Association between Vitamin D Receptor Polymorphism and Serum Vitamin D Levels in Children with Low-Energy Fractures

Objective: Fractures of bones, especially forearm fractures, are very common in children and their number is increasing. This study was designed to determine the impact of vitamin D serum levels and vitamin D receptor (VDR) polymorphisms on the occurrence of low-energy fractures in children.

Methods: The study group consisted of 100 children with clinically relevant bone fractures and a control group consisted of 127 children without fractures. Total vitamin D [25(OH)D3 plus 25(OH)D2] serum concentrations were evaluated in every patient. Genotypes for 4 restriction fragment length polymorphisms of the vitamin D receptor gene (FokI, ApaI, TaqI, and BsmI) were determined by standard polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLP) techniques.

Results: Differences in concentrations of vitamin D were observed between the group with bone fractures (median = 12 ng/ml) and the control group (median = 16 ng/ml; p = 0.000044).

Higher levels of vitamin D reduced the risk of fracture by 1.06 times (p = 0.0005). No impact of particular VDR polymorphism on the occurrence of low-energy fractures in children was detected. However, there were significant differences in the prevalence of FokI polymorphism genotypes between the fracture and control groups (p = 0.05). Furthermore, the recessive “aa” genotype of ApaI polymorphism and the dominant “TT” genotype of TaqI polymorphism were associated with higher levels of vitamin D (p = 0.005 and p = 0.036, respectively).

Conclusions: Vitamin D deficiency is an independent risk factor for fractures in children. ApaI polymorphism recessive “aa” and TaqI polymorphism dominant “TT” genotypes are associated with higher levels of vitamin D in serum.     

Association between Vitamin D and Dental Caries in a Sample of Canadian and American Preschool-Aged Children

Background: Inadequate vitamin D levels may increase the risk of caries during childhood. The purpose of this study was to investigate the association between 25-hydroxyvitamin D (25(OH)D) status and severe early childhood caries (S-ECC) in preschool children. Methods: Data were obtained from children <72 months of age in two case–control studies in Winnipeg, Manitoba and Richmond, Virginia. Serum analysis assessed 25(OH)D, calcium and parathyroid concentrations. Data on demographics, dental history and oral hygiene were obtained via questionnaires. Bivariate and multiple logistic regression analyses were performed to assess the relationships between demographic and biological variables and S-ECC. A p-value of ≤0.05 was significant. Results: Data were available for 200 children with S-ECC and 144 caries-free controls. Children with S-ECC had significantly lower 25(OH)D levels than those who were caries-free (p < 0.001), and children with deficient 25(OH)D levels were 10 times more likely to have S-ECC (p < 0.001). Multiple logistic regression revealed that having higher 25(OH)D and calcium concentrations (p = 0.019 and p < 0.0001, respectively), as well as being breastfed in infancy (p < 0.001), were significantly and independently associated with lower odds of S-ECC, while dental insurance (p = 0.006) was associated with higher odds of S-ECC. Conclusions: This study provides additional evidence of an association between nutritional status, specifically vitamin D and calcium levels, and S-ECC.     

Vitamin D Intake and Status in 6-Year-Old Icelandic Children Followed up from Infancy

High serum 25-hydroxyvitamin D (25(OH)D) levels have been observed in infants in Nordic countries, likely due to vitamin D supplement use. Internationally, little is known about tracking vitamin D status from infancy to childhood. Following up 1-year-old infants in our national longitudinal cohort, our aims were to study vitamin D intake and status in healthy 6-year-old Icelandic children (n = 139) and to track vitamin D status from one year of age. At six years, the mean 25(OH)D level was 56.5 nmol/L (SD 17.9) and 64% of children were vitamin D sufficient (25(OH)D ≥ 50 nmol/L). A logistic regression model adjusted for gender and breastfeeding showed that higher total vitamin D intake (Odds ratio (OR) = 1.27, 95% confidence interval (CI) = 1.08–1.49), blood samples collected in summer (OR = 8.88, 95% CI = 1.83–43.23) or autumn (OR = 5.64, 95% CI = 1.16–27.32) compared to winter/spring, and 25(OH)D at age one (OR = 1.02, 95% CI = 1.002–1.04) were independently associated with vitamin D sufficiency at age six. The correlation between 25(OH)D at age one and six was 0.34 (p = 0.003). Our findings suggest that vitamin D status in infancy, current vitamin D intake and season are predictors of vitamin D status in early school age children. Our finding of vitamin D status tracking from infancy to childhood provides motivation for further studies on tracking and its clinical significance.     

