{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T17:46:10Z","timestamp":1792691170412,"version":"4.5.0"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,5,17]],"date-time":"2021-05-17T00:00:00Z","timestamp":1621209600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100017577","name":"Basic Public Welfare Research Program of Zhejiang Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100017577","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017363","name":"Hangzhou Social Development of Scientific Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100017363","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:p><jats:bold>Objective:<\/jats:bold> Vitamin D deficiency and insufficiency in children are global public health problems. However, few studies have focused on vitamin D status in healthy preschool children, especially in Asia. This study aimed to investigate vitamin D status and host-related factors in healthy preschool children in Hangzhou to analyze the impact of low vitamin D levels (&amp;lt;30 ng\/mL) on health outcomes (obesity, early childhood caries, and respiratory tract infections).<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> A total of 1,510 healthy children aged 24\u201372 months from 15 kindergartens in Hangzhou were included. Data on the children's gender, age, body mass index (BMI), caries, and blood samples available for vitamin D analysis were collected from June to August 2018. A total of 325 children aged 36\u201348 months took part in a survey on the frequency of respiratory tract infections in the last year.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> The children's mean 25(OH)D level was 28.01 \u00b1 7.29 ng\/mL. A total of 11.4% of the children had vitamin D deficiency, and 52.6% had vitamin D insufficiency. Only 36.0% had vitamin D sufficiency. No significant difference was found by gender or BMI group. However, children in the obesity group had the highest prevalence of vitamin D deficiency and the lowest 25(OH)D levels. A significant negative correlation was found between the 25(OH)D level and child age (<jats:italic>r<\/jats:italic> = \u22120.144, <jats:italic>p<\/jats:italic> &amp;lt; 0.001). Regression analysis showed that the children\u2019s 25(OH)D levels decreased by 0.17 ng\/mL per month with age. In addition, children with low vitamin D levels might increase the risk of obesity and early childhood caries. Multiple linear regression indicated that the number of caries in children increased by 0.08 per 1-ng\/mL decrease in the 25(OH)D level (<jats:italic>\u03b2<\/jats:italic> = \u22120.08, <jats:italic>p<\/jats:italic> &amp;lt; 0.001).<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> Vitamin D deficiency\/insufficiency is a serious problem among healthy preschool children in Hangzhou. Public health policies or interventions should be implemented to ensure that preschool children have adequate vitamin D to reduce the risk of related diseases.<\/jats:p>","DOI":"10.3389\/fpubh.2021.675403","type":"journal-article","created":{"date-parts":[[2021,5,17]],"date-time":"2021-05-17T05:58:55Z","timestamp":1621231135000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":33,"title":["Vitamin D Status and Its Influence on the Health of Preschool Children in Hangzhou"],"prefix":"10.3389","volume":"9","author":[{"given":"Zhaojun","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Lv","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wensheng","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Qian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunxia","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,5,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"429","DOI":"10.1186\/s12889-020-08557-0","article-title":"Status and influential factors of vitamin D among children aged 0 to 6 years in a Chinese population","volume":"20","author":"Zhang","year":"2020","journal-title":"BMC Public Health."},{"key":"B2","doi-asserted-by":"publisher","first-page":"110595","DOI":"10.1016\/j.nut.2019.110595","article-title":"Vitamin D status in preschool children and its relations to vitamin D sources and body mass index-fish intervention studies-KIDS (FINS-KIDS)","volume":"70","author":"Midtbo","year":"2020","journal-title":"Nutrition."},{"key":"B3","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1007\/s42000-019-00155-z","article-title":"The association between vitamin D status and infectious diseases of the respiratory system in infancy and childhood","volume":"18","author":"Zisi","year":"2019","journal-title":"Hormones."},{"key":"B4","doi-asserted-by":"publisher","first-page":"911","DOI":"10.2174\/0929867323666161202153028","article-title":"Possible molecular mechanisms by which vitamin D prevents inflammatory bowel disease and colitis-associated colorectal cancer","volume":"24","author":"Luan","year":"2017","journal-title":"Curr Med Chem."},{"key":"B5","first-page":"8208","article-title":"The vitamin D status and serum eosinophilic cationic protein levels in infants with cow\u2019s milk protein allergy","volume":"12","author":"Dogan","year":"2020","journal-title":"Am J Transl Res."