Associations of Serum Niacin and Nicotinamide with Child Behavior: A Longitudinal Study in China
- 1Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
- 2Yiwu Center for Disease Control and Prevention, Yiwu 322000, China
Abstract
Background/Objectives: Nicotinic acid (NA; niacin) and nicotinamide (NAM) participate in nicotinamide adenine dinucleotide metabolism, but pediatric evidence relating serum concentrations of these vitamers to behavioral-problem scores is limited. Methods: We conducted an exploratory analysis of children assessed in Yiwu, Zhejiang Province, China, with serum NA and NAM concentrations recorded in 2021 and 2025 and caregiver-reported Child Behavior Checklist (CBCL) outcomes in 2025. Vitamin B3 was measured by high-performance liquid chromatography–tandem mass spectrometry (HPLC–MS/MS). Internalizing, externalizing, and total-problem raw scores were the broadband outcomes; seven common raw subscales were exploratory outcomes. Multivariable linear models and three-knot restricted cubic splines (RCSs) were conducted to assess the associations between vitamin B3 and CBCL scores. Benjamini–Hochberg correction and exposure-by-sex interaction tests were used. Results: Pooled associations were compatible with the null after correction. Per interquartile-range (IQR) increase in 2021 NA, boys’ adjusted contrasts were −2.18 (95% CI, −4.22 to −0.13) for internalizing, −3.04 (−5.05 to −1.04) for externalizing, and −5.33 (−9.18 to −1.47) for total problems. In sex-stratified RCS analyses, 2021 NA was associated with externalizing (q-overall = 0.040) and total problems (q-overall = 0.023) in boys, whereas 2025 NA was associated with these outcomes in girls (both q-overall = 0.042). Sex-stratified two-degree-of-freedom RCS models had limited sensitivity for small-to-modest associations. Conclusions: The sex-interaction and sex-stratified RCS patterns for NA are hypothesis-generating and require independent, prespecified replication.
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BibTeX
@article{zhang2026associations,
title = {{Associations of Serum Niacin and Nicotinamide with Child Behavior: A Longitudinal Study in China}},
author = {Xinhan Zhang and Kuiqing Huang and Chen Liu and Yi Wang and Jinghan Jiang and Zhijian Chen and Jie Xiang and Peiwei Xu},
journal = {Nutrients},
year = {2026},
month = oct,
doi = {10.3390/nu18203344},
url = {https://www.mdpi.com/2072-6643/18/20/3344},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Associations of Serum Niacin and Nicotinamide with Child Behavior: A Longitudinal Study in China
AU - Xinhan Zhang
AU - Kuiqing Huang
AU - Chen Liu
AU - Yi Wang
AU - Jinghan Jiang
AU - Zhijian Chen
AU - Jie Xiang
AU - Peiwei Xu
PY - 2026
DA - 2026/10/01
JO - Nutrients
DO - 10.3390/nu18203344
UR - https://www.mdpi.com/2072-6643/18/20/3344
AB - Background/Objectives: Nicotinic acid (NA; niacin) and nicotinamide (NAM) participate in nicotinamide adenine dinucleotide metabolism, but pediatric evidence relating serum concentrations of these vitamers to behavioral-problem scores is limited. Methods: We conducted an exploratory analysis of children assessed in Yiwu, Zhejiang Province, China, with serum NA and NAM concentrations recorded in 2021 and 2025 and caregiver-reported Child Behavior Checklist (CBCL) outcomes in 2025. Vitamin B3 was measured by high-performance liquid chromatography–tandem mass spectrometry (HPLC–MS/MS). Internalizing, externalizing, and total-problem raw scores were the broadband outcomes; seven common raw subscales were exploratory outcomes. Multivariable linear models and three-knot restricted cubic splines (RCSs) were conducted to assess the associations between vitamin B3 and CBCL scores. Benjamini–Hochberg correction and exposure-by-sex interaction tests were used. Results: Pooled associations were compatible with the null after correction. Per interquartile-range (IQR) increase in 2021 NA, boys’ adjusted contrasts were −2.18 (95% CI, −4.22 to −0.13) for internalizing, −3.04 (−5.05 to −1.04) for externalizing, and −5.33 (−9.18 to −1.47) for total problems. In sex-stratified RCS analyses, 2021 NA was associated with externalizing (q-overall = 0.040) and total problems (q-overall = 0.023) in boys, whereas 2025 NA was associated with these outcomes in girls (both q-overall = 0.042). Sex-stratified two-degree-of-freedom RCS models had limited sensitivity for small-to-modest associations. Conclusions: The sex-interaction and sex-stratified RCS patterns for NA are hypothesis-generating and require independent, prespecified replication.
SN - 2072-6643
ER -