The status of serum vitamin A/E and its effect on Recurrent Respiratory Tract Infections in children aged 2 to 17 years in Beijing, China, based on cross-sectional study

The status of serum vitamin A/E and its effect on Recurrent Respiratory Tract Infections in children aged 2 to 17 years in Beijing, China, based on cross-sectional study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research article The status of serum vitamin A/E and its effect on Recurrent Respiratory Tract Infections in children aged 2 to 17 years in Beijing, China, based on cross-sectional study Xiaoyan Wang, Chunhua Jin, Jiaxin Wang, Jianhong Wang, Lili Zhang, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.2.22863/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective To test the association between serum vitamin A and vitamin E and the prevalence of recurrent respiratory tract infections (RRTIs) of children and adolescents. Method A total amount of 5780 children and adolescents aged 2 to 17 were involved, who were classified into:A) Control group ;B) Diagnosed as RRTI with RTI symptoms; C) With RRTI but currently no RTI symptoms being noticed, and D) Not RRTI but showing respiratory disease symptoms. The correlation between serum vitamin A/E level and the presence of RRTIs were analyzed. Results Comparing with the prevalence of RRTI in children with normal vitamin A level, the Odds Ratio(OR) of vitamin A deficiency for RRTIs with symptoms was 8.32 (95%CI: 6.15 ～ 11.27), while the OR of marginal vitamin A deficiency was 1.30 (95%CI: 1.10 ～ 1.55). The OR of vitamin A deficiency or marginal vitamin A deficiency for asymptomatic RRTIs were 1.52 (95%CI: 1.00 ～ 2.32) and 1.30 (95%CI: 1.10 ～ 1.55) respectively, while the OR of vitamin A deficiency or marginal vitamin A deficiency for other respiratory diseases were 7.09 (95%CI: 5.37 ～ 9.37) and 1.60 (95%CI: 1.38 ～ 1.86). Whereas, the OR of vitamin E deficiency or marginal vitamin E deficiency for RRTIs or normal respiratory infections were showed without statistical significance. Conclusion The low level of vitamin A in serum is a risk factor for children and adolescents getting RRTIs or RTIs, indicating a possibly regulatory role of vitamin A in the respiratory diseases. In comparison, the vitamin E deficiency seems to have a weaker but still positive effect on the RRTIs or RTI Pediatrics Vitamin A Vitamin E BMI Chinese Children RRTIs Figures Figure 1 Figure 2 Figure 3 Background Respiratory tract infections (RTIs) are the most widespread type of infections associated with high morbidity and mortality which threaten the children’s health. Typically, the preschool-aged children who were documented for more than eight episodes of airway infections per year or the elder children who suffered from more than 6 times of respiratory infections were considered as RRTIs [ 1 ] .In China, the average frequency of the infection episodes in children having RRTIs aged 0–2, 3–5, 6–14 are respectively to be more than 7, 6, and 5 times a year [ 2 ] . In 2008, the Editorial Committee of Chinese Journal of Pediatrics, together with Department of Respiratory in Chinese Pediatric Society of Chinese Medical Association, established the official criteria to diagnose RRTIs [ 3 ], which also has been developing the principle for diagnosis and classification in our research. According to the previous research, the potential risk factors of RRTIs include the parental education level, family medical history of respiratory disease, parental smoking status, nutrition, uptake of microelements, immunity status, life style, diet, exercising, and environmental factors [ 4 ] . Previous researches showed serum vitamin A and vitamin E level associated with the morbidity of RRTIs. Multiple studies indicated that lack of vitamin A/E would increase the risk of respiratory infection [ 5 – 7 ] . Moreover, most of the young patients with bronchopneumonia were observed to have vitamin A deficiency as well, meanwhile, the patients with chronic infections presented a severer vitamin A deficiency than the acute infections [ 8 ] . Additionally, the clinical trials conducted in 100 RRTI children without acute phase response demonstrated that the exogenous supplement of vitamin A/E might decrease the morbidity of RRTIs [ 9 ] . Nowadays the supplement of vitamin nutrition is getting valued, studies focusing on the connection between vitamin A/E and pediatric disease were encouraged to be constructed. At present, most of the researches focusing on the prevention of the occurrence or recurrence of RRTIs, especially in pre-school children. However, a comprehensive study of RRTI in children and adolescents aged 2–17 considering the factors such as the infectious severity, the serum vitamin A/E level and social demography with a large sample size is still lacking, especially with the rapid development and transition of lifestyle and bebavior in Beijing China, which exert subtle influence to children’s vitamin nutrition intake. Therefore, a large sample study is needed to explore the effect of the factors such as the serum vitamin A/E level, BMI and residential distribution on the prevalence of pediatric RRTIs which can provide a reference for establishing strategy and measures to reduce the occurrence of respiratory tract infections in children. Methods Study population The involved children in this study was recruited from the patients or the healthy children who were given a physical examination in the following institutes. The institutes participating in this study include the Department of Pediatrics and the Department of Children Health Care from Capital Institute of Pediatrics, Beijing Shouer Liqiao Children’s hospital, Beijing Fangshan District Maternal and Child Health Hospital,The Civil Aviation General Hospital༌Beijing Shijingshan District Maternal and Child Health Care Hospital༌Beijing Pinggu District Maternal and Child ealth Care Hospital༌Tsinghua University Yuquan Hospital, Beijing Huairou Hospital. Criteria for recruitment Children or teenagers aged 2–17 admitted into the previously mentioned departments from April 2012 to May 2017 who was diagnosed with rhinitis, influenza, pharyngitis, amygdalitis, trachitis, bronchitis, pneumonia or other respiratory tract diseases was recruited as the affected cases. Meanwhile, all those children including affected ones at the same age group were all given a physical examination in these departments, but healthy children were invited as the healthy control in this study. Patients with inflammation involving other systems, or patients having a severe medical history (including congenital diseases and abnormal immune system diseases) or history of surgery were not considered as the objective in this study. Children without family consent for complete clinical data record were also excluded. Besides, 25 cases were excluded because of outliers in vitamin A or vitamin E level, and 2942 cases were not considered due to lack of Body Mass Index (BMI) record. Ultimately, 5780 cases were collected for statistics and analysis. Research strategy All information was collected after obtaining the parental consent to participate. The basic information of the participants was obtained from the participants’ parents through a pre-designed and pre-tested questionnaire. The questionnaire included information regarding residential conditions and medical histories. Based on the medical records of the participants, all cases were grouped into 4 categories according to the criteria in Clinical Concept and Management of Recurrent Respiratory Tract Infections in children edited by Chinese Pediatric Society of Chinese Medical Association in 2008 [ 2 ] : A) The healthy control without RRTI history or any respiratory tract infection (RTI) symptoms, B) Diagnosed RRTI patients with RTI symptoms, C) Diagnosed RRTI patient but currently presenting no RTI symptom upon enrollment, i.e. the RRTI patients who were in the asymptomatic phase between infection episodes, and D) Not RRTI patients but currently presenting respiratory disease symptoms. The amount of positive cases in total including group B, C, and D, was 2845, and the proportion of different grades of RRTIs was respective to be group B 14.64% (n = 846), group C 13.37% (n = 773), and group D 21.21% (n = 1226). Whereas cases in the healthy control group A occupied 50.77% (n = 2935) of all 5780 participants in the study. All individuals underwent physical examination, which includes the measurement of height, weight, body temperature and blood routine examination. To establish the concentration of vitamin A and vitamin E in serum, 3 ml of peripheral venous blood was collected into orange top (thrombin) blood collection tube from participant after overnight fasting. Collected blood samples were centrifuged at 3000 rpm/min for 10 min and settle down. Supernatant was transferred into a clean Eppendorf tube. Collected serum was store in -20 ℃ till analysis. The concentration of serum vitamin A and vitamin E were detected by Beijing Harmony Health Medical Diagnostics Co., Ltd. using HPLC (LC-20A; Shimadzu, Japan).All procedures in this study including doing the questionnaire, physical examination and classification were performed by professional pediatric doctors. Standards of grading and classification In this study, a concentration of vitamin A higher than 0.3 mg/ml was defined as normal, concentration lower than 0.3 mg/ml was defined as suspected subclinical deficiency, while serum vitamin A concentration lower than 0.2 mg/L was graded as deficiency. Meanwhile a vitamin E level higher than 7 mg/L was evaluated as normal, level between 5 mg/L to 7 mg/L was graded as subclinical deficiency while vitamin E level lower than 5 mg/L was classified as deficiency [ 10 ] . Participants were also classified based on their height and weight according to the criteria from Body Mass Index cut-offs for overweight and obesity in Chinese children and adolescents aged 2–18 years .Children was graded as normal, overweight and obesity by BMI [ 11 ] . Quality control The pediatric doctors worked for this study were professional and well trained before the project. Diagnosis criteria and note formula were standardized and normalized. Cases should be record accurately, particularly and seriously following demand to insure the reality and reliability. Labs should follow the judgmental criteria and obey the rules in clinical research institution. Observed results were double checked to ensure that all conclusions were summarized from reliable and accurate data. Results Essential information For 5780 individuals involving in this study, 59.2% were male and 40.8% were female; 6.4% of them were rural residents, 7.8% were residents in suburban area, while 85.8% were citizens; the mean age of all participants was 4.55 ± 2.63 years old (59.76 ± 31.58 months old). Individuals in group B, C, D were mostly aged 3–6, of which the proportion was respectively to be 60.40%, 59.77%, and 54.49%. The proportions of the 4 groups were respectively to be 50.77%, 14.64%, 13.37% and 21.21%. The prevalence of vitamin E deficiency in the groups was 20.78%, 33.22%, 22.64%, and 26.92%, respectively. With the increase of ages, the serum vitamin A level in children aged 2–17 in Beijing presented to be wavy increase (increase in the early phase, later decrease and then increase dramatically after age 15), while the serum vitamin E level keep decreasing. Group B had a large portion of country residents while group C included a higher portion of suburban residents. Essential information of age, sexuality, residence, BMI among those 4 groups all showed significant,difference, which mightly showed confounding effect on their Vitamin A and vitamin E level (Table 1 – 2 , Fig. 2 – 3 ). Table 1 Essential information of the participants in study investigating the effect of serum vitamin A/E on Recurrent Respiratory Tract Infections in children aged 2 to 17 years in Beijing Variate Group A(n = 2935) B (n = 846) C (n = 773) D (n = 1226) P value frequency Proportion (%) frequency Proportion (%) frequency Proportion (%) frequency Proportion (%) Age 2ཞ 734 25.01 159 18.79 122 15.78 281 22.92 152.17 < 0.001 3ཞ 1277 43.51 511 60.40 462 59.77 668 54.49 6ཞ 809 27.56 167 19.74 177 22.90 259 21.13 12ཞ 115 3.92 9 1.06 12 1.55 18 1.47 gender male 1711 58.30 511 60.40 448 57.96 753 61.42 4.49 0.213 female 1224 41.70 335 39.60 325 42.04 473 38.58 Residence citizen 2580 87.90 655 77.42 644 83.31 1083 88.34 150.59 < 0.001 country 126 4.29 119 14.07 36 4.66 90 7.34 floating 229 7.80 72 8.51 93 12.03 53 4.32 BMI normal 2326 79.25 583 68.91 584 75.55 848 69.17 80.20 < 0.001 overweight 315 10.73 135 15.96 80 10.35 160 13.05 obesity 294 10.02 128 15.13 109 14.10 218 17.78 Table 2 Serum vitamin A/E level in grouped children aged 2 to 17 years in Beijing Variate Group A (n = 2935) B (n = 846) C (n = 773) D (n = 1226) P value frequency Proportion (%) frequency Proportion (%) frequency Proportion (%) frequency Proportion (%) Vitamin A deficiency 87 2.96 145 17.14 33 4.27 197 16.07 446.27 < 0.001 suspected subclinical deficiency 930 31.69 384 45.39 288 37.26 452 36.87 normal 1918 65.35 317 37.47 452 58.47 577 47.06 Vitamin E deficiency 33 1.12 25 2.96 11 1.42 16 1.31 69.95 < 0.001 Subclinical deficiency 577 19.66 256 30.26 164 21.22 314 25.61 normal 2325 79.22 565 66.78 598 77.36 896 73.08 Effect of vitamin A/E Cases were graded and classified based on social demographic information and diagnosis criteria. To setup the logistic regression model, different groups were assigned and scored differently based on the severity of the judgmental condition. Details were described in Table 3 . Table 3. Scoring of multivariate for logistic regression model Variate Assigned Description Group score Healthy control 1 RRTIs, attack period 2 RRTIs, stable period 3 Not RRTIs, with respiratory disease symptoms Residence 1 Suburban area 2 Country resident 3 Citizen BMI 1 Overweight 2 Obesity 3 Normal Vitamin A 1 Deficiency 2 Suspected subclinical deficiency 3 Normal Vitamin E 1 Deficiency 2 Subclinical deficiency 3 Normal Multivariate logistic regression model was established and a series of Odd Ratio (OR) was calculated to indicate the association of vitamin A/E level to the presence of RRTIs. As a commonly used value for children health status indication, BMI of individuals and its related OR were also calculated. Comparing with the prevalence in children with normal vitamin A level, the OR of vitamin A deficiency for symptomatic RRTIs is 8.32 (95%CI: 6.15ཞ11.27), while the OR of vitamin A suspected subclinical deficiency for symptomatic RRTIs is 2.36 (95%CI: 1.98ཞ2.80), which indicates a high risk of vitamin A deficiency. Comparing with the morbidity in children with