},{"key":"B6","doi-asserted-by":"publisher","first-page":"928","DOI":"10.3109\/14767058.2015.1023710","article-title":"Association of vitamin D deficiency with acute lower respiratory tract infections in newborns","volume":"29","author":"Dinlen","year":"2016","journal-title":"J Matern Fetal Neonatal Med."},{"key":"B7","doi-asserted-by":"publisher","first-page":"553","DOI":"10.4162\/nrp.2020.14.6.553","article-title":"Vitamin D regulation of adipogenesis and adipose tissue functions","volume":"14","author":"Nimitphong","year":"2020","journal-title":"Nutr Res Pract."},{"key":"B8","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1111\/nyas.13968","article-title":"Global prevalence and disease burden of vitamin D deficiency: a roadmap for action in low- and middle-income countries","volume":"1430","author":"Roth","year":"2018","journal-title":"Ann N Y Acad Sci."},{"key":"B9","doi-asserted-by":"publisher","first-page":"783","DOI":"10.1007\/s00394-016-1368-9","article-title":"Low vitamin D deficiency in Irish toddlers despite northerly latitude and a high prevalence of inadequate intakes","volume":"57","author":"Ni Chaoimh","year":"2018","journal-title":"Eur J Nutr."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1662","DOI":"10.3390\/nu12061662","article-title":"Vitamin D status is not associated with cognitive or motor function in pre-school Ugandan children","volume":"12","author":"Mutua","year":"2020","journal-title":"Nutrients."},{"key":"B11","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1631\/jzus.B1500285","article-title":"Vitamin D status among infants, children, and adolescents in southeastern China","volume":"17","author":"Wang","year":"2016","journal-title":"J Zhejiang Univ Sci B."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1846","DOI":"10.1016\/j.scitotenv.2018.09.262","article-title":"Characterization of vertical distribution and radiative forcing of ambient aerosol over the Yangtze River Delta during 2013-2015","volume":"650","author":"Sun","year":"2019","journal-title":"Sci Total Environ."},{"key":"B13","doi-asserted-by":"publisher","first-page":"565","DOI":"10.11817\/j.issn.1672-7347.2017.05.014","article-title":"Prevalence of vitamin D insufficiency\/deficiency among overweight and obese preschool children in Yuelu District of Changsha","volume":"42","author":"He","year":"2017","journal-title":"Zhong Nan Da Xue Xue Bao Yi Xue Ban."},{"key":"B14","doi-asserted-by":"publisher","first-page":"260","DOI":"10.26719\/emhj.19.084","article-title":"Vitamin D deficiency in healthy children in Bahrain: do gender and age matter?","volume":"26","author":"Isa","year":"2020","journal-title":"East Mediterr Health J."},{"key":"B15","doi-asserted-by":"publisher","first-page":"461","DOI":"10.4274\/jcrpe.3301","article-title":"Prevalence of vitamin D deficiency and calcium homeostasis in Saudi children","volume":"8","author":"Al Shaikh","year":"2016","journal-title":"J Clin Res Pediatr Endocrinol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1111\/ped.13801","article-title":"Dental caries and vitamin D status in children in Asia","volume":"61","author":"Almoudi","year":"2019","journal-title":"Pediatr Int."},{"key":"B17","doi-asserted-by":"publisher","first-page":"149","DOI":"10.6065\/apem.2016.21.3.149","article-title":"Vitamin D deficiency in children aged 6 to 12 years: single center\u2019s experience in Busan","volume":"21","author":"Roh","year":"2016","journal-title":"Ann Pediatr Endocrinol Metab."},{"key":"B18","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1186\/1471-2458-12-126","article-title":"High prevalence of vitamin D deficiency among children aged 1 month to 16 years in Hangzhou, China","volume":"12","author":"Zhu","year":"2012","journal-title":"BMC Public Health."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/10408398.2020.1862753","article-title":"Functional effects of vitamin D: from nutrient to immunomodulator","volume":"23","author":"Meza-Meza","year":"2020","journal-title":"Crit Rev Food Sci Nutr."},{"key":"B20","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1093\/pubmed\/fdy147","article-title":"Vitamin D status in preschool children: should vitamin D supplementation, preventing vitamin D deficiency be continued in children over 2 years?","volume":"41","author":"Esmaeili Dooki","year":"2019","journal-title":"J Public Health."},{"key":"B21","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1159\/000505635","article-title":"Vitamin D in toddlers, preschool children, and adolescents","volume":"76","author":"Taylor","year":"2020","journal-title":"Ann Nutr Metab."},{"key":"B22","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1007\/s40519-020-01067-3","article-title":"Association of serum 25-hydroxyvitamin D concentration with anthropometric measures in children and adolescents: the CASPIAN-V study","author":"Bemanalizadeh","year":"2020","journal-title":"Eat Weight Disord."