The Association between Serum Vitamin D Levels and Helicobacter pylori Presence and Eradication

Background: The success of Helicobacter pylori (H. pylori) eradication depends on several host and treatment factors. Serum vitamin D levels may be associated with H. pylori infection and eradication rates. We investigated the association between vitamin D and H. pylori infection and eradication, using a large electronic database based on medical records from a population-based health maintenance organization. Methods: Data regarding adults who underwent H. pylori testing and had vitamin D measurements within one month of H. pylori testing were collected. H. pylori infection was ascertained using urea breath or stool antigen tests. A negative H. pylori test following a positive result implied eradication. Multivariate regression models were constructed to assess associations between H. pylori infection, eradication, and vitamin D. Results: Among 150,483 members who underwent H. pylori testing from 2009 to 2018, 27,077 (18%) had vitamin D measurements. Vitamin D levels were inversely associated with H. pylori infection, p < 0.001. The odds of a positive H. pylori test were 31% higher among patients with vitamin D levels <20 ng/mL, compared with those with levels ≥20 ng/mL (OR 1.31, 99% CI 1.22–1.4, p < 0.001). Purchase of vitamin D supplements was associated with a negative subsequent H. pylori test (p < 0.001). Mean vitamin D levels were moderately higher in those with successful vs. failed H. pylori eradication (19.34 ± 9.55 vs. 18.64 ± 9.61, p < 0.001). Conclusions: Vitamin D levels are associated with H. pylori infection. Increased vitamin D levels are associated with successful H. pylori eradication. Vitamin D may have a role in H. pylori eradication.     

Moderate Amounts of Vitamin D3 in Supplements are Effective in Raising Serum 25-Hydroxyvitamin D from Low Baseline Levels in Adults: A Systematic Review

There is controversy surrounding the designation of vitamin D adequacy as defined by circulating levels of the metabolite 25-hydroxyvitamin D (25(OH)D). Depending on the cutoff level chosen, dietary intakes of vitamin D may or may not provide sufficient impact upon vitamin D status measured as improvement in serum levels of 25(OH)D. We sought to examine whether modest daily doses (5–20 μg) as found in fortified foods or multivitamin supplements had a measureable impact on vitamin D status, defined as moving from below to above 50 nmol/L, or from less than 30 nmol/L to above 30 nmol/L. Published literature was searched for relevant articles describing randomized controlled trials. Exclusion criteria were: studies not involving humans; review articles; studies lacking blood level data pre- and post-treatment; no control group; bolus treatments (weekly, monthly, yearly); vitamin D <5 μg or >20 μg; baseline 25(OH)D ≥75 nmol/L; subjects not defined as healthy; studies <8 weeks; and age <19 years. Of the 127 studies retrieved, 18 publications with 25 separate comparisons met criteria. The mean rate constant, defined as change in 25(OH)D in nmol/L per μg vitamin D administered, was calculated as 2.19 ± 0.97 nmol/L per μg. There was a significant negative correlation (r = −0.65, p = 0.0004) between rate constant and administered dose. To determine impact of the dose reflecting the Estimated Average Requirement (EAR) of 10 μg administered in nine studies (10 comparisons), in every case mean 25(OH)D status rose either from “insufficient” (30–50 nmol/L) to “sufficient” (>50 nmol/L) or from “deficient” (<30 nmol/L) to “insufficient” (>30 but <50 nmol/L). Our study shows that when baseline levels of groups were <75 nmol/L, for every microgram of vitamin D provided, 25(OH)D levels can be raised by 2 nmol/L; and further, when groups were deficient or insufficient in vitamin D, there was significant value in providing additional 10 μg per day of vitamin D.     

