Vitamin D deficiency in children and adolescents: Epidemiology, impact and treatment (original) (raw)
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Vitamin D deficiency in children and adolescents; an international challenge
2014
Low vitamin D level is an important international public health problem. Vitamin D deficiency and its consequences among children and adolescents could indeed be considered as one of the most important public health problems. In fact, low vitamin D levels were reported in both children and adolescents. Several reasons could be taken into account in this regard such as the possibility of the reduced intake or synthesis of vitamin D (due to having a vitamin D deficient mother or a dark skin color), abnormal intestinal function or malabsorption (in small-bowel disorders), or reduced synthesis or increased degradation of vitamin D (in chronic liver or renal disease). More importantly, many countries in developing world, are experiencing a substantial percentage of adolescent and youth population with their own health related problems which vitamin D deficiency could affect on their health. The association between obesity and overweighting and vitamin D deficiency has been reported by ma...
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.
Vitamin D deficiency in children
Asian Journal of Medical Sciences, 2014
Background: Vitamin D deficiency in children is an important medical entity commonly diagnosed during early childhood. Prevalence and incidence of vitamin D deficiency in children is underestimated and can have far reaching consequences as per the latest evidence. Children at high risk should be identified and treated accordingly to avoid the treatable misadventures of future life. Aim: The purpose of this review is to provide summary of the latest research in particular to the practical aspects of vitamin D deficiency in children. Methods: A literature search in PubMed, Medline, Embase, Scopus, Google Scholar, and DOAJ was conducted, regarding pediatric vitamin D deficiency related research and review articles in English language, using keywords or phrases such as bones; childhood allergy; calcium; children; diabetes mellitus type 1; respiratory infections; rickets; failure to thrive, 25-OH vitamin D. Conclusion: Despite major advances in unfolding the classical and non-classical r...
Aim: To evaluate the clinical and biochemical findings of the children and adolescents with vitamin D deficiency and insufficiency in order to determine the clinical and biochemical presentation differences between age groups. Methods: This retrospective study included a review of medical reports of 543 patients (aged between 1-17 years) who were referred to our hospital between October 2011 and May 2012 with symptoms related to vitamin D deficiency or insufficiency. The patients were divided into four groups by age: 1-3 years (Group 1), 4-6 years (Group 2), 7-11 years (Group 3) and 12-17 years (Group 4). Patients diagnosed with vitamin D deficiency or insufficiency were evaluated as to their clinical and biochemical findings. Results: Gender distribution were not statistically different between the four groups. The mean ages of Groups 1-4 were 1.9 ± 0.7, 5.1 ± 0.9, 8.9 ± 1.3, 13.1 ± 1.1, respectively. Major complaints on admission were muscle weakness (91 %), low weight gain (failure to thrive) (89 %), head deformity (frontal bossing) (35.6 %), bone deformity (enlargement of wrist and ankles) (29.7 %) for Group 1. Muscle weakness (76 %) and low weight gain (failure to thrive) (68 %) for Group 2. Leg and chest pain were the major symptoms in Group 3 (57 % and 28 % , respectively) and in Group 4 (26 % and 55 % , respectively) as well as high rates of obesity (31 % and 63 %). The biochemical findings of vitamin D deficiency mostly appeared in the first group who developed vitamin D deficiency due to the lack of vitamin D supple-mentation. However, in older children, the majority of the patients had low 25 hydroxyvitamin D (25 OHD) values without evidence of biochemical findings of osteomalacia. Conclusion: Depending on the degree of deficiency and insufficiency, and the age of the patients, the clinical and biochemical findings varied widely. Children under the age of 3 who either never received vitamin D supplementa-tion or who had been receiving supplementation that was stopped too early were at a greater risk for developing clinically and biochemically proved vitamin D deficiency. In older children, low vitamin D levels mostly resulted in subtle complaints without abnormal biochemical findings.
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.
