25-Hydroxyvitamin D reference percentiles and the role of their determinants among European children and adolescents (original) (raw)
Related papers
Factors Associated with Vitamin D Deficiency in European Adolescents: The HELENA Study
Journal of Nutritional Science and Vitaminology, 2013
Adolescence is a critical life-stage period characterised by rapid growth and development. Low circulating 25-hydroxyvitamin D [25(OH)D] concentrations have been negatively associated with obesity and healthy lifestyle habits (1, 2). We have previously reported high prevalence (up to 80%) of hypovitaminosis D (,75 nmol/L) in European adolescents participating in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study (3). The complexity of vitamin D metabolism poses difficulties in the identification and determination of factors related to vitamin D insufficiency. Its status is largely determined by environmen-
British Journal of Nutrition, 2014
The impact of the familial relationship on vitamin D status has not been investigated previously. The objective of the present cross-sectional study was to assess serum 25-hydroxyvitamin D (25(OH)D) concentration and its determinants in children and adults among families in late summer in Denmark (568N). Data obtained from 755 apparently healthy children (4 -17 years) and adults (18 -60 years) recruited as families (n 200) in the VitmaD study were analysed. Blood samples were collected in September -October, and serum 25(OH)D concentration was measured by liquid chromatography -tandem MS. Information on potential determinants was obtained using questionnaires. The geometric mean serum 25(OH)D concentration was 72·1 (interquartile range 61·5 -86·7) nmol/l (range 9 -162 nmol/l), with 9 % of the subjects having 25(OH)D concentrations ,50 nmol/l. The intra-family correlation was 0·27 in all subjects, 0·24 in the adults and 0·42 in the children. Serum 25(OH)D concentration was negatively associated with BMI (P,0·001) and positively associated with dietary vitamin D intake (P¼0·008), multivitamin use (P¼ 0·019), solarium use (P¼ 0·006), outdoor stay (P¼ 0·001), sun preference (P¼0·002) and sun vacation (P,0·001), but was not associated with lifestyle-related factors in the adults when these were assessed together with the other determinants. In conclusion, the majority of children and adults among the families had serum 25(OH)D concentrations .50 nmol/l in late summer in Denmark. Both dietary and sun-related factors were determinants of vitamin D status and the familial component was stronger for the children than for the adults. Abbreviations: 25(OH)D, 25-hydroxyvitamin D; DEQAS, Vitamin D External Quality Assessment Scheme; IQR, interquartile range; LC -MS/MS, liquid chromatography-tandem MS; NIST, National Institute of Standards and Technology; PTH, parathyroid hormone.
Journal of Nutrition, 2015
Background: There is concern about a reemergence of vitamin D deficiency in children in developed countries. Objectives: The aims of this study were to describe vitamin D status in the Generation R study, a large multiethnic cohort of 6-y-old children in The Netherlands, and to examine sociodemographic, lifestyle, and dietary determinants of vitamin D deficiency. Methods: We measured serum 25-hydroxyvitamin D [25(OH)D] concentrations in 4167 children aged 6 y and defined deficiency following recommended cutoffs. We examined the associations between subject characteristics and vitamin D deficiency with the use of multivariable logistic regression analyses. Results: Serum 25(OH)D concentrations ranged from 4 to 211 nmol/L (median 64 nmol/L), with 6.2% of the children having severely deficient (<25 nmol/L), 23.6% deficient (25 to <50 nmol/L), 36.5% sufficient (50 to <75 nmol/L), and 33.7% optimal (≥75 nmol/L) 25(OH)D concentrations. The prevalence of vitamin D deficiency [25(OH)D <50 nmol/L] was higher in winter (51.3%) than in summer (10.3%); and higher in African, Asian, Turkish, and Moroccan children (54.5%) than in those with a Dutch or other Western ethnic background (17.6%). In multivariable models, several factors were associated with vitamin D deficiency, including household income (OR 1.74; 95% CI: 1.34, 2.27 for low vs. high income), child age (OR 1.39; 95% CI: 1.20, 1.62 per year), child television watching (OR 1.32; 95% CI: 1.06, 1.64 for ≥2 vs. <2 h/d), and playing outside (OR 0.71; 95% CI: 0.57, 0.89 for ≥1 vs. <1 h/d). In a subgroup with dietary data (n = 1915), vitamin D deficiency was associated with a lower diet quality, but not with vitamin D intake or supplement use in early childhood. Conclusions: Suboptimal vitamin D status is common among 6-y-old children in The Netherlands, especially among non-Western children and in winter and spring. Important modifiable factors associated with vitamin D deficiency were overall diet quality, sedentary behavior, and playing outside.
Public health nutrition, 2017
To understand the relationship between vitamin D intake and serum 25-hydroxyvitamin D (25(OH)D) levels in a sample of Portuguese adolescents. Cross-sectional evaluation carried out in the 2003/2004 school year. Vitamin D intake was assessed by an FFQ and 25(OH)D was measured in a fasting blood sample. Public and private schools in Porto, Portugal. Adolescents aged 13 years (n 521) enrolled at school (EPITeen cohort). Both mean (sd) intake and serum 25(OH)D level were far below the recommended, 4·47 (2·49) µg/d and 16·5 (5·7) ng/ml, respectively. A significant difference in serum level was found according to season, with lower values in winter than summer (14·8 (4·6) v. 17·3 (5·9) ng/ml, P<0·001). Vitamin D intake was weakly correlated with serum 25(OH)D (r=0·056, P=0·203). Dietary vitamin D and serum 25(OH)D levels were positively but weakly correlated and the error was higher among those with higher serum 25(OH)D concentration. Our results support the need for strategies that pr...