2018年石渠县学龄前儿童患龋率及其防治状况

目的调查甘孜州石渠县学龄前儿童患龋发生情况,为调整和制定当地口腔防治工作规划提供参考依据。方法2018-07,采用分层随机整群抽样方法,从石渠县农村和城市分别随机抽取1所城市幼儿园和2所农村幼儿园,由经过培训的执业医生和护士进行患龋及口腔填充情况进行全面检查,采用卡方检验、趋势卡方检验对数据进行统计分析。结果本次研究共调查460名学龄前儿童,患龋人数为297人,患龋率为64.57%。卡方趋势检验显示,6岁组及大班儿童患龋率最高(χ^2年龄=19.856,P<0.01;χ^2年级=19.628,P<0.01)。患龋牙齿数共1096颗,其中1度、2度、3度、4度和5度分别占34.03%、33.49%、13.87%、5.38%及13.23%,趋势卡方检验显示患龋严重程度随着年龄和年级的增加而升高(χ^2年龄=24.822,P<0.01;χ^2年级=14.527,P<0.01)。学龄前儿童口腔防治填充率为6.74%,其中接受窝沟封闭术4.57%,进行预防性树脂填充者2.17%。结论甘孜州石渠县学龄前儿童患龋水平高,口腔防治填充率低,需不断加强对该年龄儿童龋齿的三级预防,突出重点,以改善当地的高患龋情况。     

健康学龄前351名儿童25-羟维生素D水平及影响因素

目的 了解上海市学龄前儿童的维生素D水平并分析其影响因素,为防治该地区维生素D缺乏提供理论依据。方法 随机抽取上海市浦东新区3家幼儿园共351名3～6岁学龄前儿童(男:185名,女:166名),采用液相色谱串联质谱法(LC-MS/MS)测定测血清25-羟维生素 D[25-(OH)D]水平,并通过标准问卷获得相关影响因素数据。结果 受试学龄前儿童血清25-羟维生素 D[25-(OH)D]的平均水平为(28.14±6.70) ng/ml。维生素D缺乏[25-(OH)D＜20 ng/ml]为35例(10.0％),维生素D适宜水平(20～100 ng/ml)为316例(90.0%)。多因素分析结果显示维生素D制剂补充频率低及大年龄组(≥6岁)是学龄前儿童25-(OH)D缺乏的高危因素(P＜0.05)。结论 年龄和维生素D制剂补充与学龄前儿童维生素D水平明显相关,大年龄组(≥6岁)儿童维生素D制剂补充率相对较低。针对目前学龄前儿童仍存在维生素D缺乏的情况,应该加强儿童保健的科普教育,结合个体情况提高维生素D的补充率,同时增加儿童户外活动,促进学龄前儿童健康。     

健康学龄前351名儿童25-羟维生素D水平及影响因素

目的 了解上海市学龄前儿童的维生素D水平并分析其影响因素,为防治该地区维生素D缺乏提供理论依据。方法 随机抽取上海市浦东新区3家幼儿园共351名3～6岁学龄前儿童(男:185名,女:166名),采用液相色谱串联质谱法(LC-MS/MS)测定测血清25-羟维生素 D[25-(OH)D]水平,并通过标准问卷获得相关影响因素数据。结果 受试学龄前儿童血清25-羟维生素 D[25-(OH)D]的平均水平为(28.14±6.70) ng/ml。维生素D缺乏[25-(OH)D＜20 ng/ml]为35例(10.0％),维生素D适宜水平(20～100 ng/ml)为316例(90.0%)。多因素分析结果显示维生素D制剂补充频率低及大年龄组(≥6岁)是学龄前儿童25-(OH)D缺乏的高危因素(P＜0.05)。结论 年龄和维生素D制剂补充与学龄前儿童维生素D水平明显相关,大年龄组(≥6岁)儿童维生素D制剂补充率相对较低。针对目前学龄前儿童仍存在维生素D缺乏的情况,应该加强儿童保健的科普教育,结合个体情况提高维生素D的补充率,同时增加儿童户外活动,促进学龄前儿童健康。     