normal vitamin E level, the OR of vitamin E deficiency for RRTIs is 1.56 (95%CI: 0.88ཞ2.78), while the OR of vitamin E subclinical deficiency for symptomatic RRTIs is 1.37 (95%CI: 1.14ཞ1.65). The vitamin E level seems to be a risk factor for symptomatic RRTIs as well. Comparing with the prevalence in children with normal BMI, the OR of overweight and obesity for symptomatic RRTIs are 1.73 (95%CI: 1.37ཞ2.18) and 1.72 (95%CI: 1.36ཞ2.18), respectively; comparing with the prevalence in permanent citizens, the OR of rural residence for symptomatic RRTIs is 3.26 (95%CI: 2.46ཞ4.30), while the OR of suburban residence for symptomatic RRTIs is 1.22 (95%CI: 0.92 ~ 1.63), which indicates that the body weight and residential conditions might also affect the occurrence of RRTIs. Moreover, the vitamin A level is also positive correlated with asymptomatic RRTIs (between the infection episodes) with an OR of 1.52 (95%CI: 1.00ཞ2.32) and 1.30 (95%CI: 1.10ཞ1.55) for deficiency and suspected subclinical deficiency respectively. However, the correlation is weaker than for the symptomatic RRTIS. The association of vitamin E level and asymptomatic RRTIs is relatively weak. The OR of vitamin E deficiency and subclinical deficiency are 1.14 and 1.04 respectively. The OR of obesity for asymptomatic RRTIs is 1.52 (95%CI: 1.20ཞ1.93), while the OR of overweight is 1.04. The OR of rural residence and suburban residence for asymptomatic RRTIs are 1.64 (95%CI: 1.27ཞ2.12) and 1.13 (95%CI: 0.77ཞ1.65), respectively. This time the effect of body weight and residence seems to be weaker than on the symptomatic RRTIs. For other acute respiratory infections, the vitamin A level strongly associated with the RTIs again. The OR of vitamin A deficiency is 7.09 (95%CI: 5.37ཞ9.37), while the OR of vitamin A suspected subclinical deficiency is 1.60 (95%CI: 1.38ཞ1.86). Whereas the vitamin E level appears to be not completely associated with the RTIs this time. The OR of vitamin E deficiency is 0.69 (95%CI: 0.36ཞ1.32), while the OR of vitamin E subclinical deficiency is 1.17 (95%CI: 0.99ཞ1.38). The OR of overweight and obesity for respiratory symptoms are 1.43 (95%CI: 1.16ཞ1.77) and 2.02 (95%CI: 1.66ཞ2.47), indicating a risk of getting respiratory symptoms. The OR of rural and suburban residence are respectively to be OR = 1.56 (95%CI: 1.16ཞ2.08) and OR = 0.55 (95%CI: 0.40ཞ0.76). Only settling down in the countryside might be a risk factor of getting acute RTIs. The OR of age are all 0.99 (95%CI: 0.99ཞ0.99) or 1.00 (95%CI: 0.99ཞ1.00) in all groups, indicating that the age distribution did not significantly affect the result when taking all effect factors into consideration (Table 4 ). Table 4 Results of multivariate for logistic regression analysis Group Score B Wald value P OR 95%CI B intercept -1.63 238.13 0.000 [VA = 1] 2.12 187.85 0.000 8.32 6.15ཞ11.27 [VA = 2] 0.86 94.16 0.000 2.36 1.98ཞ2.80 [VA = 3] 0 b . . . . [VE = 1] 0.44 2.27 0.132 1.56 0.88ཞ2.78 [VE = 2] 0.31 10.82 0.001 1.37 1.14ཞ1.65 [VE = 3] 0 b . . . . [body shape = 1] 0.55 21.36 0.000 1.73 1.37ཞ2.18 [body shape = 2] 0.54 20.19 0.000 1.72 1.36ཞ2.18 [body shape = 3] 0 b . . . . [residence = 1] 0.20 1.84 0.175 1.22 0.92ཞ1.63 [residence = 2] 1.18 68.93 0.000 3.26 2.46ཞ4.30 [residence = 3] 0 b . . . . Age (month) -0.01 31.14 0.000 0.99 0.99ཞ1.00 C Intercept -1.38 204.72 0.000 [VA = 1] 0.42 3.86 0.05 1.52 1.00ཞ2.32 [VA = 2] 0.27 9.35 0.002 1.30 1.10ཞ1.55 [VA = 3] 0 b . . . . [VE = 1] 0.13 0.14 0.711 1.14 0.57ཞ2.30 [VE = 2] 0.04 0.16 0.688 1.04 0.85ཞ1.27 [VE = 3] 0 b . . . . [body shape = 1] 0.04 0.08 0.773 1.04 0.80ཞ1.35 [body shape = 2] 0.42 11.67 0.001 1.52 1.20ཞ1.93 [body shape = 3] 0 b . . . . [residence = 1] 0.50 14.23 0.000 1.64 1.27ཞ2.12 [residence = 2] 0.12 0.37 0.544 1.13 0.77ཞ1.65 [residence = 3] 0 b . . . . Age (month) 0.00 5.15 0.023 1.00 0.99ཞ1.00 D Intercept -0.84 93.20 0.000 [VA = 1] 1.96 190.80 0.000 7.09 5.37ཞ9.37 [VA = 2] 0.47 37.93 0.000 1.60 1.38ཞ1.86 [VA = 3] 0 b . . . . [VE = 1] -0.37 1.24 0.265 0.69 0.36ཞ1.32 [VE = 2] 0.16 3.26 0.071 1.17 0.99ཞ1.38 [VE = 3] 0 b . . . . [body shape = 1] 0.36 10.91 0.001 1.43 1.16ཞ1.77 [body shape = 2] 0.71 47.97 0.000 2.02 1.66ཞ2.47 [body shape = 3] 0 b . . . . [residence = 1] -0.59 13.59 0.000 0.55 0.40ཞ0.76 [residence = 2] 0.44 8.92 0.003 1.56 1.16ཞ2.08 [residence = 3] 0 b . . . . Age (month) -0.01 51.03 0.000 0.99 0.99ཞ0.99 Note :0 b Reference Discussion Respiratory tract infections are a series of respiratory system diseases caused by infections resulting from proliferation of pathogenic microorganism. RTIs can be divided into upper respiratory infections and lower respiratory infections, the former one includes rhinitis, pharyngitis, and laryngitis while the latter one includes tracheitis, bronchitis, and pneumonia [ 12 – 13 ] . Possible complications like acute carditis, nephritis, and rheumatism may also happen to a few people. Children, most of whom with weaker immunity, are susceptible to RTIs and may even getting worse to RRTIs. RRTIs are a special form of RTIs which extremely popular in children. Delayed diagnosis or unthoroughly treatment would induce the severe complications and serious impact their healthy growth [ 14 ] . Scientists have been studying on the occurrence and development as well as risk factors of RTIs for years, wherein the status of vitamin A and vitamin E in children can be a topic in focus. Association between vitamin A/E and RRTIs Several independent reported double-blind, randomized trials indicated that supplement of vitamin A /vitamin E would boost the immunity system of infected patients who suffered from chronic vitamin deficiency [ 15 – 17 ] . Ma et al., set up a case-control study analyzed comparing the acute bronchiolitis group and uninfected/other respiratory disease group, to confirm the association between the infection of acute bronchitis and vitamin A/D level through independent risk factor analysis. Moreover, when using the multi-factor model, they also accidentally find another risk factor, vitamin [ 18 ] . Zhang et al studied RRTIs in children aged 0.5–14 in northern China (Harbin) demonstrated that low level of vitamin A/D/E had a positive association with RRTIs in children [ 19 ] . The concentration of serum vitamin E lower than 7,85 mg/L can be a risk factor of RRTIs [ 20 ] . Our study detected an even lower level of serum vitamin A/E in some young patients, and the vitamin A/E level showed a negative association with symptomatic RRTIs in children. Thus, children should be well fed with a balanced nutrition in their important developmental period to avoid vitamin A/E insufficiency and to prevent the attack of RRTIs. Vitamin A plays a significant role in supporting body growth and immune response in mammals. Common infectious diseases such as measles, diarrhea and respiratory infection are comprised of different types of immune response [ 21 ] . IgA is one of the most important compounds in mucosal immunity system, which is confirmed associating with the respiratory infection [ 22 ] . Previous research indicated that vitamin A played a major role in the differentiation of T cells as well as the secretion and class switching of IgA [ 23 – 25 ] . Additionally, airway mucus, a protective barrier to against antigen, was consist of mucoprotein and glycoprotein [ 26 ] . Deficiency in vitamin A would impact the expression of mucoprotein and decrease the proliferation of lymphocytes following antigen activation, and indeed decrease the immune response in airway mucus in patient [ 27 ] . Besides, scientists had investigated that significant impair of virus-specific IgA and CD8 + T- cells were observed in the airway of vitamin A-deficient mice [ 28 ] . These studies demonstrated the deficiency of Vitamin A would reduce the status of immunity, thus increase the probability of infection. In this study, children with high vitamin A level displayed a much lower morbidity of symptomatic RRTIs, and serum vitamin A level showed a negative association with both symptomatic RRTIs and symptomatic acute RTIs, and a mild but not significant correlation with asymptomatic RRTIs in children, which is consist with the hypothesis mentioned before. Vitamin E, as a lipid-soluble antioxidant, can protect cell membrane and prevent the oxidative damage induced by high metabolism and the accumulation of unsaturated fatty acid [ 29 – 30 ] . Vitamin E is also an important immunomodulator. BouGhanem,E.N. et al demonstrated that α-tocopherol, an active form of vitamin E, is an effective regulator of neutrophils [ 31 ] . Neutrophils are the most abundant white blood cells which are considered to be the first barrier attacking infections, including RTIs and RRTIs [ 32 ] . Therefore, there might be an association between vitamin E and RRTIs. Our study indicates a lower morbidity of symptomatic RRTIs in individuals with high vitamin E level, which is corresponding with early studies as well. However, it didn’t display a significant correlation with asymptomatic RRTIs or symptomatic acute RTIs, which may probably due to the demand of vitamin E in immune response is lower than vitamin A. Additionally, we also found a mild but not significant effect of age for RRTIs. In addition to the age, the morbidity of RRTIs in obesity or overweight group is also 0.72 ~ 0.73 times higher than normal, which indicate the accumulation of fatty acid may affect the status of immunity. Moreover, the morbidity in rural resident is 3.26 times higher than the citizen, which may probably due to the combination of effects including different economic level, sanity conditions, nutrition supplements, diversification or preference of diet, or different outpatient rate etc. Further study In this cross-sectional and analytical study, we enrolled an extremely large sample size, 5780 cases, which is unprecedented in respiratory disease study, which helps decreasing the sampling error and makes the result more convincing. However, there are still some unresolved questions. For example, our study is still hard to specify if the low serum vitamin A/E is the inducer or result of RRTI diseases since it is just a prevalence study focusing on the current status. If the decreasing of serum vitamin A/E is aroused by RRTIs which can be reversed automatically, supplementation of vitamin A/E may not be an effective therapeutic strategy, vice versa. Some presented studies demonstrated that the supplementation of vitamin A didn’t produce a substantial reduction in symptoms or morbidity of respiratory infections [ 33 ] , only one publication displayed that vitamin A supply would decrease the mortality of young measles patients and decrease the severer status of measly infection, but it didn’t work for other respiratory infections [ 34 ] . Dibley et al [ 35 ] investigated that high dose of supplementary vitamin A would oppositely increase the morbidity of lower respiratory infections, which is extremely significant in nutritionally adequate children. It was also suggested not giving vitamin A to all children to prevent the acute RTIs, except for those who was under nutrition [ 36 ] . We assume that the decreasing of serum vitamin A is a consequence of infections due to the consumption of vitamin A by immune response leading to rearrangement of vitamin A in body. But for the malnutritional children, chronic vitamin A deficiency could be an inducer of RRTIs due to the immunodeficiency. Suitable supplementation would assist the disease cure. This assumption could be supported by the research of Grobler et al. They observed that nutrient supplementation for patients with active tuberculosis didn’t present any clinically benefits, but their serum vitamin A level increased rapidly following tuberculosis treatment regardless of supplementation [ 37 ] . Other scientists also demonstrated that inflammation would affect serum vitamin A level, but it is able to re-normalized without therapeutic intervention[36]. Similarly, the supplementation of vitamin E didn’t demonstrate a consistent significant effect to human immunity, opposite effects were observed in some trials [ 38 ] . We assume than wavy serum vitamin E level might also due to the spending and replenishment of vitamin E. Once infected, vitamin E in serum would be used to support the regulation of neutrophils resulted in a low vitamin E level, while the reduction would be normalized later through body regulate system. However, assumptions described above are all speculated according to published conclusions and current study. Further exploration is requested to demonstrate the hypothesis by conducting the further cohort-study. Another unresolved question of this study is if the pathogen of RRTIs associated with serum vitamin in children. Comparing with bacteria, virus induced infections would active different types of immune responses, of which the consumption of vitamins might be different as well. Vitamin A contribute in both T cell differentiation and class switch recombination of antibody expression [ 23 – 25 ] , which helps against both bacteria and virus. However, vitamin E contribute more on proliferation and regulation of neutrophils, trending to control bacteria and fungal induced inflammation [ 39 – 40 ] . It is possible that most individuals involved in this study were attacked by virus, which explains the weaker association between RRTIs and vitamin E than the association between RRTIs and vitamin A. Besides, dietary structure of individuals, which may highly affect their physique and the recurrence of serum vitamin, is not included in this study as well. In later cohort studies, we would like to monitor the immunity status, such as lymphocytes cell level or neutrophils level, as well as serum vitamin level in children with RRTIs to further investigate the mechanism of vitamins and its association between RRTIs. Patients infected by different pathogens would be classified and analyzed in different groups, and the relationship between different vitamins, pathogens and immune responses would be summarized and concluded. Other vitamins such as vitamin C and vitamin D would be considered to investigate if they display similar association with RRTIs. Optimized grading and classification criteria would be used. For instance, thin and emaciation group would be added when classify individuals through BMI, and residential environment could be graded based on the residential area and the hygiene status. Additional aimed risk factors, such as dietary structure and racism, would be included in the study as well. A comprehensive statistical logistic regression model would be set up to better investigate the risk factors of RRTIs. Conclusion Vitamin A and vitamin E level are negative risk factors of pediatric RRTIs. Their deficiency especially