Abstract: Objective To analyze the impact of different primary caregivers on vitamin D insufficiency in children aged 0-18 years, and to provide a basis for family-based prevention and control of vitamin D insufficiency in children and adolescents. Methods A total of 12 630 children and adolescents aged 0 - 18 years from 18 regions in Hainan Province were selected as the study population between January 2021 and March 2022. Investigators used a self-designed questionnaire to collect information on caregivers' age, family type, occupation, and educational level. Fasting venous blood samples were collected from the children, and vitamin D levels were measured using electrochemiluminescence immunoassay. Chi-square tests and Fisher's exact tests were used for univariate analysis, and logistic regression was employed for multivariate analysis. Results The detection rate of vitamin D insufficiency and deficiency among children and adolescents aged 0 - 18 years in Hainan Province was 23.42% (2 958/12 630). Significant differences in vitamin D levels were observed based on the child's gender (χ²=215.284),age (χ²=1 484.55), resident area (χ²=180.202), primary caregiver (χ²=229.889), parental occupation (χ²=53.638,51.606), and educational level (χ²=87.965,91.826)and daily outdoor physical activity (χ²=71.844)(P<0.001). After adjusting for confounding factors, multivariate logistic regression analysis revealed thatchildren with grandparents as main caregivers had a higher risk for vitamin D insufficiency and deficiency in children (OR=1.225, 95%CI: 1.009 - 1.487, P<0.05). Conclusions Different primary caregivers have a significant impact on vitamin D levels in children and adolescents. Greater attention should be paid to the family environment to reduce the occurrence of vitamin D insufficiency and deficiency in this population.

Key words: caregivers, vitamin D, insufficiency, deficiency, family rearing environment, children and adolescents

摘要： 目的 分析研究不同主要照护者对0~18岁儿童维生素D不足的影响,为儿童青少年维生素D不足的家庭防控提供依据。方法 选取2021年1月—2022年3月来自海南省18个地区的0~18岁12 630名儿童青少年为研究对象,由调查员使用自制调查表对照护者年龄、家庭类型、职业、文化程度进行调查,并取儿童空腹静脉血经电化学发光免疫分析儿童维生素D水平,采用χ²检验及Fisher精确检验进行单因素分析,logistic回归进行多因素分析。结果 海南省0~18岁儿童青少年维生素D不足及缺乏检出率23.42%(2 958/12 630)。不同性别(χ²=215.284)、年龄(χ²＝1 484.55)、城乡分类(χ²＝180.202)、主要照护者(χ²=229.889)、父母职业(χ²=53.638、51.606)和文化程度(χ²=87.965、91.826)及每日户外活动时间(χ²＝71.844)的儿童青少年维生素D水平差异具有统计学意义(P<0.001)。多因素logistic回归分析结果显示,调整混杂因素后,主要照护者为祖父母的儿童维生素D不足及缺乏发生的风险较高(OR=1.225,95%CI:1.009~1.487,P<0.05)。结论 不同照护者对儿童青少年维生素D水平存在显著影响。应重视儿童家庭环境,减少儿童青少年维生素D不足及缺乏的发生。

关键词: 照护者, 维生素D, 不足, 缺乏, 家庭养育环境, 儿童青少年