Adequate Dietary Intake and Vitamin D Supplementation: A Study of Their Relative Importance in Determining Serum Vitamin D and Ferritin Concentrations during Pregnancy

Vitamin D is essential for human health. However, it is not clear if vitamin D supplementation is necessary for all pregnant women. This study examines the relative importance of dietary patterns and vitamin D supplementation frequency in determining serum 25-hydroxyvitamin D (25(OH)D) and ferritin concentrations among pregnant women in Hong Kong, China. A total of 572 healthy women were recruited from antenatal clinics at 25–35 weeks pregnant. Participants completed an electronic version of the food frequency questionnaire and a web questionnaire on supplement use. Their blood samples were tested for serum 25(OH)D and ferritin. The associations of dietary patterns and vitamin D supplementation frequency with serum 25(OH)D and ferritin concentrations were analyzed using moderated hierarchical regression. Two dietary patterns were identified. The adequate dietary intake was characterized by the high probability of meeting recommended daily food group servings, whereas the inadequate dietary intake was characterized by inadequate consumption of vegetables, fruits, meat, fish, and eggs, or alternatives. The association between adequate dietary intake and serum ferritin concentrations was independent of vitamin D supplementation frequency (β = 0.05, p = 0.035), but dietary patterns interacted with vitamin D supplementation frequency to determine serum 25(OH)D concentrations (β = −13.22, p = 0.014). The current study presents evidence on the relative importance of dietary patterns and vitamin D supplementation in maintaining sufficient vitamin D and iron in pregnancy. Antenatal nutrition counselling services should be provided to pregnant women who show signs of inadequate dietary intake.     

张家港市2299名学龄前儿童龋病调查分析

目的 了解张家港市学龄前儿童龋病的流行情况及易感因素.方法 抽取张家港市23所幼儿园的2 299名学龄前儿童对其进行口腔检查并发放问卷,由家长填写后统一收回.应用x2检验筛选出乳牙龋病易感者的相关因素.结果 学龄前儿童患龋率为61.11％,龋均为3.42,龋失充填率为2.79％;男童、女童患龋率差异无统计学意义（P＞0.05）;随着年龄的增长,患龋率升高,不同年龄组间患龋率差异有统计学意义（P＜0.05）;不同牙位乳牙患龋率差异有统计学意义（P＜0.05）,上颌乳中切牙患龋率最高,其次为下颌的乳磨牙;儿童口腔卫生、饮食习惯,父母口腔卫生知识、态度和行为等多因素与儿童乳牙龋病密切相关.结论 张家港市学龄前儿童的患龋率较高,需早期开展预防工作;加强对父母口腔知识的宣传、刷牙指导,限制糖的摄入频率以及避免不当的进食方式对预防乳牙龋极为重要.     

氟离子透入防龋仪防治儿童龋齿的体会

目的:探讨氟离子透入防龋仪防治儿童龋齿的体会。方法:选取2018年4月~2019年3月本院收治的儿童龋齿患者50例,随机分为两组,对照组应用常规方法对患者进行防治,研究组应用氟离子透入防龋仪对患者进行防治。比较两组患者在透氟前后的患病率。结果:研究组患病率低于对照组(P<0.05)。结论:儿童龋齿的防治过程当中,氟离子透入防龋仪对儿童的防治效果理想,为了让儿童不受龋齿的影响。     