vitamin A deficiency are strongly associated with the disease morbidity. Body mass index is the positive risk factor of RRTIs, i.e. RRTIs are more frequently observed in children with overweight or obesity. Besides, the residential quality also related to the development of RRTIs as well. Consequently, in future governmental children health program, monitoring serum vitamin A and vitamin E level through periodically physical exanimation, evaluating the nutrition status of vitamin A/E objectively, screening out children suffering from long-term nutrition deficiency and supplying them adequate amount of vitamin though balanced diet or nutrition supplements can be valuable and worth popularized. Children should routinely do exercise and have less greasy food for a good body shape, they should also pay more attention on their personal hygiene to keep a healthy lifestyle. Abbreviations Recurrent respiratory tract infections RRTIs Respiratory tract infection RTI Body Mass Index BMI Odd Ratio OR Declarations Ethics approval and consent to participate: This research is approved by the Ethics Committee of Capital Institute of Pediatrics, with the ethics batch number of SHERLL2015001.Participants and participants’ family were informed during the investigation, and children’s parents have provided signed informed consent for research enrollment and data accessibility. Consent for publication: The authors declare that they consent for publication. Availability of data and materials: we state that data will be shared. Competing interest: The authors declare that they have no competing interests. Fund ： Not applicable. Authors Contributions: XW,CJ and XL conceived the study design, conceptualized the ideas, and supervised the whole analytical procedure. JW,JW,LZ,NL,NJ and WS contributed to data collection and manuscript writing. XW and XL also provided technical support for drafting and revising the manuscript. All authors have read and approved the manuscript. Acknowledgments: We appreciate all 5780 investigators who participated in this online survey. And we would also give thanks to Department of Children Health Care, Capital Institute of Pediatrics who supported us for the survey. Especially we would extend our thanks to those doctors of Beijng Pediatrics Hospital or Pediatrics Department of some genenral hospitals, who contributed to the process of data collection. References [1] Korppi M. Recurrent respiratory infections in children: A practical approach for clinical work[J]. Pediatric Pulmonology, 1997, 23(S16):144-145. [2]Dong F, Yu H, Ma J, et al. Exploring association between gastrointestinal heat retention syndrome and recurrent respiratory tract infections in children: a prospective cohort study[J]. Bmc Complementary & Alternative Medicine, 2016, 16(1):1-8. [3] Subspecialty Group of Respiratory Diseases ; Society of Pediatrics, Chinese Medical Association ; Editorial Board, Chinese Journal of Pediatrics . Clinical concept and management of recurrent respiratory tract infections in children (revised). Zhonghua Er Ke Za Zhi, 2008, 46(2):108-110. [4]Martino M D, Ballotti S. The child with recurrent respiratory infections: normal or not?[J]. Pediatr Allergy Immunol, 2010, 18(s18):13-18. [5] Zhang X, Ding F, Li H, et al. Low Serum Levels of Vitamins A, D, and E Are Associated with Recurrent Respiratory Tract Infections in Children Living in Northern China: A Case Control Study. PLoS One, 2016, 11(12): p. e0167689. [6] Long KZ, Montoya Y, Hertzmark E, et al. A double-blind, randomized, clinical trial ofthe effect of vitamin A and zinc supplementation on diarrheal disease and respiratory tract infections inchildren in Mexico City, Mexico. Am J Clin Nutr, 2006, 83(3):693-700. [7] Meydani SN, Leka LS, Fine BC, et al. Vitamin E and respiratory tractinfections in elderly nursing home residents: a randomized controlled trial. JAMA, 2004, 292(7): 828-836. [8] Jiang Y, Peng D. Serum level of vitamin A in children with pneumonia aged less than 3 years. Chinese Journal of Contemporary Pediatrics, 2016, 18(10):980. [9] Li YQ, Zhao T, Li YH el at. Effect of supplemental vitamin A and vitamin E to children with recurrent respiratory track infections, Maternal and Child Health Care of China, 2018,33(16):123-125. [10]] Jiang Z, Shen K, Shen Y, et al. Practical Pediatrics. 8th ed.People's Medical Publishing House; 2014: 553-555. [11] Li H, Zong X N, Ji C Y, et al. Body mass index cut-offs for overweight and obesity in Chinese children and adolescents aged 2-18 years. Zhonghua Liu Xing Bing Xue Za Zhi, 2010, 31(6):616-620. [12]Eccles M P, Grimshaw J M, Johnston M, et al. Applying psychological theories to evidence-based clinical practice: Identifying factors predictive of managing upper respiratory tract infections without antibiotics[J]. Implementation Science,2,1(2007-08-03), 2007, 2(1):26-26. [13]Rojas M X, Rugeles C G. Oxygen therapy for lower respiratory tract infections in children between 3 months and 15 years of age[M]// The Cochrane Library. 2006. [14]Jesenak M, Urbancikova I, Banovcin P. Respiratory Tract Infections and the Role of Biologically Active Polysaccharides in Their Management and Prevention[J]. Nutrients, 2017, 9(7):779. [15] Zimmermann MB,Biebinger R,Rohner F,et al.Vitamin A supplementation in children with poor vitamin A and iron status increase erythropoietin and hemoglobin concentrations without changing total body iron[J].Am J Clin Nutr,2006,84(3):580. [16] Hemila H,Kaprio J,Albanes D,et al. Vitamin C,vitamin E,and beta-carotene in relation to common cold incidence in male smokers [J].Epidemiology，2002,13(1):32-37. [17] Lin J,Song F,Yao P,et al. Effect of vitamin A supplementation on immune function of well-nourished children suffering from vitamin A deficiency in China[J].European Journal of Clinical Nutrition，2008,62(12):1412-1418.。 [18] HULLOOWAN Leessit Sharma,The Relationship of Vitamins A, D and E with Acute Bronchiolitis in Infants and Younger Children [19] Xuguang Zhang, Fengshu Ding, Huaining Li, Wenfeng Zhao, Hong Jing,Yageng Yan, Yanping Chen.Low Serum Levels of Vitamins A, D, and E AreAssociated with Recurrent Respiratory TractInfections in Children Living in NorthernChina: A Case Control Study.PLOS ONE | DOI:10.1371/journal.pone.0167689 December 9, 2016 3 / 9 [20] Drewel BT, Giraud DW, Davy SR, Driskell JA. Less than adequate vitamin E status observed in a group of preschool boys and girls living in the United States. J Nutr Biochem. 2006; 17(2):132–8. Epub 2005/09/20. doi: 10.1016/j.jnutbio.2005.06.003 PMID: 16169199 [21] Semba RD (1998) The role of vitamin A and related retinoids in immune function. Nutrition Reviews 56, S38–S48. DOI: 10.1111/j.1753-4887.1998.tb01643.x Nutr Rev. 1998 Jan;56(1 Pt 2):S38-48. [22] Moreira A, Mortatti AL, Arruda AF, Freitas CG, de Arruda M, Aoki MS. Salivary IgA response and upperrespiratory tract infection symptoms during a 21-week competitive season in young soccer players. J.Strength Cond Res. 2014; 28(2):467–73. Epub 2014/01/30. doi: 10.1519/JSC.0b013e31829b5512PMID: 24473469。 [23] Mora JR, von Andrian UH. Role of retinoic acid in the imprinting of gut-homing IgA-secreting cells.Semin Immunol. 2009; 21(1):28–35. Epub 2008/09/23. doi: 10.1016/j.smim.2008.08.002 PMID:18804386 [24] Wang C, Thangamani S, Kim M, Gu BH, Lee JH, TaparowskyEJ, et al. BATF is required for normalexpression of gut-homing receptors by T helper cells in response to retinoic acid. J Exp Med. 2013; 210(3):475–89. Epub 2013/03/06. doi: 10.1084/jem.20121088 PMID: 23460729 [25] Hall JA, Grainger JR, Spencer SP, Belkaid Y. The role of retinoic acid in tolerance and immunity. Immunity. 2011; 35(1):13–22. Epub 2011/07/23. doi: 10.1016/j.immuni.2011.07.002 PMID: 21777796 [26] Kim KC, McCracken K, Lee BC, Shin CY, Jo MJ, Lee CJ, et al. Airway goblet cell mucin: its structureand regulation of secretion. Eur Respir J. 1997; 10(11):2644–9. Epub 1998/01/13.PMID: 9426108 [27]Fan X, Liu S, Liu G, et al. Vitamin A Deficiency Impairs Mucin Expression and Suppresses the Mucosal Immune Function of the Respiratory Tract in Chicks[J]. Plos One, 2015, 10(9):e0139131. [28]Surman, Sherri L., et al. "Enhanced CD103 Expression and Reduced Frequencies of Virus-Specific CD8+ T Cells Among Airway Lymphocytes After Influenza Vaccination of Mice Deficient in Vitamins A+ D." Viral immunology 30.10 (2017): 737-743. [29] Young IS, Woodside JV. Antioxidants in health and disease. J Clin Pathol. 2001; 54(3):176–86. Epub2001/03/17. doi: 10.1136/jcp.54.3.176 PMID: 11253127 [30] Coquette A, Vray B, VanderpasJ. Role of vitamin E in the protection of the resident macrophage mem-brane against oxidative damage. Arch Int Physiol Biochim. 1986; 94(5):S29–34. Epub 1986/12/01.PMID: 2440399 [31] Bou Ghanem, E. N.Lee, J. N.Joma, B. H.Meydani, S. N.Leong, J. M.Panda, A.Front Cell Infect Microbiol J.2017;7:161 DOI:10.3389/fcimb.2017.00161 [32]Uribequerol E, Rosales C. Neutrophils in cancer: two sides of the same coin[J]. Journal of Immunology Research,2015,(2015-12-24), 2015, 2015(6):1-21. [33]Grobler, Liesl, et al. "Nutritional supplements for people being treated for active tuberculosis." Cochrane Database of Systematic Reviews 6 (2016). Abdeljaber, Mutee H., et al. "The impact of vitamin A supplementation on morbidity: a randomized community intervention trial." American journal of public health 81.12 (1991): 1654-1656. [34]Brow N,Robert C.Vitamin A for acute respiratory infection in developing countries:a meta-analysis[J].Acta Paediatrica,2004,93(11):1437. [35] Dibley MJ, Sadjimin T, Kjolhede CL, Moulton LH. Vitamin A supplement -ation fails to reduce incidence of acute respiratory illness and diarrhea in preschool-age Indonesian children[J]. The Journal ofNutrition, 1996,126(2):434-442. [36]Dibley M J , Sadjimin T , Kjolhede C L , et al. Vitamin A supplementation fails to reduce incidence of acute respiratory illness and diarrhea in preschool-age Indonesian children.[J]. Journal of Nutrition, 1996, 126(2):434. [37]Grobler, Liesl, et al. "Nutritional supplements for people being treated for active tuberculosis." Cochrane Database of Systematic Reviews 6 (2016). [38]Lee, Ga, and Sung Han. "The role of vitamin E in immunity." Nutrients 10.11 (2018): 1614. [39]Hogan, J. S., et al. "Bovine neutrophil responses to parenteral vitamin E." Journal of dairy science 75.2 (1992): 399-405. [40]Drescher, Brandon, and Fengwei Bai. "Neutrophil in viral infections, friend or foe?." Virus research 171.1 (2013): 1-7. Supplementary Files STROBEchecklist.doc Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. 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15:52:19","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.2.22863/v1","doiUrl":"https://doi.org/10.21203/rs.2.22863/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":462967,"identity":"aa88f746-76f8-4c72-b802-33bc71065b8b","added_by":"auto","created_at":"2020-02-07 16:05:47","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":165786,"visible":true,"origin":"","legend":"Flow chart of research strategy investigating the effect of serum vitamin A/E on Recurrent Respiratory Tract Infections in children aged 2 to 17 years in Beijing","description":"","filename":"Picture1.png","url":"https://assets-eu.researchsquare.com/files/d5313913-c5d7-4b1f-b117-ce7255882337/v1/Picture1.png"},{"id":462968,"identity":"bcd5d8fd-6a60-493d-b5fd-ba750d30ec30","added_by":"auto","created_at":"2020-02-07 16:05:48","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":28311,"visible":true,"origin":"","legend":"Concentration of serum vitamin A along age distribution in children aged 2-17 in Beijing","description":"","filename":"Picture2.png","url":"https://assets-eu.researchsquare.com/files/d5313913-c5d7-4b1f-b117-ce7255882337/v1/Picture2.png"},{"id":462969,"identity":"31552925-8c40-49e5-aad6-3c885f500747","added_by":"auto","created_at":"2020-02-07 16:05:48","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":74419,"visible":true,"origin":"","legend":"Concentration of serum vitamin E along age distribution in children aged 2-17 in Beijing","description":"","filename":"Picture3.png","url":"https://assets-eu.researchsquare.com/files/d5313913-c5d7-4b1f-b117-ce7255882337/v1/Picture3.png"},{"id":13488280,"identity":"001e7667-8340-45c4-a7fb-040612c0c6f7","added_by":"auto","created_at":"2021-09-16 22:14:03","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":517178,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-13437/v1/fb5a34c9-3bea-4868-bfc4-0d3cc742881d.pdf"},{"id":462966,"identity":"926b936f-4b65-41dd-aacd-52994585c4cb","added_by":"auto","created_at":"2020-02-07 16:05:47","extension":"doc","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":114688,"visible":true,"origin":"","legend":"","description":"","filename":"STROBEchecklist.doc","url":"https://assets-eu.researchsquare.com/files/d5313913-c5d7-4b1f-b117-ce7255882337/v1/STROBE_checklist.doc"}],"financialInterests":"","formattedTitle":"The status of serum vitamin A/E and its effect on Recurrent Respiratory Tract Infections in children aged 2 to 17 years in Beijing, China, based on cross-sectional study","fulltext":[{"header":"Background","content":" \u003cp\u003eRespiratory tract infections (RTIs) are the most widespread type of infections associated with high morbidity and mortality which threaten the children\u0026rsquo;s health. Typically, the preschool-aged children who were documented for more than eight episodes of airway infections per year or the elder children who suffered from more than 6 times of respiratory infections were considered as RRTIs\u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e.In China, the average frequency of the infection episodes in children having RRTIs aged 0\u0026ndash;2, 3\u0026ndash;5, 6\u0026ndash;14 are respectively to be more than 7, 6, and 5 times a year\u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e. In 2008, the Editorial Committee of Chinese Journal of Pediatrics, together with Department of Respiratory in Chinese Pediatric Society of Chinese Medical Association, established the official criteria to diagnose RRTIs \u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e],\u003c/sup\u003e which also has been developing the principle for diagnosis and classification in our research.