Abstract: Vitamin A and vitamin D deficiencies or insufficiencies in children remain global public health problems. The deficiencies of both vitamin A and vitamin D exist in Chinese children, the deficiency of vitamin A is mainly marginal (about 30%) in children aged 0 - 12 years.Vitamin D deficiency and prevalence are common in healthy children aged 0 - 18 years, among which the severe deficiency rate is 2.46%, the deficiency rate is 21.57%, and the marginal deficiency rate is 28.71%.The deficiency rate gradually increases with the increase of age.Since the respective bioactive metabolites of vitamin A and vitamin D, retinoic acid and 1 and 25-dihydroxyvitamin D₃ have hormone-like properties, and both metabolites are synthesized from their vitamin precursors by different tissues and cells in the body, there may be a synergistic effect between both on target cells remotely by binding to nuclear hormone receptors.A high proportion of concurrent vitamin A and vitamin D deficiencies (comorbidities) in malnourished children under 5 years of age in low- and middle-income countries and poor areas will affect the immune response in a highly specific way, in addition to causing growth and developmental disorders (e.g., growth retardation, motor retardation), it also increases susceptibility to infectious diseases (e.g., recurrent respiratory infections, diarrhea), allergic diseases (e.g., asthma, atopic dermatitis), and neurodevelopmental disorders (touretic disorder, autism spectrum disorder).Therefore, children in the period of growth and development may benefit from supplementing with vitamin A and vitamin D.

Key words: vitamin A, vitamin D, children, comorbidity, nutritional status

摘要： 儿童维生素A和维生素D缺乏或不足仍然是全球性公共卫生问题。我国儿童中同时存在维生素A和维生素D缺乏问题,0～12岁儿童中维生素A以边缘性缺乏为主(约30%);0～18岁健康儿童中维生素D缺乏和不足较普遍,其中严重缺乏率为2.46%、缺乏率为21.57%、不足率为28.71%,缺乏率随着年龄增加逐渐增高。由于维生素A和维生素D各自的生物活性代谢物视黄酸和 1,25-二羟基维生素 D₃具有激素样特性,而且这两种代谢物都是由体内不同的组织和细胞从其维生素前体合成,通过与核激素受体结合远程对靶细胞两者可能发挥协同作用。在中低收入国家和贫困地区的5岁以下营养不良儿童中,同时存在较高比例的维生素A和维生素D缺乏(共病),这会以高度特异性的方式影响机体的免疫反应,除了导致生长发育障碍(如生长迟缓、运动发育迟缓),还增加感染性疾病(如反复呼吸道感染、腹泻)、过敏性疾病(如哮喘、特应性皮炎)、神经发育障碍(抽动症、孤独症谱系障碍)等疾病的易感性。因此,对于处在生长发育期的儿童维生素A和维生素D同时补充,可促进其健康发展。

关键词: 维生素A, 维生素D, 儿童, 共病, 营养状况