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. 2025 Apr 30;22(1):33.
doi: 10.1186/s12986-025-00931-2.

Serum vitamin C associated with lipids levels in children and adolescents: a national cross-sectional study

Xiaoqi Su  1 , Shanliang Zhu  1 , Ye Chen  1 , Xin Zhou  1 , Jun Chen #  2 , Nishant Patel #  3   4 , Xuming Mo #  5
Affiliations

Serum vitamin C associated with lipids levels in children and adolescents: a national cross-sectional study

Xiaoqi Su et al. Nutr Metab (Lond). .

Abstract

Background: The relationship between serum vitamin C (sVC) and blood lipids in adolescents in the US has not been thoroughly studied. This study investigates the correlation between sVC and blood lipids among adolescents using data from the National Health and Nutrition Examination Survey (NHANES).

Methods: Data from the NHANES 2003-2006 and 2017-2018 cycles, encompassing 4,965 participants aged 12-19 years, were analyzed. sVC served as the independent variable and blood lipids as the dependent variables. Multiple linear regression models assessed the relationship between sVC and blood lipids, with subgroup analyses based on sex, age, and race. Additionally, smooth curve fitting and saturation threshold analysis were employed to explore nonlinear relationships.

Results: Adjusted analyses revealed a positive correlation between sVC and high-density lipoprotein cholesterol (HDL-C) (β = 2.77, 95%CI 2.06-3.47), with no significant association with total cholesterol, low-density lipoprotein cholesterol (LDL-C), or triglycerides. This positive correlation persisted across subgroups divided by age, gender, and race (p < 0.05). The nonlinear relationship between sVC and HDL-C was characterized by an inverted U-shaped curve in adolescents aged 12-15 years, males, females, and non-Hispanic Whites.

Conclusions: This study confirms a positive association between sVC levels and HDL-C in adolescents, suggesting that higher vitamin C intake/status may be associated with a higher HDL-C in adolescents.

Keywords: Adolescents; Blood lipids; HDL-cholesterol; NHANES; Serum vitamin C.

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Conflict of interest statement

Declarations. Ethical approval and consent to participate: This study used data from the publicly available National Health and Nutrition Examination Survey (NHANES) database. Ethical approval was obtained from the National Health Statistics Center’s ethical review committee. All study procedures conformed to relevant guidelines and regulations, including the Helsinki Declaration. Written informed consent was secured from all participants before their participation. Consent for publication: No consent for publication is required. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Eligible participants and those included in the analyses of the association between serum vitamin C and high-density lipoprotein cholesterol in adolescents
Fig. 2
Fig. 2
The association between serum vitamin C and high-density lipoprotein cholesterol. (a) Each black point represents a sample. (b) The area between the two blue dotted lines represents the 95% confidence interval (CI). Each point shows the magnitude of serum vitamin C and is connected to form a continuous line. Age, sex, race, poverty-income ratio (PIR), glycohemoglobin, glucose, creatinine, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were adjusted
Fig. 3
Fig. 3
The association between serum vitamin C and high-density lipoprotein cholesterol by age. Sex, race, PIR, glycohemoglobin, glucose, creatinine, SBP, and DBP were adjusted
Fig. 4
Fig. 4
The association between serum vitamin C and high-density lipoprotein cholesterol by sex. Age, race, PIR, glycohemoglobin, glucose, creatinine, SBP, and DBP were adjusted
Fig. 5
Fig. 5
The association between serum vitamin C and high-density lipoprotein cholesterol by race. Age, sex, PIR, glycohemoglobin, glucose, creatinine, SBP, and DBP were adjusted
See this image and copyright information in PMC

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