\u003c/p\u003e \u003cp\u003eAccording to the previous research, the potential risk factors of RRTIs include the parental education level, family medical history of respiratory disease, parental smoking status, nutrition, uptake of microelements, immunity status, life style, diet, exercising, and environmental factors \u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e. Previous researches showed serum vitamin A and vitamin E level associated with the morbidity of RRTIs. Multiple studies indicated that lack of vitamin A/E would increase the risk of respiratory infection \u003csup\u003e[\u003cspan additionalcitationids=\"CR6\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003e. Moreover, most of the young patients with bronchopneumonia were observed to have vitamin A deficiency as well, meanwhile, the patients with chronic infections presented a severer vitamin A deficiency than the acute infections\u003csup\u003e[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e. Additionally, the clinical trials conducted in 100 RRTI children without acute phase response demonstrated that the exogenous supplement of vitamin A/E might decrease the morbidity of RRTIs \u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eNowadays the supplement of vitamin nutrition is getting valued, studies focusing on the connection between vitamin A/E and pediatric disease were encouraged to be constructed. At present, most of the researches focusing on the prevention of the occurrence or recurrence of RRTIs, especially in pre-school children. However, a comprehensive study of RRTI in children and adolescents aged 2\u0026ndash;17 considering the factors such as the infectious severity, the serum vitamin A/E level and social demography with a large sample size is still lacking, especially with the rapid development and transition of lifestyle and bebavior in Beijing China, which exert subtle influence to children\u0026rsquo;s vitamin nutrition intake. Therefore, a large sample study is needed to explore the effect of the factors such as the serum vitamin A/E level, BMI and residential distribution on the prevalence of pediatric RRTIs which can provide a reference for establishing strategy and measures to reduce the occurrence of respiratory tract infections in children.\u003c/p\u003e "},{"header":"Methods","content":"\u003cp\u003eStudy population\u003c/p\u003e \u003cp\u003eThe involved children in this study was recruited from the patients or the healthy children who were given a physical examination in the following institutes. The institutes participating in this study include the Department of Pediatrics and the Department of Children Health Care from Capital Institute of Pediatrics, Beijing Shouer Liqiao Children\u0026rsquo;s hospital, Beijing Fangshan District Maternal and Child Health Hospital,The Civil Aviation General Hospital༌Beijing Shijingshan District Maternal and Child Health Care Hospital༌Beijing Pinggu District Maternal and Child ealth Care Hospital༌Tsinghua University Yuquan Hospital, Beijing Huairou Hospital.\u003c/p\u003e \u003cp\u003eCriteria for recruitment\u003c/p\u003e \u003cp\u003eChildren or teenagers aged 2\u0026ndash;17 admitted into the previously mentioned departments from April 2012 to May 2017 who was diagnosed with rhinitis, influenza, pharyngitis, amygdalitis, trachitis, bronchitis, pneumonia or other respiratory tract diseases was recruited as the affected cases. Meanwhile, all those children including affected ones at the same age group were all given a physical examination in these departments, but healthy children were invited as the healthy control in this study. Patients with inflammation involving other systems, or patients having a severe medical history (including congenital diseases and abnormal immune system diseases) or history of surgery were not considered as the objective in this study. Children without family consent for complete clinical data record were also excluded. Besides, 25 cases were excluded because of outliers in vitamin A or vitamin E level, and 2942 cases were not considered due to lack of Body Mass Index (BMI) record. Ultimately, 5780 cases were collected for statistics and analysis.\u003c/p\u003e \u003cp\u003eResearch strategy\u003c/p\u003e \u003cp\u003eAll information was collected after obtaining the parental consent to participate. The basic information of the participants was obtained from the participants\u0026rsquo; parents through a pre-designed and pre-tested questionnaire. The questionnaire included information regarding residential conditions and medical histories. Based on the medical records of the participants, all cases were grouped into 4 categories according to the criteria in \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eClinical Concept and Management of Recurrent Respiratory Tract Infections in children\u003c/span\u003e edited by Chinese Pediatric Society of Chinese Medical Association in 2008 \u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e: A) The healthy control without RRTI history or any respiratory tract infection (RTI) symptoms, B) Diagnosed RRTI patients with RTI symptoms, C) Diagnosed RRTI patient but currently presenting no RTI symptom upon enrollment, i.e. the RRTI patients who were in the asymptomatic phase between infection episodes, and D) Not RRTI patients but currently presenting respiratory disease symptoms. The amount of positive cases in total including group B, C, and D, was 2845, and the proportion of different grades of RRTIs was respective to be group B 14.64% (n\u0026thinsp;=\u0026thinsp;846), group C 13.37% (n\u0026thinsp;=\u0026thinsp;773), and group D 21.21% (n\u0026thinsp;=\u0026thinsp;1226). Whereas cases in the healthy control group A occupied 50.77% (n\u0026thinsp;=\u0026thinsp;2935) of all 5780 participants in the study.\u003c/p\u003e \u003cp\u003eAll individuals underwent physical examination, which includes the measurement of height, weight, body temperature and blood routine examination. To establish the concentration of vitamin A and vitamin E in serum, 3\u0026nbsp;ml of peripheral venous blood was collected into orange top (thrombin) blood collection tube from participant after overnight fasting. Collected blood samples were centrifuged at 3000\u0026nbsp;rpm/min for 10\u0026nbsp;min and settle down. Supernatant was transferred into a clean Eppendorf tube. Collected serum was store in -20 ℃ till analysis. The concentration of serum vitamin A and vitamin E were detected by Beijing Harmony Health Medical Diagnostics Co., Ltd. using HPLC (LC-20A; Shimadzu, Japan).All procedures in this study including doing the questionnaire, physical examination and classification were performed by professional pediatric doctors.\u003c/p\u003e \u003cp\u003eStandards of grading and classification\u003c/p\u003e \u003cp\u003eIn this study, a concentration of vitamin A higher than 0.3\u0026nbsp;mg/ml was defined as normal, concentration lower than 0.3\u0026nbsp;mg/ml was defined as suspected subclinical deficiency, while serum vitamin A concentration lower than 0.2\u0026nbsp;mg/L was graded as deficiency. Meanwhile a vitamin E level higher than 7\u0026nbsp;mg/L was evaluated as normal, level between 5\u0026nbsp;mg/L to 7\u0026nbsp;mg/L was graded as subclinical deficiency while vitamin E level lower than 5\u0026nbsp;mg/L was classified as deficiency \u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eParticipants were also classified based on their height and weight according to the criteria from \u003cspan type=\"Italic\" class=\"Italic\" name=\"Emphasis\"\u003eBody Mass Index cut-offs for overweight and obesity in Chinese children and adolescents aged 2\u0026ndash;18\u0026nbsp;years\u003c/span\u003e.Children was graded as normal, overweight and obesity by BMI \u003csup\u003e[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eQuality control\u003c/p\u003e \u003cp\u003eThe pediatric doctors worked for this study were professional and well trained before the project. Diagnosis criteria and note formula were standardized and normalized. Cases should be record accurately, particularly and seriously following demand to insure the reality and reliability. Labs should follow the judgmental criteria and obey the rules in clinical research institution. Observed results were double checked to ensure that all conclusions were summarized from reliable and accurate data.\u003c/p\u003e "},{"header":"Results","content":" \u003cp\u003eEssential information\u003c/p\u003e \u003cp\u003eFor 5780 individuals involving in this study, 59.2% were male and 40.8% were female; 6.4% of them were rural residents, 7.8% were residents in suburban area, while 85.8% were citizens; the mean age of all participants was 4.55\u0026thinsp;\u0026plusmn;\u0026thinsp;2.63\u0026nbsp;years old (59.76\u0026thinsp;\u0026plusmn;\u0026thinsp;31.58\u0026nbsp;months old). Individuals in group B, C, D were mostly aged 3\u0026ndash;6, of which the proportion was respectively to be 60.40%, 59.77%, and 54.49%. The proportions of the 4 groups were respectively to be 50.77%, 14.64%, 13.37% and 21.21%. The prevalence of vitamin E deficiency in the groups was 20.78%, 33.22%, 22.64%, and 26.92%, respectively. With the increase of ages, the serum vitamin A level in children aged 2\u0026ndash;17 in Beijing presented to be wavy increase (increase in the early phase, later decrease and then increase dramatically after age 15), while the serum vitamin E level keep decreasing. Group B had a large portion of country residents while group C included a higher portion of suburban residents. Essential information of age, sexuality, residence, BMI among those 4 groups all showed significant,difference, which mightly showed confounding effect on their Vitamin A and vitamin E level (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e2\u003c/span\u003e, Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cdiv class=\"SimplePara\"\u003eEssential information of the participants in study investigating the effect of serum vitamin A/E on Recurrent Respiratory Tract Infections in children aged 2 to 17\u0026nbsp;years in Beijing\u003c/div\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"12\"\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cdiv class=\"SimplePara\"\u003eVariate\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cdiv class=\"SimplePara\"\u003eGroup\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eA(n\u0026thinsp;=\u0026thinsp;2935)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eB (n\u0026thinsp;=\u0026thinsp;846)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eC (n\u0026thinsp;=\u0026thinsp;773)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003eD (n\u0026thinsp;=\u0026thinsp;1226)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\" morerows=\"1\" rowspan=\"2\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cdiv id=\"IEq1\" class=\"InlineEquation\"\u003e\u003cdiv class=\"InlineMediaObject\"\u003e\u003cdiv class=\"downldimg_cls\" data-href=\"imagedump.php?token=2n0yDEWC8SYvxdpuoU5GvWGchSjZR0vJZb5aH0Ra51YnXam9Bi9lfXyjCUfN6E_8\u0026amp;file=image1.wmf\"\u003e\u003cimg src=\"images/info.png\" title=\"Please click here to download the original image file\" /\u003e\u003c/div\u003e\u003cimg color=\"BlackWhite\" fileref=\"image1.wmf\" format=\"JPEG\" rendition=\"HTML\" resolution=\"120\" type=\"Linedraw\" alt=\"Click here to Correct\" id=\"\" name=\"ImageObject\" src=\"imagedump.php?token=2n0yDEWC8SYvxdpuoU5GvWGchSjZR0vJZb5aH0Ra51YnXam9Bi9lfXyjCUfN6E_8\u0026amp;Img=image1.wmf\" title=\"Click here to Correct\" xmlheight=\"001\" xmlwidth=\"001\" /\u003e\u003c/div\u003e\u003c/div\u003e\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\" morerows=\"1\" rowspan=\"2\"\u003e \u003cdiv class=\"SimplePara\"\u003eP value\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003efrequency\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eProportion (%)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003efrequency\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eProportion (%)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003efrequency\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003eProportion (%)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003efrequency\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003eProportion (%)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cdiv class=\"SimplePara\"\u003eAge\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e2ཞ\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e734\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e25.01\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e159\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e18.79\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e122\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e15.78\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e281\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e22.92\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\" morerows=\"3\" rowspan=\"4\"\u003e \u003cdiv class=\"SimplePara\"\u003e152.17\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\" morerows=\"3\" rowspan=\"4\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e3ཞ\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e1277\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e43.51\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e511\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e60.40\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e462\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e59.77\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e668\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e54.49\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e6ཞ\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e809\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e27.56\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e167\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e19.74\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e177\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e22.90\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e259\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e21.13\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e12ཞ\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e115\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e3.92\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e9\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.06\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e12\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.55\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e18\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.47\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cdiv class=\"SimplePara\"\u003egender\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003emale\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e1711\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e58.30\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e511\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e60.40\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e448\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e57.96\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e753\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e61.42\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\" morerows=\"1\" rowspan=\"2\"\u003e \u003cdiv class=\"SimplePara\"\u003e4.49\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\" morerows=\"1\" rowspan=\"2\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.213\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003efemale\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e1224\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e41.70\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e335\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e39.60\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e325\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e42.04\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e473\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e38.58\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cdiv class=\"SimplePara\"\u003eResidence\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003ecitizen\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e2580\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e87.90\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e655\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e77.42\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e644\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e83.31\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e1083\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e88.34\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\" morerows=\"2\" rowspan=\"3\"\u003e \u003cdiv class=\"SimplePara\"\u003e150.59\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\" morerows=\"2\" rowspan=\"3\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003ecountry\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e126\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e4.29\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e119\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e14.07\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e36\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e4.66\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e90\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e7.34\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003efloating\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e229\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e7.80\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e72\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e8.51\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e93\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e12.03\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e53\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e4.32\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cdiv class=\"SimplePara\"\u003eBMI\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003enormal\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e2326\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e79.25\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e583\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e68.91\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e584\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e75.55\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e848\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e69.17\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\" morerows=\"2\" rowspan=\"3\"\u003e \u003cdiv class=\"SimplePara\"\u003e80.20\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\" morerows=\"2\" rowspan=\"3\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eoverweight\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e315\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e10.73\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e135\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e15.96\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e80\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e10.35\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e160\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e13.05\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eobesity\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e294\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e10.02\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e128\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e15.13\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e109\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e14.10\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e218\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e17.78\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cdiv class=\"SimplePara\"\u003eSerum vitamin A/E level in grouped children aged 2 to 17\u0026nbsp;years in Beijing\u003c/div\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"15\"\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cdiv class=\"SimplePara\"\u003eVariate\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cdiv class=\"SimplePara\"\u003eGroup\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eA (n\u0026thinsp;=\u0026thinsp;2935)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eB (n\u0026thinsp;=\u0026thinsp;846)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003eC (n\u0026thinsp;=\u0026thinsp;773)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c13\" namest=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003eD (n\u0026thinsp;=\u0026thinsp;1226)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u003cdiv id=\"IEq2\" class=\"InlineEquation\"\u003e\u003cdiv class=\"InlineMediaObject\"\u003e\u003cdiv class=\"downldimg_cls\" data-href=\"imagedump.php?token=2n0yDEWC8SYvxdpuoU5GvWGchSjZR0vJZb5aH0Ra51YnXam9Bi9lfXyjCUfN6E_8\u0026amp;file=image2.wmf\"\u003e\u003cimg src=\"images/info.png\" title=\"Please click here to download the original image file\" /\u003e\u003c/div\u003e\u003cimg color=\"BlackWhite\" fileref=\"image2.wmf\" format=\"JPEG\" rendition=\"HTML\" resolution=\"120\" type=\"Linedraw\" alt=\"Click here to Correct\" id=\"\" name=\"ImageObject\" src=\"imagedump.php?token=2n0yDEWC8SYvxdpuoU5GvWGchSjZR0vJZb5aH0Ra51YnXam9Bi9lfXyjCUfN6E_8\u0026amp;Img=image2.wmf\" title=\"Click here to Correct\" xmlheight=\"001\" xmlwidth=\"001\" /\u003e\u003c/div\u003e\u003c/div\u003e\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\" morerows=\"1\" rowspan=\"2\"\u003e \u003cdiv class=\"SimplePara\"\u003eP value\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003efrequency\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eProportion (%)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003efrequency\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eProportion (%)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003efrequency\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003eProportion (%)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003efrequency\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cdiv class=\"SimplePara\"\u003eProportion (%)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cdiv class=\"SimplePara\"\u003eVitamin A\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003edeficiency\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e87\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e2.96\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e145\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e17.14\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e33\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e4.27\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003e197\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cdiv class=\"SimplePara\"\u003e16.07\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\" morerows=\"2\" rowspan=\"3\"\u003e \u003cdiv class=\"SimplePara\"\u003e446.27\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\" morerows=\"2\" rowspan=\"3\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003esuspected subclinical deficiency\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e930\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e31.69\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e384\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e45.39\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e288\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e37.26\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003e452\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cdiv class=\"SimplePara\"\u003e36.87\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003enormal\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e1918\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e65.35\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e317\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e37.47\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e452\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e58.47\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003e577\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cdiv class=\"SimplePara\"\u003e47.06\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cdiv class=\"SimplePara\"\u003eVitamin E\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003edeficiency\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e33\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.12\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e25\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e2.96\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e11\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.42\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003e16\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.31\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\" morerows=\"2\" rowspan=\"3\"\u003e \u003cdiv class=\"SimplePara\"\u003e69.95\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\" morerows=\"2\" rowspan=\"3\"\u003e \u003cdiv class=\"SimplePara\"\u003e\u0026lt;\u0026thinsp;0.001\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eSubclinical deficiency\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e577\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e19.66\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e256\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e30.26\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e164\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e21.22\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003e314\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cdiv class=\"SimplePara\"\u003e25.61\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003enormal\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003e2325\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e79.22\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e565\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e66.78\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cdiv class=\"SimplePara\"\u003e598\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cdiv class=\"SimplePara\"\u003e77.36\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cdiv class=\"SimplePara\"\u003e896\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cdiv class=\"SimplePara\"\u003e73.08\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eEffect of vitamin A/E\u003c/p\u003e \u003cp\u003eCases were graded and classified based on social demographic information and diagnosis criteria. To setup the logistic regression model, different groups were assigned and scored differently based on the severity of the judgmental condition. Details were described in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e \n\n\u003cp style=\"line-height: 150%;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eTable 3. Scoring of multivariate for logistic regression model\u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"border-collapse: collapse; border: none;\" width=\"568\"\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 76.3pt; border: none; border-top: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eVariate\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 53.0pt; border: none; border-top: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"71\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eAssigned \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 296.8pt; border: none; border-top: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"396\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eDescription\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 76.3pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" rowspan=\"4\" width=\"102\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eGroup\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 53.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"71\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003escore\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 296.8pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"396\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eHealthy control\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 53.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"71\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 296.8pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"396\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eRRTIs, attack period\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 53.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"71\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 296.8pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"396\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eRRTIs, stable period\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 53.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"71\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 296.8pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"396\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eNot RRTIs, with respiratory disease symptoms\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 76.3pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" rowspan=\"3\" width=\"102\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eResidence\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 53.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"71\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 296.8pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"396\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eSuburban area\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 53.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"71\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 296.8pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"396\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eCountry resident\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 53.