},{"key":"B23","first-page":"93","article-title":"Suboptimal serum vitamin D associated with early childhood caries in special health care needs children","volume":"85","author":"Seminario","year":"2018","journal-title":"J Dent Child."},{"key":"B24","doi-asserted-by":"publisher","first-page":"199","DOI":"10.5005\/jp-journals-10005-1511","article-title":"Comparison of vitamin D level of children with severe early childhood caries and children with no caries","volume":"11","author":"Chhonkar","year":"2018","journal-title":"Int J Clin Pediatr Dent."},{"key":"B25","doi-asserted-by":"publisher","first-page":"1471","DOI":"10.3390\/nu12051471","article-title":"Vitamin D deficiency and oral health: a comprehensive review","volume":"12","author":"Botelho","year":"2020","journal-title":"Nutrients."},{"key":"B26","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1177\/0022034519834518","article-title":"Association of maternal vitamin D deficiency with early childhood caries","volume":"98","author":"Singleton","year":"2019","journal-title":"J Dent Res."},{"key":"B27","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1159\/000502793","article-title":"Toward preventing enamel hypoplasia: modeling maternal and neonatal biomarkers of human calcium homeostasis","volume":"54","author":"Reed","year":"2020","journal-title":"Caries Res."},{"key":"B28","doi-asserted-by":"publisher","first-page":"8133","DOI":"10.26355\/eurrev_201909_19033","article-title":"Correlation of serum vitamin A, D, and E with recurrent respiratory infection in children","volume":"23","author":"Zhang","year":"2019","journal-title":"Eur Rev Med Pharmacol Sci."},{"key":"B29","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1007\/s12098-019-02933-4","article-title":"Infection status of rural schoolchildren and its relationship with vitamin D concentrations","volume":"86","author":"Mandlik","year":"2019","journal-title":"Indian J Pediatr."},{"key":"B30","doi-asserted-by":"publisher","first-page":"29954","DOI":"10.3402\/ijch.v75.29954","article-title":"Food insecurity, vitamin D insufficiency and respiratory infections among Inuit children","volume":"75","author":"Tse","year":"2016","journal-title":"Int J Circumpolar Health."},{"key":"B31","doi-asserted-by":"publisher","first-page":"467","DOI":"10.1097\/MPG.0000000000001658","article-title":"Vitamin D deficiency is not associated with growth or the incidence of common morbidities among Tanzanian infants","volume":"65","author":"Sudfeld","year":"2017","journal-title":"J Pediatr Gastroenterol Nutr."},{"key":"B32","doi-asserted-by":"publisher","first-page":"117","DOI":"10.4162\/nrp.2020.14.2.117","article-title":"Occurrence of infections in schoolchildren subsequent to supplementation with vitamin D-calcium or zinc: a randomized, double-blind, placebo-controlled trial","volume":"14","author":"Mandlik","year":"2020","journal-title":"Nutr Res Pract."},{"key":"B33","doi-asserted-by":"publisher","first-page":"e151","DOI":"10.18295\/squmj.2020.20.02.005","article-title":"National prevalence of micronutrient deficiencies, anaemia, genetic blood disorders and over- and undernutrition in Omani women of reproductive age and preschool children","volume":"20","author":"Petry","year":"2020","journal-title":"Sultan Qaboos Univ Med J."},{"key":"B34","doi-asserted-by":"publisher","first-page":"1034","DOI":"10.1017\/S0007114518002258","article-title":"Serum 25-hydroxyvitamin D levels showed strong seasonality but lacked association with vitamin D intake in 3-year-old Japanese children","volume":"120","author":"Ando","year":"2018","journal-title":"Br J Nutr."},{"key":"B35","doi-asserted-by":"publisher","first-page":"2503","DOI":"10.3390\/ijerph15112503","article-title":"Vitamin D status and analysis of specific correlates in preschool children: a cross-sectional study in Southern Croatia","volume":"15","author":"Karin","year":"2018","journal-title":"Int J Environ Res Public Health."},{"key":"B36","doi-asserted-by":"publisher","first-page":"e12805","DOI":"10.1111\/mcn.12805","article-title":"Micronutrient status differs among Maasai and Kamba preschoolers in a supplementary feeding programme in Kenya","volume":"15","author":"Houghton","year":"2019","journal-title":"Matern Child Nutr."},{"key":"B37","doi-asserted-by":"publisher","first-page":"e12340","DOI":"10.1111\/mcn.12340","article-title":"Predictors of vitamin D status in New Zealand preschool children","volume":"13","author":"Cairncross","year":"2017","journal-title":"Matern Child Nutr."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2021.675403\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,17]],"date-time":"2021-05-17T05:59:14Z","timestamp":1621231154000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2021.675403\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,17]]},"references-count":37,"alternative-id":["10.3389\/fpubh.2021.675403"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2021.675403","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,17]]},"article-number":"675403"}}