Public Health Nutrition, 2012
Objective: To describe the vitamin D status of Belgian children and examine the influence of non-nutritional determinants, in particular of anthropometric variables. Design: Cross-sectional data of Belgian participants of the EU 6th Framework Programme IDEFICS (Identification and Prevention of Dietary-and Lifestyle-Induced Health Effects in Children and Infants) Study. Setting: 25-Hydroxyvitamin D (25(OH)D) was measured using RIA. Vitamin D status was categorized as deficient (,25 nmol/l), insufficient (25-50 nmol/l), sufficient (50-75 nmol/l) and optimal ($75 nmol/l). Anthropometric measurements included height, weight, waist and hip circumferences and triceps and subscapular skinfold thicknesses. Subjects: Children (n 357) aged 4-11 years. Results: Serum 25(OH)D ranged from 13?6 to 123?5 nmol/l (mean 47?2 (SD 14?6) nmol/l); with 5 % deficient, 53 % insufficient, 40 % sufficient and 2 % optimal. No significant differences were found by age and gender. Significant differences in 25(OH)D were observed for month of sampling (P , 0?001), number of hours playing outside per week (r 5 0?140), weight (r 5 20?121), triceps (r 5 20?112) and subscapular (r 5 20?119) skinfold thickness, sum of two skinfold thicknesses (r 5 20?125) and waist circumference (r 5 20?108). Linear regression analysis of 25(OH)D adjusted for age, month of sampling and hours playing outside per week suggested that (i) weight, (ii) BMI Z-score, (iii) waist circumference and (iv) triceps and subscapular skinfold thickness (as well as the sum of both) independently influenced 25(OH)D. Conclusions: The majority of Belgian children had a suboptimal vitamin D status, with more than half having an insufficient status in winter and spring. Month of the year, weekly number of hours playing outside and body composition -both central and abdominal obesity -were identified as important determinants of vitamin D status in Belgian children.
New Zealand children, particularly those of Ma ori and Pacific ethnicity, may be at risk for low vitamin D status because of low vitamin D intakes, the country's latitude (35-46°S), and skin color. The aim of this study was to determine 25-hydroxyvitamin D concentrations and their determinants in a national sample of New Zealand children aged 5-14 y. The 2002 National Children's Nutrition Survey was designed to survey New Zealand children, including oversampling of Ma ori and Pacific children to allow ethnic-specific analyses. A 2-stage recruitment process occurred using a random selection of schools, and children within each school. Serum 25-hydroxyvitamin D concentration [mean (99% CI) nmol/L] in Ma ori children (n ϭ 456) was 43 (38,49), in Pacific (n ϭ 646) 36 (31,42), and in New Zealand European and Others (NZEO) (n ϭ 483) 53 (47,59). Among Ma ori, Pacific, and NZEO, the prevalence (%, 99% CI) of serum 25-hydroxyvitamin D deficiency (Ͻ17.5 nmol/L) was 5 (2,12), 8 (5,14), and 3 (1,7), respectively. The prevalence of insufficiency (Ͻ37.5 nmol/L) was 41 (29,53), 59 (42,75), and 25 (15,35), respectively. Multiple regression analysis found that 25-hydroxyvitamin D concentrations were lower in winter than summer [adjusted mean difference (99% CI) nmol/L; 15 (8,22)], lower in girls than boys [5 (1,10)], and lower in obese children than in those of "normal" weight [6 (1,11)]. Relative to NZEO, 25-hydroxyvitamin D concentrations were lower in Ma ori [9 (3,15)] and Pacific children [16 (10,22)]. Ethnicity and season are major determinants of serum 25hydroxyvitamin D. There is a high prevalence of vitamin D insufficiency in New Zealand children, which may or may not contribute to increased risk of osteoporosis and other chronic disease. There is a pressing need for more convincing evidence concerning the health risks associated with the low vitamin D status in New Zealand children.
The British journal of nutrition, 2014
Despite the importance of skeletal growth during adolescence, there is limited research reporting vitamin D status and its predictors in adolescents. Using prospective data from the Western Australian Pregnancy Cohort (Raine) Study, we investigated vitamin D status and predictors of serum 25-hydroxyvitamin D (25(OH)D) concentrations in adolescents. Serum 25(OH)D concentrations were measured in the same participants at 14 and 17 years (n 1045 at both time points). The percentage of adolescents with serum 25(OH)D concentrations < 50, 50-74·9 and ≥ 75 nmol/l was reported year-round and by month of blood collection. We examined the predictors of serum 25(OH)D concentrations, including sex, race, month of blood collection, physical activity, BMI, family income, and Ca and vitamin D intakes (n 919 at 14 years; n 570 at 17 years), using a general linear mixed model. At 14 years, 31 % of adolescents had serum 25(OH)D concentrations between 50 and 74·9 nmol/l and a further 4 % had concent...
The American journal of clinical nutrition, 2006
Evidence suggests that adults and adolescents throughout the United States are at risk of poor vitamin D status. However, vitamin D concentrations in young American children have not been assessed. The relations between serum 25-hydroxyvitamin D [25(OH)D] and bone were examined in prepubertal girls. In the present cross-sectional study, serum 25(OH)D concentration was assessed in 168 prepubertal girls aged 4-8 y living in the southeastern United States with the use of radioimmunoassay. Bone area, bone mineral content, and areal bone mineral density were measured from total body, lumbar spine, proximal femur, and forearm with dual-energy X-ray absorptiometry. Data were analyzed with analysis of variance, analysis of covariance, stepwise multiple regression, and partial correlations. The mean (+/-SD) serum 25(OH)D was 93.8 +/- 28.1 nmol/L (range: 31.1-181.4 nmol/L). In a multiple regression analysis, race and season were the strongest predictors of vitamin D status. The black girls ha...