ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutritional Epidemiology
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1539590
This article is part of the Research Topic The Relationship between Nutrition and Frailty/Multimorbidity: Prevention and Clinical Nutritional Management View all 8 articles
Two-Phase Linear Relationship of Vitamin D and Vitamin A among Children Aged 0 to 14 Years: A Cross-sectional Study
Provisionally accepted
Wenyuan Liu 1* Qiao Wang 2 Bibo Mao 1 Fei Xu 1 Yefang Ke 1 Shengying Zhang 1 Chenbo Zhou 1 Chunyan Liu 1 Wenbo Lu 1 Jishan Zheng 3*- 1 Laboratory of medicine, The Affiliated Women and Children's Hospital of Ningbo University, Ningbo, China
- 2 Laboratory of medicine, Qiu'ga Central Health Clinic, Yinzhou District, Ningbo, China
- 3 Department of Pediatrics, The Affiliated Women and Children's Hospital of Ningbo University, Ningbo, China
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Background: Vitamin 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.Objective: To explore the relationship between Vitamin D and Vitamin A levels in children and identify any critical thresholds.A 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.Results: A 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).The 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.
Keywords: Vitamin D, Vitamin A, Children, Micronutrients, Dose-response relationship, public health intervention
Received: 04 Dec 2024; Accepted: 14 Mar 2025.
Copyright: © 2025 Liu, Wang, Mao, Xu, Ke, Zhang, Zhou, Liu, Lu and Zheng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Wenyuan Liu, Laboratory of medicine, The Affiliated Women and Children's Hospital of Ningbo University, Ningbo, China
Jishan Zheng, Department of Pediatrics, The Affiliated Women and Children's Hospital of Ningbo University, Ningbo, China
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