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"71\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 296.8pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"396\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eCitizen\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 76.3pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" rowspan=\"3\" width=\"102\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eBMI\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 53.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"71\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 296.8pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"396\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eOverweight \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 53.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"71\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 296.8pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"396\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eObesity\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 53.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"71\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 296.8pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"396\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eNormal\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 76.3pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eVitamin A\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 53.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"71\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 296.8pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"396\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eDeficiency\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 76.3pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 53.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"71\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 296.8pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"396\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eSuspected subclinical deficiency\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 76.3pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 53.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"71\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 296.8pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"396\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eNormal\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 76.3pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eVitamin E\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 53.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"71\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 296.8pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"396\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eDeficiency\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 76.3pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: left; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 53.0pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"71\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 296.8pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"396\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eSubclinical deficiency\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 76.3pt; border: none; border-bottom: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: left; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 53.0pt; border: none; border-bottom: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"71\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 296.8pt; border: none; border-bottom: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"396\"\u003e\n\u003cp style=\"text-align: center; line-height: 150%; text-autospace: none;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003eNormal\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style=\"line-height: 150%;\"\u003e\u003cspan style=\"font-size: 9.0pt; line-height: 150%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\n\u003cp\u003eMultivariate logistic regression model was established and a series of Odd Ratio (OR) was calculated to indicate the association of vitamin A/E level to the presence of RRTIs. As a commonly used value for children health status indication, BMI of individuals and its related OR were also calculated. Comparing with the prevalence in children with normal vitamin A level, the OR of vitamin A deficiency for symptomatic RRTIs is 8.32 (95%CI: 6.15ཞ11.27), while the OR of vitamin A suspected subclinical deficiency for symptomatic RRTIs is 2.36 (95%CI: 1.98ཞ2.80), which indicates a high risk of vitamin A deficiency. Comparing with the morbidity in children with normal vitamin E level, the OR of vitamin E deficiency for RRTIs is 1.56 (95%CI: 0.88ཞ2.78), while the OR of vitamin E subclinical deficiency for symptomatic RRTIs is 1.37 (95%CI: 1.14ཞ1.65). The vitamin E level seems to be a risk factor for symptomatic RRTIs as well. Comparing with the prevalence in children with normal BMI, the OR of overweight and obesity for symptomatic RRTIs are 1.73 (95%CI: 1.37ཞ2.18) and 1.72 (95%CI: 1.36ཞ2.18), respectively; comparing with the prevalence in permanent citizens, the OR of rural residence for symptomatic RRTIs is 3.26 (95%CI: 2.46ཞ4.30), while the OR of suburban residence for symptomatic RRTIs is 1.22 (95%CI: 0.92\u0026thinsp;~\u0026thinsp;1.63), which indicates that the body weight and residential conditions might also affect the occurrence of RRTIs.\u003c/p\u003e \u003cp\u003eMoreover, the vitamin A level is also positive correlated with asymptomatic RRTIs (between the infection episodes) with an OR of 1.52 (95%CI: 1.00ཞ2.32) and 1.30 (95%CI: 1.10ཞ1.55) for deficiency and suspected subclinical deficiency respectively. However, the correlation is weaker than for the symptomatic RRTIS. The association of vitamin E level and asymptomatic RRTIs is relatively weak. The OR of vitamin E deficiency and subclinical deficiency are 1.14 and 1.04 respectively. The OR of obesity for asymptomatic RRTIs is 1.52 (95%CI: 1.20ཞ1.93), while the OR of overweight is 1.04. The OR of rural residence and suburban residence for asymptomatic RRTIs are 1.64 (95%CI: 1.27ཞ2.12) and 1.13 (95%CI: 0.77ཞ1.65), respectively. This time the effect of body weight and residence seems to be weaker than on the symptomatic RRTIs.\u003c/p\u003e \u003cp\u003eFor other acute respiratory infections, the vitamin A level strongly associated with the RTIs again. The OR of vitamin A deficiency is 7.09 (95%CI: 5.37ཞ9.37), while the OR of vitamin A suspected subclinical deficiency is 1.60 (95%CI: 1.38ཞ1.86). Whereas the vitamin E level appears to be not completely associated with the RTIs this time. The OR of vitamin E deficiency is 0.69 (95%CI: 0.36ཞ1.32), while the OR of vitamin E subclinical deficiency is 1.17 (95%CI: 0.99ཞ1.38). The OR of overweight and obesity for respiratory symptoms are 1.43 (95%CI: 1.16ཞ1.77) and 2.02 (95%CI: 1.66ཞ2.47), indicating a risk of getting respiratory symptoms. The OR of rural and suburban residence are respectively to be OR\u0026thinsp;=\u0026thinsp;1.56 (95%CI: 1.16ཞ2.08) and OR\u0026thinsp;=\u0026thinsp;0.55 (95%CI: 0.40ཞ0.76). Only settling down in the countryside might be a risk factor of getting acute RTIs. The OR of age are all 0.99 (95%CI: 0.99ཞ0.99) or 1.00 (95%CI: 0.99ཞ1.00) in all groups, indicating that the age distribution did not significantly affect the result when taking all effect factors into consideration (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cdiv class=\"SimplePara\"\u003eResults of multivariate for logistic regression analysis\u003c/div\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eGroup\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eScore\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cdiv class=\"SimplePara\"\u003eB\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003eWald value\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003eP\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003eOR\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e95%CI\u003c/div\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"13\" rowspan=\"14\"\u003e \u003cdiv class=\"SimplePara\"\u003eB\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eintercept\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e-1.63\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e238.13\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.000\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[VA\u0026thinsp;=\u0026thinsp;1]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e2.12\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e187.85\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.000\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e8.32\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e6.15ཞ11.27\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[VA\u0026thinsp;=\u0026thinsp;2]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.86\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e94.16\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.000\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e2.36\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.98ཞ2.80\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[VA\u0026thinsp;=\u0026thinsp;3]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0\u003csup\u003eb\u003c/sup\u003e\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[VE\u0026thinsp;=\u0026thinsp;1]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.44\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e2.27\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.132\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.56\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.88ཞ2.78\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[VE\u0026thinsp;=\u0026thinsp;2]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.31\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e10.82\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.001\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.37\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.14ཞ1.65\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[VE\u0026thinsp;=\u0026thinsp;3]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0\u003csup\u003eb\u003c/sup\u003e\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[body shape\u0026thinsp;=\u0026thinsp;1]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.55\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e21.36\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.000\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.73\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.37ཞ2.18\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[body shape\u0026thinsp;=\u0026thinsp;2]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.54\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e20.19\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.000\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.72\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.36ཞ2.18\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[body shape\u0026thinsp;=\u0026thinsp;3]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0\u003csup\u003eb\u003c/sup\u003e\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[residence\u0026thinsp;=\u0026thinsp;1]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.20\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.84\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.175\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.22\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.92ཞ1.63\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[residence\u0026thinsp;=\u0026thinsp;2]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.18\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e68.93\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.000\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e3.26\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e2.46ཞ4.30\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[residence\u0026thinsp;=\u0026thinsp;3]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0\u003csup\u003eb\u003c/sup\u003e\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eAge (month)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e-0.01\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e31.14\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.000\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.99\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.99ཞ1.00\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"13\" rowspan=\"14\"\u003e \u003cdiv class=\"SimplePara\"\u003eC\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eIntercept\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e-1.38\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e204.72\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.000\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[VA\u0026thinsp;=\u0026thinsp;1]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.42\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e3.86\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.05\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.52\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.00ཞ2.32\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[VA\u0026thinsp;=\u0026thinsp;2]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.27\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e9.35\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.002\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.30\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.10ཞ1.55\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[VA\u0026thinsp;=\u0026thinsp;3]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0\u003csup\u003eb\u003c/sup\u003e\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[VE\u0026thinsp;=\u0026thinsp;1]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.13\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.14\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.711\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.14\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.57ཞ2.30\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[VE\u0026thinsp;=\u0026thinsp;2]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.04\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.16\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.688\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.04\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.85ཞ1.27\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[VE\u0026thinsp;=\u0026thinsp;3]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0\u003csup\u003eb\u003c/sup\u003e\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[body