Vitamin D status of apparently healthy early adolescents in Amravati City of Maharashtra, India (original) (raw)
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Vitamin D status and determinants in Indian children and adolescents: a multicentre study
Scientific Reports, 2022
Studies performed on Indian children to assess vitamin-D status have been on small sample sizes, limited to specific geographical locations and used non-standard methods to measure 25(OH)D 3. This multicentre study assessed 25(OH)D 3 concentrations from dried blood spots (DBS) in 5-18-year-old Indian children and adolescents using a standardized protocol and identified factors contributing towards vitamin D deficiency. Cross-sectional, observational school-based study was conducted by multi-stage stratified random sampling. A city and nearby village were selected from 6 Indian states covering wide geographical areas. Demography, anthropometry, body-composition, dietary-intakes and DBS samples were collected. 25(OH)D 3 was assessed from DBS using Liquid chromatography with tandem-mass spectrometry. Vitamin-D status was assessed in 2500 children; with additional data collected on a subset (n = 669) to assess predictors. Mean vitamin-D concentration was 45.8 ± 23.9 nmol/L, 36.8% of subjects had sufficient vitamin-D (> 50 nmol/L); rural subjects and boys had higher concentrations (p < 0.05). On regression analysis, younger age, female-gender, overweight and urban residence significantly contributed to deficiency. More than half the Indian children/ adolescents were vitamin-D deficient or insufficient. Our study reinforces vitamin-D deficiency as a major public health problem and the need for supplementation, food fortification and educating the population as initiatives required to improve sufficiency status. Vitamin D is a secosterol with a major role in maintaining calcium and phosphorus homeostasis. Vitamin D affects calcium homeostasis by its action on the kidney, intestine and bone 1. Vitamin D also has direct and indirect effects on growth plates, bone and bone cells 1. The extra-skeletal role of vitamin D has been suggested in various organs and ailments like skin (psoriasis, skin cancer), muscle function, cardiomyopathy, immune system (respiratory tract infection, inflammatory bowel disorder, allergy), colorectal carcinoma, cardiovascular risk factors (hypertension, diabetes, obesity, metabolic syndrome), neurological disorders and reproductive function 1. It is generally accepted that serum 25-hydroxyvitamin D (25(OH)D) is a reliable measure of an individual's vitamin D status. Serum total 25(OH)D concentration is the sum of the 25(OH)D 3 and 25(OH)D 2 concentrations. Various methods such as Radioimmunoassay (RIA), Chemiluminescence immunoassay, Enzyme-Linked Immunosorbent Assay (ELISA), and protein binding assays are used for measurement of 25(OH)D concentrations. However, High-Performance Liquid Chromatography (HPLC) or tandem mass spectrometry are considered to be the gold standard for the assessment of 25(OH)D 3 2. Thus, liquid chromatography-tandem mass spectrometry (LC-MS/ MS) is the widely accepted reference method for 25(OH)D measurement, however, it requires expensive equipment and expertise and is seldom used in low-or middle-income countries such as India 3. The Indian Academy of Paediatrics Guidelines and the Global Consensus on Prevention as well as Management of Nutritional Rickets recommend that 25(OH)D concentrations of over 50nmols/L (20ngm/ml) are sufficient, between 30 and 50 nmols/L (12-20 ngm/ml) are insufficient and below 30 nmols/L (12 ngm/ml) are in the deficiency range in children and adolescents 3,4. A systematic review published in 2014 suggests that vitamin D deficiency and insufficiency are a major public health problem globally irrespective of age, even in populations residing in countries where it is assumed that UV radiation is adequate and in industrialized countries where fortification has been implemented for years 5. It is estimated that about 1 billion people across all ethnicities and age groups have low vitamin D concentrations worldwide 6. In India, approximately 490 million people are
British Journal of Nutrition, 2007
Forty to fifty per cent of skeletal mass, accumulated during childhood and adolescence, is influenced by sunlight exposure, physical activity, lifestyle, endocrine status, nutrition and gender. In view of scarce data on association of nutrition and lifestyle with hypovitaminosis D in Indian children and adolescents, an in-depth study on 3127 apparently healthy Delhi schoolgirls (6–18 years) from the lower (LSES, n 1477) and upper socioeconomic strata (USES, n 1650) was carried out. These girls were subjected to anthropometry and clinical examination for hypovitaminosis D. Girls randomly selected from the two strata (LSES, n 193; USES, n 211) underwent detailed lifestyle, dietary, biochemical and hormonal assessment. Clinical vitamin D deficiency was noted in 11·5 % girls (12·4 % LSES, 10·7 % USES). USES girls had significantly higher BMI than LSES counterparts. Prevalence of biochemical hypovitaminosis D (serum 25-hydroxyvitamin D < 50 nmol/l) was seen in 90·8 % of girls (89·6 % ...
