Meta-Analysis of Zinc Deficiency and Its Influence Factors in Children Under 14-year-old in China

Abstract

Background: In recent years, zinc deficiency in children has attracted global attention. There are some differences in zinc deficiency in different countries and regions. However, there are few multi-center and large-sample studies on zinc deficiency in children in mainland China. Objective: To evaluate the status of zinc deficiency and its influence factors in children under 14-year-old in mainland China, and to provide evidence-based evidence for the strategy of prevention and treatment of zinc deficiency in children. Methods: PubMed, Embase, CNKI and other databases were searched about the cross-sectional survey literature on zinc deficiency and its influencing factors of under 14-year-old children in mainland China from 2005 to 2021. Stata 14.0 statistical software was used for Meta-analysis. Two independent reviewers identified eligible studies. Results: We identified 55 studies with 292,877 healthy children and adolescents in the Meta-analysis. The overall zinc deficiency rate was 27.0% (95% CI 22.8%-31.3%). From coastal areas of China showed that the zinc deficiency rate was 21.7% (95% CI 16.2%-27.1%) as 29.6% (95% CI 24.9%- 34.4%) from inland area of China. The zinc deficiency rate in the male group was greater than in the female group, and the difference was statistically significant [OR=1.052, 95% CI (1.019, 1.087), p=0.002]. The zinc deficiency rate in infant group was higher than that in toddler group [OR=1.38, 95% CI (1.16, 1.64), p=0.000], preschool group [OR=1.475, 95% CI (1.163, 1.870), p=0.001], and school-age group [OR=1.746, 95% CI (1.257, 2.425), p=0.001], with statistical significance. There was no significant difference in zinc deficiency rate between the toddler group and the preschool group [OR=1.059, 95% CI (0.918, 1.222), p=0.429], the toddler group and the school-age group [OR=1.136, 95% CI (0.848, 1.523), p=0.394], and the preschool group and the school-age group [OR=0.986, 95% CI (0.754, 1.291), p=0.919]. There was no statistically significant difference in zinc deficiency rate between the groups of well-educated and the poor-educated dietary provider. (OR=1.095, 95% CI (0.867, 1.383), p=0.446), and no statistical significance in zinc deficiency rate between urban group and rural group [OR=1.152, 95% CI (0.810, 1.637), p=0.432]. Conclusions: At present, zinc deficiency in children and adolescents in mainland China is still serious, especially in infants. The zinc deficiency rate in male children was more serious than that of female children. The zinc deficiency rate of children in inland areas was higher than that in coastal areas. Factors such as different educational level of food providers and different areas from urban or rural were not the major influencing factors of zinc deficiency.