shape\u0026thinsp;=\u0026thinsp;1]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.04\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.08\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.773\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.04\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.80ཞ1.35\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[body shape\u0026thinsp;=\u0026thinsp;2]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.42\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e11.67\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.001\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.52\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.20ཞ1.93\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[body shape\u0026thinsp;=\u0026thinsp;3]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0\u003csup\u003eb\u003c/sup\u003e\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[residence\u0026thinsp;=\u0026thinsp;1]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.50\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e14.23\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.000\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.64\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.27ཞ2.12\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[residence\u0026thinsp;=\u0026thinsp;2]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.12\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.37\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.544\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.13\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.77ཞ1.65\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[residence\u0026thinsp;=\u0026thinsp;3]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0\u003csup\u003eb\u003c/sup\u003e\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eAge (month)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.00\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e5.15\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.023\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.00\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.99ཞ1.00\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"13\" rowspan=\"14\"\u003e \u003cdiv class=\"SimplePara\"\u003eD\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eIntercept\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e-0.84\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e93.20\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.000\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[VA\u0026thinsp;=\u0026thinsp;1]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.96\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e190.80\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.000\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e7.09\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e5.37ཞ9.37\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[VA\u0026thinsp;=\u0026thinsp;2]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.47\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e37.93\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.000\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.60\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.38ཞ1.86\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[VA\u0026thinsp;=\u0026thinsp;3]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0\u003csup\u003eb\u003c/sup\u003e\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[VE\u0026thinsp;=\u0026thinsp;1]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e-0.37\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.24\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.265\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.69\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.36ཞ1.32\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[VE\u0026thinsp;=\u0026thinsp;2]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.16\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e3.26\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.071\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.17\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.99ཞ1.38\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[VE\u0026thinsp;=\u0026thinsp;3]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0\u003csup\u003eb\u003c/sup\u003e\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[body shape\u0026thinsp;=\u0026thinsp;1]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.36\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e10.91\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.001\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.43\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.16ཞ1.77\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[body shape\u0026thinsp;=\u0026thinsp;2]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.71\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e47.97\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.000\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e2.02\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.66ཞ2.47\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[body shape\u0026thinsp;=\u0026thinsp;3]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0\u003csup\u003eb\u003c/sup\u003e\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[residence\u0026thinsp;=\u0026thinsp;1]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e-0.59\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e13.59\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.000\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.55\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.40ཞ0.76\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[residence\u0026thinsp;=\u0026thinsp;2]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.44\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e8.92\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.003\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.56\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e1.16ཞ2.08\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e[residence\u0026thinsp;=\u0026thinsp;3]\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e0\u003csup\u003eb\u003c/sup\u003e\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e.\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eAge (month)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e-0.01\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e51.03\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.000\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.99\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cdiv class=\"SimplePara\"\u003e0.99ཞ0.99\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003eNote :0\u003csup\u003eb\u003c/sup\u003e Reference\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e "},{"header":"Discussion","content":" \u003cp\u003eRespiratory tract infections are a series of respiratory system diseases caused by infections resulting from proliferation of pathogenic microorganism. RTIs can be divided into upper respiratory infections and lower respiratory infections, the former one includes rhinitis, pharyngitis, and laryngitis while the latter one includes tracheitis, bronchitis, and pneumonia\u003csup\u003e[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/sup\u003e. Possible complications like acute carditis, nephritis, and rheumatism may also happen to a few people. Children, most of whom with weaker immunity, are susceptible to RTIs and may even getting worse to RRTIs. RRTIs are a special form of RTIs which extremely popular in children. Delayed diagnosis or unthoroughly treatment would induce the severe complications and serious impact their healthy growth\u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e. Scientists have been studying on the occurrence and development as well as risk factors of RTIs for years, wherein the status of vitamin A and vitamin E in children can be a topic in focus.\u003c/p\u003e \u003cp\u003eAssociation between vitamin A/E and RRTIs\u003c/p\u003e \u003cp\u003eSeveral independent reported double-blind, randomized trials indicated that supplement of vitamin A /vitamin E would boost the immunity system of infected patients who suffered from chronic vitamin deficiency \u003csup\u003e[\u003cspan additionalcitationids=\"CR16\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/sup\u003e. Ma et al., set up a case-control study analyzed comparing the acute bronchiolitis group and uninfected/other respiratory disease group, to confirm the association between the infection of acute bronchitis and vitamin A/D level through independent risk factor analysis. Moreover, when using the multi-factor model, they also accidentally find another risk factor, vitamin \u003csup\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]\u003c/sup\u003e. Zhang et al studied RRTIs in children aged 0.5\u0026ndash;14 in northern China (Harbin) demonstrated that low level of vitamin A/D/E had a positive association with RRTIs in children\u003csup\u003e[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/sup\u003e. The concentration of serum vitamin E lower than 7,85\u0026nbsp;mg/L can be a risk factor of RRTIs\u003csup\u003e[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/sup\u003e. Our study detected an even lower level of serum vitamin A/E in some young patients, and the vitamin A/E level showed a negative association with symptomatic RRTIs in children. Thus, children should be well fed with a balanced nutrition in their important developmental period to avoid vitamin A/E insufficiency and to prevent the attack of RRTIs.\u003c/p\u003e \u003cp\u003eVitamin A plays a significant role in supporting body growth and immune response in mammals. Common infectious diseases such as measles, diarrhea and respiratory infection are comprised of different types of immune response\u003csup\u003e[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/sup\u003e. IgA is one of the most important compounds in mucosal immunity system, which is confirmed associating with the respiratory infection\u003csup\u003e[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]\u003c/sup\u003e. Previous research indicated that vitamin A played a major role in the differentiation of T cells as well as the secretion and class switching of IgA \u003csup\u003e[\u003cspan additionalcitationids=\"CR24\" citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]\u003c/sup\u003e. Additionally, airway mucus, a protective barrier to against antigen, was consist of mucoprotein and glycoprotein\u003csup\u003e[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]\u003c/sup\u003e. Deficiency in vitamin A would impact the expression of mucoprotein and decrease the proliferation of lymphocytes following antigen activation, and indeed decrease the immune response in airway mucus in patient\u003csup\u003e[\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]\u003c/sup\u003e. Besides, scientists had investigated that significant impair of virus-specific IgA and CD8\u0026thinsp;+\u0026thinsp;T- cells were observed in the airway of vitamin A-deficient mice\u003csup\u003e[\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]\u003c/sup\u003e. These studies demonstrated the deficiency of Vitamin A would reduce the status of immunity, thus increase the probability of infection. In this study, children with high vitamin A level displayed a much lower morbidity of symptomatic RRTIs, and serum vitamin A level showed a negative association with both symptomatic RRTIs and symptomatic acute RTIs, and a mild but not significant correlation with asymptomatic RRTIs in children, which is consist with the hypothesis mentioned before.\u003c/p\u003e \u003cp\u003eVitamin E, as a lipid-soluble antioxidant, can protect cell membrane and prevent the oxidative damage induced by high metabolism and the accumulation of unsaturated fatty acid \u003csup\u003e[\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]\u003c/sup\u003e. Vitamin E is also an important immunomodulator. BouGhanem,E.N. et al demonstrated that α-tocopherol, an active form of vitamin E, is an effective regulator of neutrophils \u003csup\u003e[\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]\u003c/sup\u003e. Neutrophils are the most abundant white blood cells which are considered to be the first barrier attacking infections, including RTIs and RRTIs\u003csup\u003e[\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]\u003c/sup\u003e. Therefore, there might be an association between vitamin E and RRTIs. Our study indicates a lower morbidity of symptomatic RRTIs in individuals with high vitamin E level, which is corresponding with early studies as well. However, it didn\u0026rsquo;t display a significant correlation with asymptomatic RRTIs or symptomatic acute RTIs, which may probably due to the demand of vitamin E in immune response is lower than vitamin A.\u003c/p\u003e \u003cp\u003eAdditionally, we also found a mild but not significant effect of age for RRTIs. In addition to the age, the morbidity of RRTIs in obesity or overweight group is also 0.72\u0026thinsp;~\u0026thinsp;0.73 times higher than normal, which indicate the accumulation of fatty acid may affect the status of immunity. Moreover, the morbidity in rural resident is 3.26 times higher than the citizen, which may probably due to the combination of effects including different economic level, sanity conditions, nutrition supplements, diversification or preference of diet, or different outpatient rate etc.