Abstract: Objective To explore the correlation of serum vitamin D level of children aged 0 to 3 years with their caregivers' nutritional knowledge, attitude and practice (KAP) in Yibin, in order to provide reference for the prevention of vitamin D deficiency in children. Methods A total of 783 children aged 0 to 3 years who underwent child health care at the First People's Hospital of Yibin from January to December 2020 were selected into this study. Children's general conditions (feeding, growth and development, lifestyle, etc.) were collected, and venous blood samples were taken to detect serum 25-(OH)D concentration using the chemiluminescence method. The caregivers' nutritional KAP was investigated using a self-designed knowledge-attitude-practice questionnaire. The relationship between the children's vitamin D nutritional status and their caregivers' nutritional KAP was analyzed using pearson correlation analysis. Results 1) The exclusive breastfeeding rate of children aged 0 to 3 years was about 62.2%. Significant differences were found in outdoor activity time and average vitamin D supplementation among different age groups (t=9.030, 10.260, P<0.05). 2) The average concentration of serum 25-(OH)D was (36.8±8.7)ng/mL, and the incidence of vitamin D deficiency was 21.84%. Significant differences were found in serum 25-(OH)D level and the incidence of vitamin D deficiency among children of different ages, body shapes, outdoor activities, and vitamin D supplementation (t/F:2.220 - 6.302, χ²:5.346 - 33.134, P<0.05). 3) The caregivers' nutritional KAP scores were 78.9±9.9, 88.1±8.3, and 78.3±11.8, respectively, with parents scoring higher than other caregivers (P<0.05). 4) Serum 25-(OH)D level was positively correlated with the nutritional knowledge, attitude, and behavior scores of caregivers (r=0.805, 0.650, 0.831, P<0.05). The caregivers' nutritional KAP grade was correlated with vitamin D deficiency (P<0.05). 5) Overweight/obesity was a possible risk factor for vitamin D deficiency in children (OR=2.126, 95%CI: 1.162 - 3.887). Outdoor activity duration ≥2h/d (OR=0.592, 95%CI: 0.392 - 0.895), regular vitamin D supplementation (OR=0.618, 95%CI: 0.456 - 0.838), and good nutritional behavior of caregivers(OR=0.725, 95%CI: 0.563 - 0.933) were protective factors for vitamin D deficiency in children (P<0.05). Conclusions The prevalence of vitamin D deficiency is high among children aged 0 to 3 years in Yibin, and it is related to the nutritional KAP of their caregivers. Improving the nutritional KAP of caregivers can help prevent and manage vitamin D deficiency in children.

Key words: vitamin D, children, knowledge, attitude, practice, caregivers

摘要： 目的 探讨宜宾市0~3岁儿童血清维生素D水平与其监护人营养知识态度行为(KAP)的相关性,为预防儿童维生素D缺乏提供参考。方法 选取2020年1—12月于宜宾市第一人民医院进行儿童保健且检测血清25-(OH)D的783名0~3岁儿童为研究对象,收集所有儿童一般情况(喂养情况、生长发育情况、生活方式等),采集静脉血用化学发光法测定血清25-(OH)D水平,使用自行设计的喂养知识-态度-行为问卷调查其监护人KAP,采用Pearson相关和关联性分析儿童维生素D营养状况与监护人营养KAP的关系。结果 1) 0~3岁儿童纯母乳喂养率为62.2%,不同年龄段儿童的每日户外活动时间、维生素D平均补充量差异有统计学意义(t=9.030、10.260,P＜0.05)。2) 血清25-(OH)D浓度平均为(36.8±8.7)ng/mL,维生素 D缺乏率为21.84%,不同年龄段、体型、户外活动时间及维生素D制剂补充情况的儿童血清25-(OH)D水平及维生素D缺乏率差异有统计学意义(t/F:2.220~6.302,χ²:5.346~33.134,P＜0.05)。3) 监护人营养KAP得分分别为(78.9±9.9)、(88.1±8.3)分和(78.3±11.8)分,父母KAP得分高于其他监护人(P＜0.05)。4) 血清25-(OH)D水平与监护人营养知识、态度和行为评分均呈正相关(r=0.805、0.650、0.831,P＜0.05),监护人营养KAP分级和维生素D缺乏有关联性(P＜0.05)。5)体型超重或肥胖是维生素D缺乏的危险因素(OR=2.126,95%CI:1.162~3.887),每日户外活动时间≥2h(OR=0.592,95%CI:0.392~0.895)、规律补充维生素D(OR=0.618,95%CI:0.456~0.838)和监护人营养行为良好(OR=0.725,95%CI:0.563~0.933)是儿童维生素D缺乏的保护因素(P＜0.05)。结论 宜宾市0~3岁儿童维生素D缺乏率高,维生素D营养状况与监护人营养KAP有关,提高监护人营养KAP有利于预防儿童维生素D缺乏。

关键词: 维生素D, 儿童, 知识, 态度, 行为, 监护人