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

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).