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

Analysis of Serum Vitamin A and Vitamin D Levels and Their Correlation with Myopia in Children from Huizhou

摘要: 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。

Abstract: 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 (b = 0.006, t = 5.604, P < 0.001). Vitamin D nutritional status was poorest in spring (deficiency and insufficiency rate: 29.5%), which was significantly different from that in summer (χ² = 31.649, P < 0.001). Overweight or obese children had significantly lower 25(OH)D levels and poorer nutritional status compared to normal-weight children (t = 3.166, P = 0.002; χ² = 10.966, P = 0.004). The proportion of vitamin D deficiency and insufficiency was higher in the normal vision group than in the myopic group (35.0% vs. 31.1%, P = 0.016). Conclusion: Vitamin A and vitamin D deficiency or insufficiency are common among children aged 0~15 years in Huizhou. Vitamin A insufficiency is particularly prominent in infants aged 0~1 year, while vitamin D deficiency and insufficiency are more prevalent and show an increasing trend with age. The nutritional status of the two vitamins is poorest in spring and relatively better in summer. Although there is a certain difference in the rate of vitamin D deficiency and insufficiency between children with normal vision and those with myopia, this difference lacks clinical significance. Therefore, this study does not support the presence of a clinically meaningful association between vitamin A and vitamin D levels and myopia.