儿童血清25-羟维生素D及钙磷水平调查

目的调查舟山海岛地区0～6岁儿童血清25-羟维生素D、钙和磷水平。方法选取2011年4—8月在舟山市妇幼保健院儿保门诊和入托入园体检的0～6岁儿童共813名,取清晨空腹血,分别用电化学发光法、离子电极法、磷钼酸紫外法检测其血清25-羟维生素D、血清钙、血清磷水平。结果 813名儿童中,维生素D缺乏、相对缺乏、合适水平和过量的分别为118(14.51%)、235(28.91%)、459(56.46%)和1名(0.12%)。男童和女童血清25-羟维生素D水平分别为(87.37±38.42)nmol/L和(89.00±50.58)nmol/L,差异无统计学意义(t=-0.52,P0.05);男女血清钙水平分别为(2.39±0.12)mmol/L和(2.37±0.09)mmol/L,差异有统计学意义(t=-2.68,P0.01);男女血清磷水平分别为(1.74±0.08)mmol/L和(1.77±0.13)mmol/L,差异有统计学意义(t=-3.97,P0.01)。男女血清25-羟维生素D、钙、磷水平都随着年龄增高而下降。结论血清25-羟维生素D、钙、磷水平随年龄变化,2～6岁的儿童需补充维生素D。     

Systematic Review of Economic Evaluations of Primary Caries Prevention in 2- to 5-Year-Old Preschool Children

ObjectivesTo describe and summarize evidence on economic evaluations (EEs) of primary caries prevention in preschool children aged 2 to 5 years and to evaluate the reporting quality of full EE studies using a quality assessment tool.MethodsA systematic literature search was conducted in several databases. Full and partial EEs were included. The reporting quality of full EE studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist.ResultsA total of 808 studies were identified, and 39 were included in the review. Most papers were published between 2000 and 2017 and originated in the United States and the United Kingdom. The most common type of intervention investigated was a complex multicomponent intervention, followed by water fluoridation. Cost analysis and cost-effectiveness analysis were the most frequently used types of EE. One study employed cost-utility analysis. The proportion of full EEs increased over time. The parameters not reported well included study perspective, baseline year, sensitivity analysis, and discount rate. The CHEERS items that were most often unmet were characterizing uncertainty, study perspective, study parameters, and estimating resources and costs.ConclusionsWithin the past 2 decades, there has been an increase in the number of EEs of caries prevention interventions in preschool children. There was inconsistency in how EEs were conducted and reported. Lack of preference-based health-related quality-of-life measure utilization in the field was identified. The use of appropriate study methodologies and greater attention to recommended EE design are required to further improve quality.     

Vitamin D and prevention of osteoporosis: Japanese perspective

Vitamin D insufficiency or a low vitamin D status, is a prevalent condition worldwide. However, there have been no studies addressing this public health issue until recently. In this review article, a summary of a series of studies conducted by the author and his colleagues to determine whether the vitamin D status of Japanese people is adequate and how their vitamin D status affects bone mass and bone metabolism is presented. The observational studies conducted by our group revealed that vitamin D insufficiency does not seem to be a serious problem among active elderly people, but that elderly people with a low level of activities of daily living (ADL) are at a very high risk of vitamin D insufficiency. In young adults, a high intact PTH concentration due to vitamin D insufficiency, which adversely affects their bone mass, is common, suggesting that vitamin D nutrition, as well as dietary calcium intake, should be improved. However, the effects of vitamin D insufficiency among elderly Japanese on bone metabolism, bone mass, and fractures have not been clarified, and should be studied further to determine whether specific preventive strategies, such as vitamin D supplementation, are required for this high-risk group. Intervention studies targeting Japanese populations are required to further address this issue. This article is based upon the research that was given Encouragement Award at the 76th Annual Meeting of the Japanese Society for Hygiene held in Yamaguchi, Japan on March 25–28, 2006.     

Vitamin D and the occurrence of depression: causal association or circumstantial evidence?

While recent laboratory-based studies have substantially advanced our understanding of the action of vitamin D in the brain, much is still unknown concerning how vitamin D relates to mood. The few epidemiological studies of vitamin D and depression have produced inconsistent results and generally have had substantial methodological limitations. Recent findings from a randomized trial suggest that high doses of supplemental vitamin D may improve mild depressive symptoms, but important questions persist concerning how vitamin D may affect monoamine function and hypothalamic-pituitary-adrenal axis response to stress, whether vitamin D supplementation can improve mood in individuals with moderate-to-severe depression, and whether vitamin D sufficiency is protective against incident depression and recurrence. At this time, it is premature to conclude that vitamin D status is related to the occurrence of depression. Additional prospective studies of this relationship are essential.     