\u003c/p\u003e \u003cp\u003eFurther study\u003c/p\u003e \u003cp\u003eIn this cross-sectional and analytical study, we enrolled an extremely large sample size, 5780 cases, which is unprecedented in respiratory disease study, which helps decreasing the sampling error and makes the result more convincing. However, there are still some unresolved questions. For example, our study is still hard to specify if the low serum vitamin A/E is the inducer or result of RRTI diseases since it is just a prevalence study focusing on the current status. If the decreasing of serum vitamin A/E is aroused by RRTIs which can be reversed automatically, supplementation of vitamin A/E may not be an effective therapeutic strategy, vice versa. Some presented studies demonstrated that the supplementation of vitamin A didn\u0026rsquo;t produce a substantial reduction in symptoms or morbidity of respiratory infections\u003csup\u003e[\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]\u003c/sup\u003e, only one publication displayed that vitamin A supply would decrease the mortality of young measles patients and decrease the severer status of measly infection, but it didn\u0026rsquo;t work for other respiratory infections \u003csup\u003e[\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]\u003c/sup\u003e. Dibley et al \u003csup\u003e[\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]\u003c/sup\u003e investigated that high dose of supplementary vitamin A would oppositely increase the morbidity of lower respiratory infections, which is extremely significant in nutritionally adequate children. It was also suggested not giving vitamin A to all children to prevent the acute RTIs, except for those who was under nutrition\u003csup\u003e[\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]\u003c/sup\u003e. We assume that the decreasing of serum vitamin A is a consequence of infections due to the consumption of vitamin A by immune response leading to rearrangement of vitamin A in body. But for the malnutritional children, chronic vitamin A deficiency could be an inducer of RRTIs due to the immunodeficiency. Suitable supplementation would assist the disease cure. This assumption could be supported by the research of Grobler et al. They observed that nutrient supplementation for patients with active tuberculosis didn\u0026rsquo;t present any clinically benefits, but their serum vitamin A level increased rapidly following tuberculosis treatment regardless of supplementation\u003csup\u003e[\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]\u003c/sup\u003e. Other scientists also demonstrated that inflammation would affect serum vitamin A level, but it is able to re-normalized without therapeutic intervention[36]. Similarly, the supplementation of vitamin E didn\u0026rsquo;t demonstrate a consistent significant effect to human immunity, opposite effects were observed in some trials\u003csup\u003e[\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]\u003c/sup\u003e. We assume than wavy serum vitamin E level might also due to the spending and replenishment of vitamin E. Once infected, vitamin E in serum would be used to support the regulation of neutrophils resulted in a low vitamin E level, while the reduction would be normalized later through body regulate system. However, assumptions described above are all speculated according to published conclusions and current study. Further exploration is requested to demonstrate the hypothesis by conducting the further cohort-study.\u003c/p\u003e \u003cp\u003eAnother unresolved question of this study is if the pathogen of RRTIs associated with serum vitamin in children. Comparing with bacteria, virus induced infections would active different types of immune responses, of which the consumption of vitamins might be different as well. Vitamin A contribute in both T cell differentiation and class switch recombination of antibody expression \u003csup\u003e[\u003cspan additionalcitationids=\"CR24\" citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]\u003c/sup\u003e, which helps against both bacteria and virus. However, vitamin E contribute more on proliferation and regulation of neutrophils, trending to control bacteria and fungal induced inflammation\u003csup\u003e[\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]\u003c/sup\u003e. It is possible that most individuals involved in this study were attacked by virus, which explains the weaker association between RRTIs and vitamin E than the association between RRTIs and vitamin A. Besides, dietary structure of individuals, which may highly affect their physique and the recurrence of serum vitamin, is not included in this study as well.\u003c/p\u003e \u003cp\u003eIn later cohort studies, we would like to monitor the immunity status, such as lymphocytes cell level or neutrophils level, as well as serum vitamin level in children with RRTIs to further investigate the mechanism of vitamins and its association between RRTIs. Patients infected by different pathogens would be classified and analyzed in different groups, and the relationship between different vitamins, pathogens and immune responses would be summarized and concluded. Other vitamins such as vitamin C and vitamin D would be considered to investigate if they display similar association with RRTIs. Optimized grading and classification criteria would be used. For instance, thin and emaciation group would be added when classify individuals through BMI, and residential environment could be graded based on the residential area and the hygiene status. Additional aimed risk factors, such as dietary structure and racism, would be included in the study as well. A comprehensive statistical logistic regression model would be set up to better investigate the risk factors of RRTIs.\u003c/p\u003e "},{"header":"Conclusion","content":" \u003cp\u003eVitamin A and vitamin E level are negative risk factors of pediatric RRTIs. Their deficiency especially vitamin A deficiency are strongly associated with the disease morbidity. Body mass index is the positive risk factor of RRTIs, i.e. RRTIs are more frequently observed in children with overweight or obesity. Besides, the residential quality also related to the development of RRTIs as well. Consequently, in future governmental children health program, monitoring serum vitamin A and vitamin E level through periodically physical exanimation, evaluating the nutrition status of vitamin A/E objectively, screening out children suffering from long-term nutrition deficiency and supplying them adequate amount of vitamin though balanced diet or nutrition supplements can be valuable and worth popularized. Children should routinely do exercise and have less greasy food for a good body shape, they should also pay more attention on their personal hygiene to keep a healthy lifestyle.\u003c/p\u003e "},{"header":"Abbreviations","content":" \u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eRecurrent respiratory tract infections\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eRRTIs\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eRespiratory tract infection\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eRTI\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eBody Mass Index\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eBMI\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eOdd Ratio\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eOR\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e "},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate:\u003c/strong\u003e This research is approved by the Ethics Committee of Capital Institute of Pediatrics, with the ethics batch number of SHERLL2015001.Participants and participants\u0026rsquo; family were informed during the investigation, and children\u0026rsquo;s parents have provided signed informed consent for research enrollment and data accessibility. \u003cstrong\u003eConsent for publication:\u003c/strong\u003e The authors declare that they consent for publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u003c/strong\u003e we state that data will be shared.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interest:\u003c/strong\u003e The authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFund\u003c/strong\u003e\u003cstrong\u003e：\u003c/strong\u003e Not applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors Contributions: \u003c/strong\u003eXW,CJ and XL conceived the study design, conceptualized the ideas, and supervised the whole analytical procedure. JW,JW,LZ,NL,NJ and WS contributed to data collection and manuscript writing. XW and XL also provided technical support for drafting and revising the manuscript. All authors have read and approved the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments:\u003c/strong\u003e We appreciate all 5780 investigators who participated in this online survey. And we would also give thanks to Department of \u0026nbsp;Children Health Care, Capital Institute of Pediatrics who supported us for the survey. Especially we would extend our thanks to those doctors of \u0026nbsp;Beijng Pediatrics Hospital or Pediatrics Department\u0026nbsp; of\u0026nbsp; some genenral hospitals, who contributed to the process of data collection.\u003c/p\u003e"},{"header":"References","content":"\u003cp\u003e[1] Korppi M. Recurrent respiratory infections in children: A practical approach for clinical work[J]. 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Epub 1998/01/13.PMID: 9426108\u003c/p\u003e\n\u003cp\u003e[27]Fan X, Liu S, Liu G, et al. Vitamin A Deficiency Impairs Mucin Expression and Suppresses the Mucosal Immune Function of the Respiratory Tract in Chicks[J]. Plos One, 2015, 10(9):e0139131.\u003c/p\u003e\n\u003cp\u003e[28]Surman, Sherri L., et al. \"Enhanced CD103 Expression and Reduced Frequencies of Virus-Specific CD8+ T Cells Among Airway Lymphocytes After Influenza Vaccination of Mice Deficient in Vitamins A+ D.\"\u0026nbsp;Viral immunology\u0026nbsp;30.10 (2017): 737-743.\u003c/p\u003e\n\u003cp\u003e[29] Young IS, Woodside JV. Antioxidants in health and disease. J Clin Pathol. 2001; 54(3):176\u0026ndash;86. Epub2001/03/17. doi: 10.1136/jcp.54.3.176 PMID: 11253127\u003c/p\u003e\n\u003cp\u003e[30] Coquette A, Vray B, VanderpasJ. Role of vitamin E in the protection of the resident macrophage mem-brane against oxidative damage. Arch Int Physiol Biochim. 1986; 94(5):S29\u0026ndash;34. Epub 1986/12/01.PMID: 2440399\u003c/p\u003e\n\u003cp\u003e[31] Bou Ghanem, E. N.Lee, J. N.Joma, B. H.Meydani, S. N.Leong, J. M.Panda, A.Front Cell Infect Microbiol J.2017;7:161 DOI:10.3389/fcimb.2017.00161\u003c/p\u003e\n\u003cp\u003e[32]Uribequerol E, Rosales C. Neutrophils in cancer: two sides of the same coin[J]. Journal of Immunology Research,2015,(2015-12-24), 2015, 2015(6):1-21.\u003c/p\u003e\n\u003cp\u003e[33]Grobler, Liesl, et al. \"Nutritional supplements for people being treated for active tuberculosis.\"\u0026nbsp;Cochrane Database of Systematic Reviews\u0026nbsp;6 (2016).\u003c/p\u003e\n\u003cp\u003eAbdeljaber, Mutee H., et al. \"The impact of vitamin A supplementation on morbidity: a randomized community intervention trial.\"\u0026nbsp;American journal of public health\u0026nbsp;81.12 (1991): 1654-1656.\u003c/p\u003e\n\u003cp\u003e[34]Brow N,Robert C.Vitamin A for acute respiratory infection in developing countries:a meta-analysis[J].Acta Paediatrica,2004,93(11):1437.\u003c/p\u003e\n\u003cp\u003e[35] Dibley MJ, Sadjimin T, Kjolhede CL, Moulton LH. Vitamin A supplement -ation fails to reduce incidence of acute respiratory illness and diarrhea in preschool-age Indonesian children[J]. The Journal ofNutrition, 1996,126(2):434-442.\u003c/p\u003e\n\u003cp\u003e[36]Dibley M J , Sadjimin T , Kjolhede C L , et al. Vitamin A supplementation fails to reduce incidence of acute respiratory illness and diarrhea in preschool-age Indonesian children.[J]. Journal of Nutrition, 1996, 126(2):434.\u003c/p\u003e\n\u003cp\u003e[37]Grobler, Liesl, et al. \"Nutritional supplements for people being treated for active tuberculosis.\"\u0026nbsp;Cochrane Database of Systematic Reviews\u0026nbsp;6 (2016).\u003c/p\u003e\n\u003cp\u003e[38]Lee, Ga, and Sung Han. \"The role of vitamin E in immunity.\"\u0026nbsp;Nutrients\u0026nbsp;10.11 (2018): 1614.\u003c/p\u003e\n\u003cp\u003e[39]Hogan, J. S., et al. \"Bovine neutrophil responses to parenteral vitamin E.\"\u0026nbsp;Journal of dairy science\u0026nbsp;75.2 (1992): 399-405.\u003c/p\u003e\n\u003cp\u003e[40]Drescher, Brandon, and Fengwei Bai. \"Neutrophil in viral infections, friend or foe?.\"\u0026nbsp;Virus research\u0026nbsp;171.1 (2013): 1-7.\u003c/p\u003e\n"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Vitamin A, Vitamin E, BMI, Chinese, Children, RRTIs","lastPublishedDoi":"10.21203/rs.2.22863/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.2.22863/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eObjective \u003c/p\u003e\u003cp\u003eTo test the association between serum vitamin A and vitamin E and the prevalence of recurrent respiratory tract infections (RRTIs) of children and adolescents. \u003c/p\u003e\u003cp\u003eMethod \u003c/p\u003e\u003cp\u003eA total amount of 5780 children and adolescents aged 2 to 17 were involved, who were classified into:A) Control group ;B) Diagnosed as RRTI with RTI symptoms; C) With RRTI but currently no RTI symptoms being noticed, and D) Not RRTI but showing respiratory disease symptoms. The correlation between serum vitamin A/E level and the presence of RRTIs were analyzed. \u003c/p\u003e\u003cp\u003eResults \u003c/p\u003e\u003cp\u003eComparing with the prevalence of RRTI in children with normal vitamin A level, the Odds Ratio(OR) of vitamin A deficiency for RRTIs with symptoms was 8.32 (95%CI: 6.15 ～ 11.27), while the OR of marginal vitamin A deficiency was 1.30 (95%CI: 1.10 ～ 1.55). The OR of vitamin A deficiency or marginal vitamin A deficiency for asymptomatic RRTIs were 1.52 (95%CI: 1.00 ～ 2.32) and 1.30 (95%CI: 1.10 ～ 1.55) respectively, while the OR of vitamin A deficiency or marginal vitamin A deficiency for other respiratory diseases were 7.09 (95%CI: 5.37 ～ 9.37) and 1.60 (95%CI: 1.38 ～ 1.86). Whereas, the OR of vitamin E deficiency or marginal vitamin E deficiency for RRTIs or normal respiratory infections were showed without statistical significance. \u003c/p\u003e\u003cp\u003eConclusion \u003c/p\u003e\u003cp\u003eThe low level of vitamin A in serum is a risk factor for children and adolescents getting RRTIs or RTIs, indicating a possibly regulatory role of vitamin A in the respiratory diseases.\u0026nbsp;In comparison, the vitamin E deficiency seems to have a weaker but still positive effect on the RRTIs or RTI\u003c/p\u003e","manuscriptTitle":"The status of serum vitamin A/E and its effect on Recurrent Respiratory Tract Infections in children aged 2 to 17 years in Beijing, China, based on cross-sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2020-02-07 16:05:47","doi":"10.21203/rs.2.22863/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"bf5847b2-09b7-495e-ac5e-3eaa64dd8276","owner":[],"postedDate":"February 7th, 2020","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":56608,"name":"Pediatrics"}],"tags":[],"updatedAt":"2020-06-09T18:50:08+00:00","versionOfRecord":[],"versionCreatedAt":"2020-02-07 16:05:47","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-13437","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"identity":"rs-13437","version":["v1"]},"buildId":"7rjqhiLT3MXkJMwkYKINL","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}