Prevalence of vitamin D deficiency/insufficiency among children and adolescents
Journal of Chitwan Medical College, 2017
Background: Vitamin D is an essential prohormone for the normal skeletal and extraskeletal health. Vitamin D deficiency/ insufficiency is an unrecognized epidemic among children and adults worldwide. There are growing data from studies of young children and adolescents in other countries, but a limited information are available regarding the prevalence of this nutritional deficiency/insufficiency among the Nepalese children and adolescents. Thus this study was aimed to find out the prevalence of vitamin D deficiency/insufficiency among children and adolescents, who has attended in Chitwan Medical College (CMC). Methods: This was a retrospective hospital based study in children between 2 months and 19 years of age, conducted in CMC from April 2015 to December 2016. Results: Among 108 total studied, overall 74.1% (80) patients had 25(OH) D levels lower than 30 ng/ml with 27.8% having severe deficiency (< 10 ng/ml), 28.7% deficiency (10-19 ng/ml) and 17.6% insufficiency (20-29 ng/ml) category. The prevalence was found higher in females (95.2%), though the difference in prevalence between sexes was not statistically significant (P-value 0.243). Conclusion: Our study concluded that a high prevalence of low Vitamin D status (deficiency/insufficiency) found among the paediatric population (all paediatric age groups) indicates a need for further national level study to find out the actual prevalence of this nutritional deficiency, as well as the need for vitamin D supplementation to all children and adolescents.
Vitamin D Deficiency in Children and Adolescents
Journal of Clinical Research in Pediatric Endocrinology, 2012
Ori gi nal Ar tic le 2 5 In tro duc ti on Vitamin D deficiency is an important public health problem in both developed and developing countries, with a reported worldwide prevalence of 30-80% in children and adults (1,2,3). The role of vitamin D in bone mineralization is well-documented. However, only recently, numerous studies have reported a link between vitamin D deficiency and several chronic disorders such as type 1 diabetes mellitus (T1DM), systemic lupus erythematosus (SLE), multiple sclerosis (MS), cardiovascular disease (CVD) and several malignancies (4,5,6,7,8). These recent findings have led to greater emphasis on treatment of vitamin D deficiency and/or vitamin D supplementation. Prevalence studies on vitamin D deficiency and/or insufficiency in the Turkish population, especially among prepubertal children over 3 years of age, are relatively scarce (9). The aim of this study was to determine the frequency of deficiency and insufficiency of vitamin D in a sample of Turkish children and adolescents and to investigate the factors associated with low vitamin D status. Methods This study was undertaken by the Fatih University Pediatrics Department and conducted in the University hospital, situated in Ankara, Turkey. We retrospectively reviewed the records of a total of 440 children and adolescents aged between 0 and 16 years who had presented to the outpatient clinic between January 2008 and January 2010. All patients were subjected to a careful physical examination. Weights were measured using a calibrated digital scale. Height measurements were done in ABS TRACT Ob jec ti ve: Vitamin D deficiency is an important health problem in both developed and developing countries. Recent reports on the extraskeletal effects of vitamin D have led to increased interest in prevalence studies on states of deficiency/insufficiency of vitamin D. The aim of this study was to determine the frequency of vitamin D deficiency and insufficiency in children and adolescents residing in Ankara, Turkey and to investigate the factors associated with low vitamin D status. Methods: A total of 440 children and adolescents aged between 0 and 16 years were enrolled in this study. The subjects were divided into three groups according to their vitamin D status (deficiency ≤15 ng/mL; insufficiency: 15-20 ng/mL; sufficiency ≥20 ng/mL) and also according to their age (preschool<5 years; middle childhood: 5-10 years; adolescence: 11-16 years). Results: Overall, 40% of the subjects were found to have 25 hydroxy vitamin D [25(OH)D] levels of less than 20 ng/mL. The levels indicated a deficiency state in 110 subjects (25%) and insufficiency-in 66 (15%). The rate of vitamin D deficiency was higher in girls, regardless of age. 25(OH)D levels correlated negatively with age (r=-0.48, p<0.001), body mass index (BMI) (r=-0.20, p=0.001) and intact parathyroid hormone (iPTH) level (r=-0.31, p=0.001). A positive correlation was observed between 25(OH)D and serum ferritin levels (r=0.15, p=0.004). Conclusions: The high frequency of vitamin D deficiency in childhood (especially among adolescent girls) indicates a need for supplementation and nutritional support.