Plasma 25-Hydroxyvitamin D Responses of Younger and Older Men to Three Weeks of Supplementation with 1800 IU/day of Vitamin D

Objective: The objective of this study was to compare changes in plasma 25-hydroxyvitamin D (25(OH)D) levels of younger and older men after three weeks of oral vitamin D supplementation.

Methods: Nine younger men (22 to 28 years) and nine older men (65 to 73 years) with self-reported vitamin D intakes below 200 IU/d were enrolled in February and randomized to 1800 IU/d of ergocalciferol (vitamin D₂, n=11) or to a control group (n=7) and followed for three weeks. Blood was collected at baseline, and after one, two and three weeks for measurement of plasma concentrations of total 25(OH)D, 25(OH)D₂ and 25(OH)D₃.

Results: In both the younger and older supplemented men, 25(OH)D₂ and total 25(OH)D concentrations increased significantly during the study, whereas values of these metabolites did not change in younger or older control subjects. No group showed significant changes in 25-hydroxyvitamin D₃. There was a significant interaction between age group and supplement group, suggesting that the effect of vitamin D₂ supplementation on changes in 25(OH)D₂ changes with age. The mean increase in 25(OH)D₂ was greater in the younger supplemented men than in the older supplemented men (37±9 nmol/L vs. 19.5 nmol/L, p=0.027), and this accounted for their significantly greater increase in total 25(OH)D.

Conclusion: These data are consistent with an age-related decline in the absorption, transport or liver hydroxylation of orally-consumed vitamin D.     

冬季早期婴儿维生素D营养状况观察

目的 观察早期婴儿维生素D营养状况,为合理地补充维生素D提供依据。方法 以我国北方地区冬季出生的72例婴儿为研究对象,自生后15 d起口服维生素D补充剂,满月起逐月询问生活史和体检。于出生及4月龄时分别采集脐血和静脉血,测定血清25-(OH)D、钙、磷和碱性磷酸酶浓度。结果 脐血25-(OH)D平均水平(21.91±5.75)nmol/L,72例(100.0%)维生素D缺乏;婴儿4月龄时血清25-(OH)D平均水平(108.12±45.30)nmol/L,10例(13.9%)维生素D缺乏。血清25-(OH)D平均水平在每日摄入维生素D 200 U~组升至(112.37±37.98)nmol/L,在400 U~组升至(133.97±34.93)nmol/L。但维生素D不足和缺乏者在每日摄入维生素D 200 U~组6例(23.1%),400 U~组仅2例(7.1%)。新生儿及婴儿血钙、磷、碱性磷酸酶水平均正常。结论 北方地区冬季新生儿普遍存在维生素D缺乏,生后尽早补充可以显著改善维生素D营养状况。每日补充200 U维生素D可显著提高早期婴儿血清25-(OH)D水平;若要达到维生素D营养充足,至少补充400 U维生素D。     

Vitamin D Metabolite Ratio in Pregnant Women with Low Blood Vitamin D Concentrations Is Associated with Neonatal Anthropometric Data

Existing evidence on the correlation between maternal vitamin D concentrations and birth outcomes is conflicting. Investigation of these associations requires accurate assessment of vitamin D status, especially in individuals with low 25-hydroxyvitamin D (25(OH)D) concentrations. This study examined the correlations between birth outcomes and the maternal vitamin D metabolite ratio (VMR) 1 (defined as the ratio of 24,25(OH)₂D₃ to 25(OH)D) and VMR2 (defined as the ratio of 3-epi-25(OH)D₃ to 25(OH)D) using data from the Japan Environment and Children’s Study at Chiba Regional Center. A total of 297 mother–neonate pairs were analyzed. Using liquid chromatography–tandem mass spectrometry, we measured 25(OH)D₂, 25(OH)D₃, 24,25(OH)₂D₃, and 3-epi-25(OH)D₃ concentrations in maternal serum samples. These data were analyzed in relation to birth anthropometric data using multivariable linear regression. Of the study participants, 85.2% showed insufficient vitamin D concentrations. VMR1 was strongly correlated with 25(OH)D concentrations, whereas VMR2 showed a weak correlation. Only VMR2 was associated with all anthropometric data. VMR2 in pregnant women with low vitamin D blood concentrations is a useful marker for neonatal anthropometric data and is independent of 25(OH)D. Accurate measurement of vitamin D metabolites could help better understand the effects of vitamin D on birth outcomes.     

