Vitamin D status in Mainland of China: A systematic review and meta-analysis

Wenhua Liu; Jing Hu; Yuanyuan Fang; Peng Wang; Yanjun Lu; Na Shen

doi:10.1016/j.eclinm.2021.101017

Vitamin D status in Mainland of China: A systematic review and meta-analysis

EClinicalMedicine. 2021 Jul 14:38:101017. doi: 10.1016/j.eclinm.2021.101017. eCollection 2021 Aug.

Authors

Wenhua Liu¹, Jing Hu², Yuanyuan Fang³, Peng Wang⁴, Yanjun Lu⁵, Na Shen⁵

Affiliations

¹ Clinical Research Center,Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China.
² Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, HUST, Wuhan, China.
³ Department of Neurology, Tongji Hospital,Tongji Medical College, HUST, Wuhan, China.
⁴ Institute and Department of Infectious Disease, Tongji Hospital, Tongji Medical College, HUST, Wuhan, China.
⁵ Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, HUST, Wuhan, China.

Abstract

Background: Low vitamin D (VitD) status is becoming a global health issue. Previous heterogenous results are urging a meta-analysis to delineate a panorama of VitD conditions in the general population in Mainland of China.

Methods: We performed a systematic review and meta-analysis by searching PubMed, Web of Science, EMBASE, China National Knowledge Infrastructure, WanFang, and VIP databases up to June 4, 2021. The inclusion criteria were as follows: (1) original articles or dissertations focused on VitD status of people in Mainland of China; and (2) studies were population-based, cross-sectional, or longitudinal cohort with baseline data. The outcomes were serum 25(OH)D concentration and the prevalence of low VitD status. Low VitD status included VitD deficiency (< 30 nmol/L) and VitD inadequacy (< 50 nmol/L). Data were estimated by Hierarchical Bayesian methods. All included studies were cross-sectional or longitudinal cohort studies about VitD status of people in Mainland of China. (Registration: PROSPERO CRD42021226130).

Findings: A total of 105 eligible studies including 234,519 subjects were included. In adults, the overall mean 25(OH)D concentration was 44.3 nmol/L (95% Credible Interval [CrI]: 39.8-48.7). The pooled prevalence of VitD deficiency and inadequacy was 20.7% (95% CrI: 11.9-32.9) and 63.2% (95% CrI: 53.5-72.3), respectively. In children and adolescents, the overall mean 25(OH)D concentration was 52.2 nmol/L (95% CrI: 46.7-57.5). The pooled prevalence of VitD deficiency and inadequacy was 23.0% (95% CrI: 8.9-44.3) and 46.8% (95% CrI: 37.2-56.6), respectively. Specially, we identified that the prevalence of VitD inadequacy increased with age in populations with age ≤ 18 years and ≥ 60 years.

Interpretation: Low VitD status is prominent in general population of Mainland of China, especially for adults.

Funding: National Major Scientific and Technological Special Project for "Significant New Drugs Development" (2017ZX09304022).

Keywords: Deficiency; Mainland of China; Meta-analysis; Systematic review; Vitamin D.