with age
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