Inverse Correlation between Vitamin D and C-Reactive Protein in Newborns

Some studies suggested that adequate vitamin D might reduce inflammation in adults. However, little is known about this association in early life. We aimed to determine the relationship between cord blood 25-hydroxyvitamin D (25(OH)D) and C-reactive protein (CRP) in neonates. Cord blood levels of 25(OH)D and CRP were measured in 1491 neonates in Hefei, China. Potential confounders including maternal sociodemographic characteristics, perinatal health status, lifestyle, and birth outcomes were prospectively collected. The average values of cord blood 25(OH)D and CRP were 39.43 nmol/L (SD = 20.35) and 6.71 mg/L (SD = 3.07), respectively. Stratified by 25(OH)D levels, per 10 nmol/L increase in 25(OH)D, CRP decreased by 1.42 mg/L (95% CI: 0.90, 1.95) among neonates with 25(OH)D <25.0 nmol/L, and decreased by 0.49 mg/L (95% CI: 0.17, 0.80) among neonates with 25(OH)D between 25.0 nmol/L and 49.9 nmol/L, after adjusting for potential confounders. However, no significant association between 25(OH)D and CRP was observed among neonates with 25(OH)D ≥50 nmol/L. Cord blood 25(OH)D and CRP levels showed a significant seasonal trend with lower 25(OH)D and higher CRP during winter-spring than summer-autumn. Stratified by season, a significant linear association of 25(OH)D with CRP was observed in neonates born in winter-spring (adjusted β = −0.11, 95% CI: −0.13, −0.10), but not summer-autumn. Among neonates born in winter-spring, neonates with 25(OH)D <25 nmol/L had higher risk of CRP ≥10 mg/L (adjusted OR = 3.06, 95% CI: 2.00, 4.69), compared to neonates with 25(OH)D ≥25 nmol/L. Neonates with vitamin D deficiency had higher risk of exposure to elevated inflammation at birth.     

Association between Predictors of Vitamin D Serum Levels and Risk of Retinoblastoma in Children: A Case-Control Study

Background: vitamin D (VD) may be a protective factor for retinoblastoma, though no temporal association has been reported during pregnancy or the child’s first year of life. Serum VD concentrations are determined by both distal (DF) and proximal factors (PF). Objective: To identify if DF and PF can predict VD insufficiency (VDI) and VD deficiency (VDD) in women of childbearing age; and to test whether maternal exposure to DF and PF during pregnancy and a child’s exposure during the first 11.9 months postpartum are associated with sporadic retinoblastoma (SRb) in children. Methods: This is a secondary analysis of data from the Epidemiology of SRb in Mexico (EpiRbMx) study and the National Health and Nutrition Survey 2018–2019 (ENSANUT 2018–2019, for its acronym in Spanish). The association of DF and PF with VDD or VDI was estimated using ENSANUT 2018–2019, and the association of DF and PF with SRb using EpiRbMx. All were estimated using logistic regression, with comparable samples selected from ENSANUT 2018–2019 and EpiRbMx. Results: Altitude, latitude and obesity predicted VDI and VDD in ENSANUT women. In EpiRbMx, residence in a rural location during pregnancy increased the risk of SRb. For children, rural residence and latitude increased the risk of SRb, while the number of days exposed to the spring–summer season during months 6 to 11.9 of life was protective. Conclusions: risk of VDI and VDD in women (ENSANUT 2018–2019) increased with altitude, urban dwelling, overweight and obesity. The child and mother’s place of residence, including altitude, latitude and rural classification were important predictors of SRb in EpiRbMx.