International Journal of Endocrinology, 2010
Vitamin D deficiency is common in the developing countries and exists in both childhood and adult life. The great importance of Vitamin D is the moderation of calcium (Ca) and phosphorus (P) homeostasis as well as the absorption of Ca. While insufficiency of vitamin D is a significant contributing factor to risk of rickets in childhood, it is possible that a more marginal deficiency of vitamin D during life span contribute to osteoporosis as well as potentially to the development and various other chronic diseases such as cardiovascular disease, cancer and diabetes. This paper reviews the metabolism, epidemiology, and treatment of vitamin D and calcium insufficiency as well as its relation to various diseases during childhood and adolescence.
British Journal of Nutrition, 2019
In India, there is a lack of information about the adequate daily dose of vitamin D 3 supplementation in school children. Hence, we undertook this study to evaluate the adequacy and efficacy of different doses of vitamin D 3 in schoolchildren. A total of 1008 vitamin D-deficient (VDD) children, aged 6-16 years with serum 25-hydroxyvitamin D (25(OH)D) levels <50 nmol/l, were cluster randomised into three groups (A-344, B-341 and C-232) for supplementation (600, 1000 and 2000 IU daily) of vitamin D 3 under supervision for 6 months. Of the 1008 subjects who completed the study, 938 (93 %) were compliant. Baseline and post-supplementation fasting blood and urine samples were evaluated for Ca, phosphates, alkaline phosphatase, 25(OH)D and parathormone and urine Ca:creatinine ratio. The mean age of the subjects was 11•7 (SD 2•4) years, and the overall mean baseline serum 25(OH)D level was 24•3 (SD 9•5) nmol/l. Post-supplementation rise in serum 25(OH)D in compliant group was maximum with 2000 IU (70•0 (SD 30•0) nmol/l), followed by 1000 IU (46•8 (SD 22•5) nmol/l) and 600 IU (36•5 (SD 18•5) nmol/l), and serum 25(OH)D levels of ≥50 nmol/l were achieved in 71•5, 81•8 and 92•9 % by groups A, B and C, respectively. Secondary hyperparathyroidism decreased from 31•7 to 8•4 % post-supplementation. Two participants developed hypercalciuria, but none developed hypercalcaemia. Children with VDD benefit maximum with the daily supplementation of 2000 IU of vitamin D 3. Whether recommendations of 400 IU/d by Indian Council of Medical Research or 600 IU by Indian Academy of Pediatrics or Institute of Medicine would suffice to achieve vitamin D sufficiency in children with VDD remains debatable.