Journal of Young Pharmacists, 2021
Vitamin D is an essential compound for growth and development throughout the human lifecycle. The deficiency of vitamin D is a major health problem worldwide in all age groups. It maintains normal level of calcium, Phosphorus and provide protection from the diseases and individual's risk of developing, diabetes, multiple sclerosis, lupus, rheumatoid arthritis, heart failure, strokes, hypertension, peripheral vascular disease, coronary heart disease, muscle weakness, respiratory tract infection, skeletal deformities and others. Vitamin D deficiency is more prevalent in countries such as Saudi Arabia,
Vitamin D is known to be a key regulator of bone metabolism and is associated with muscle strength. Vitamin D deficiency is widely prevalent worldwide. In adults, vitamin D deficiency has been implicated in numerous health conditions including osteoporosis, cancer, diabetes, and autoimmune diseases. Considerable changes have occurred in lifestyles and childhood activities in the past years. Studies have shown that the children population is at high risks of vitamin D deficiency. The objective of this study was to learn about the extent of vitamin D deficiency in children worldwide and especially in sunny country like Israel. In this article we reviewed the extent and severity of vitamin D deficiency worldwide and especially in Israel, through a very comprehensive review of previous reports and research studies done during the last years. We found reports on vitamin D deficiency in children, which was associated with metabolic syndromes and obesity. It was more prevalent in children who spend less time on outdoor activities, in obese children, and in cases when there was imbalance between nutritional intakes and requirements. Vitamin D deficiency is common even in children living in sunny places like Israel. Health professionals should be aware of the fact that although vitamin D deficiency is prevalent in the elderly population, it is also common in the children, and can be associated with different illnesses. We encourage supplementation of vitamin D to special populations (pregnant and lactating women, infants, and high risk groups). We also encourage implementation of international food fortification programs. Core tip: Vitamin D is known to be a key regulator of bone metabolism and muscle strength. Vitamin D deficiency is widely prevalent worldwide. In this article we emphasize that vitamin D status may be also related to a number of non-skeletal diseases, including cardiovascular events, cancer, diabetes, and autoimmune diseases. Obesity has also been recently associated with vitamin D insufficiency. We demonstrate that the pediatric population is also at high risks of vitamin D deficiency. Studies that investigated the status of vitamin D deficiency in Israel, which is a known multi-cultural sunny country, revealed a high prevalence of vitamin D deficiency. Haimi M, Kremer R. Vitamin D deficiency/insufficiency from childhood to adulthood: Insights from a sunny country. World J Clin Pediatr 2017; 6(1): 1-9 Available from:
Vitamin D status among the juvenile population: A retrospective study
The Journal of steroid biochemistry and molecular biology, 2017
Vitamin D deficiency is a clinical problem and recently we have shown that 82.5% of our entire study cohort had inadequate serum 25(OH)D levels. In this study, we analysed serum 25(OH)D levels of juvenile patients admitted to the Burjeel Hospital of VPS Health care in Abu Dhabi, United Arab Emirates (UAE) from October 2012 to September 2014. Out of a total of 7883 juvenile patients considered in this study, almost 58.1% of females and 43.3% of males in the age group of 1-18 years were found to have low serum 25(OH)D levels (<50nmol/L). According to the coefficient of variation, females had significantly higher variability among juveniles (63.8%) than males (49.9%). Among the juveniles group of patients, age appears to be an important determining factor for defining vitamin D deficiency.The risk of deficiency (<30nmol/L) was found to be present in 31.4% of patients in the age group of 10-12 years, followed by 50.4% of patients in the age group of 13-15 years and 52.9% of patien...
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
Vitamin D: effects on childhood health and disease
Nature reviews. Endocrinology, 2013
Vitamin D is a key nutrient for both healthy children and those with chronic illnesses. Understanding its roles in health and disease has become one of the most important issues in the nutritional management of children. Formal guidelines related to nutrient requirements for vitamin D in healthy children, recommending dietary intakes of 400 IU per day for infants and 600 IU per day for children over 1 year of age, were released by the Institute of Medicine in November 2010. However, application of these guidelines to children with acute and chronic illnesses is less clear. In this Review, we consider major illness categories and specific examples of conditions in children that might be affected by vitamin D. This information can be used in developing both model systems of investigation and clinical trials of vitamin D in children with acute and chronic illnesses.