Vitamin D deficiency in adolescents
Indian Journal of Endocrinology and Metabolism, 2014
In general, a serum 25(OH) D at concentration less than 25 nmol/L (10 ng/mL) is a useful marker of the risk of clinical defi ciency, but the terminology and cutoffs used to defi ne less than desirable vitamin D status is controversial. It includes terms such as insuffi ciency, inadequate level, defi ciency (VDD) and hypovitaminosis D and may result in subclinical conditions with chronic latent manifestations, the most recognized of which is osteoporosis. The 25(OH) D cutoffs to defi ne this condition vary and have recently been defi ned as desirable level at 20 ng/ml (50 nmol/L), and the Endocrine Society Guidelines set at 30 ng/ml (75 nmol/L). [1,2] PREVALENCE OF VDD IN ADOLESCENTS WORLDWIDE Adequate vitamin D status is essential for active calcium absorption in the gut and for bone development and remodeling. While bone disease secondary to VDD (rickets and osteomalcia) is almost eradicated in western populations, its prevalence remains unacceptably high in Asia, Africa and the Middle-east. [3,4] In a review conducted
Amerta Nutrition, 2021
Latar Belakang: Stunting dan penurunan densitas tulang merupakan salah satu masalah gizi yang umum diderita oleh remaja. Hal ini terjadi akibat kurangnya asupan zat gizi yang adekuat terutama vitamin D yang berfungsi untuk pertumbuhan tulang dan mineralisasi jaringan. Jumlah yang terbatas dari makanan dan faktor pigmentasi kulit menjadi penyebab terjadinya defisiensi vitamin D sehingga dibutuhkan upaya suplementasi untuk memenuhi kebutuhan tersebut.Tujuan: Untuk menganalisis efek suplementasi vitamin D terhadap pertumbuhan linier remaja.Metode: Penelusuran artikel pada tinjauan pustaka ini dilakukan menggunakan mesin pencarian melalui Medline, PubMed, EBSCO, ELSEVIER, Cambridge Core, dan WILEY. Artikel memuat teks penuh, berbahasa inggris dan tahun terbit mulai dari 2010 hingga 2020. Kata kunci pencarian yang dimasukkan adalah vitamin D supplementation, adolescent or teenagers, linear growth, dan Bone Mass Density (BMD).Hasil: Hasil skrining menemukan 12 artikel yang memenuhi kriter...
Impact of dietary and lifestyle on vitamin D in healthy student girls aged 11-15 years
The Journal of Medical Investigation, 2006
Objective : To study daily intake of calcium, phosphorus and vitamin D,to determine the biochemical findings of rickets and the effect of sunlight exposure and vitamin D supplemention in school girls with hypovitaminosis D. Methods: A cross-sectional study was conducted on school girls aged 11-15 years selected randomly from various areas of Tehran, Iran. Dietary information and amount of sunlight exposure were estimated by a 7 day recalling method using self-reported questionnaire. Hypovitaminosis D defined as low serum 25-hydroxyvitamin D concentration with two or more others abnormal biochemical findings. Girls with hypovitaminoses D were randomly divided into two groups. The faces and hands of girls in group 1 were exposed to sunlight for one hour per day for twenty days, while those in group 2 were administered vitamin D capsules, 50,000 IU per day for the same period. Results : four-hundred fourteen girls evaluated, mean daily calcium intake, sunlight exposure and vitamin D acquirement were 360 mg, 10 minutes and 119 IU, respectively. Mean serum 25-hydroxyvitamin D concentration was 30 ng/ml among all girls whereas in 15 (3.63% %) of 414 girls was 7.8 ng/ml. Abnormal biochemical findings in these girls included hypocalcemia (n=4), hypophosphatemia (n=5), raised serum alkaline phosphatase (n= 13), and parathyroid hormone (n=15). After intervention,mean serum 25-hydroxyvitamin D concentration in sunlight exposure (n=8) and vitamin D (n=7) supplementation increased to 14.4 4 ng/ml and 23 4 ng/ml respectively.There was a significant difference between the two groups (p<0.05). Conclusion: Vitamin D deficiency developed in rapid growth period of girls without clear clinical rickets in sunny temperate climate city in Iran which vitamin D supplemention improved biochemical findings better than sunlight exposure.
Vitamin D and bone mineral density status of healthy schoolchildren in northern India
The American journal of clinical nutrition, 2005
Current data on the prevalence of vitamin D deficiency in India are scarce. We assessed the calcium-vitamin D-parathyroid hormone axis in apparently healthy children from 2 different socioeconomic backgrounds in New Delhi, India. Clinical evaluation for evidence of vitamin D deficiency was carried out in 5137 apparently healthy schoolchildren, aged 10-18 y, attending lower (LSES) and upper (USES) socioeconomic status schools. Serum calcium, inorganic phosphorus, alkaline phosphatase, 25-hydroxyvitamin D [25(OH)D], and immunoreactive parathyroid hormone were measured in 760 children randomly selected from the larger cohort. Bone mineral density of the forearm and the calcaneum was measured in 555 children by using peripheral dual-energy X-ray absorptiometry. Clinical evidence of vitamin D deficiency was noted in 10.8% of the children. Children in the LSES group had a significantly (P < 0.01) lower 25(OH)D concentration (10.4 +/- 0.4 ng/mL) than did those in the USES group (13.7 +/...