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??Objective??To assessed serum level of 25??OH??D3 in children with juvenile idiopathic arthritis, in order to find the association between the vitamin D and disease activity as well as bone mineral density. Methods??We evaluated 110 patients??58 females and 52 males??mean age being 9.04±3.37 years?? that fulfilled the 2011 ILAR criteria for juvenile idiopathic arthritis. Patients underwent laboratory tests of serum25??OH??D3??plasma parathyroidhormone and dual-energyx-ray absorptiometry examination. JIA patients were categorized by ACR standard of disease status in 2011??and the disease activity was measured by using JADAS-27. We analyzed the relationship between serum 25??OH??D3 level and other indexes. Results??The mean serum 25??OH??D3 level of 110 JIA patients was??49.8±15.3?? μmol/L. Vitamin D deficiency was detected in 59 patients??53.6%?? and insufficiency in 43 patients??39.1%??. Patients with active disease had significantly reduced serum 25??OH??D3 levels compared to patients with inactive disease??t??5.162??P??0.001????but there was no significant association between serum 25??OH??D3 level and JADAS-27??r??-0.72??P??0.05??. JIA patients with vitamin D deficiency showed a significantly lower bone mineral density than those with normal 25??OH??D3 level??t??3.791??P??0.05??. Patients using glucocorticoid showed significantly lower 25??OH??D3 level than those who never used glucocorticoid??t??2.823??P??0.01??. Conclusion??JIA patients have reduced serum 25??OH??D3??particularly those with active disease or/and using glucocorticoid. JIA patients with vitamin D deficiency showed a significantly lower bone mineral density.     

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??Abstracts?? Objective To study serum 25-hydroxyvitamin D ??25-hydroxyvitamin D??25??OH??D?? distribution in May in preschool children in Suzhou area?? giving scientific basis for the intake and supplementation of vitamin D for children. Methods Totally 852 cases of preschool children??454 cases of male??398 cases of female?? aged from 3 to 7 years were selected in May of 2012??and all cases were divided into four groups named as 3??4 year group????4??5 year group????5??6 year group and ??6??7 year group.The height and weight of every case were measured and were used to calculate the Body Mass Index??BMI??for evaluating the body shape?? according the normal reference values of P85 and P95 of BMI for children below 7 years old provided by WHO??all cases were classified into overweight or no-overweight??obesity or no obesity groups. Serum 25??OH??D levels were measured by ELISA. Results There were 42.37%??361/852??of cases for preschool children in Suzhou area who showed deficiency of serum 25??OH??D??and insufficiency was presented in 40.38%??344/852?? of cases.For the distribution of 25??OH??D among age groups?? they were 61.20??53.30??75.20??nmol/L??55.50??45.5??65.10??nmol/L??48.30??40.40??57.50??nmol/L and 48.90??40.40??60.20??nmol/L from 3??4 year group to ??6??7 year group in turn. Comparing every two groups?? the serum 25??OH??D declined with the increasing age except between ??5??6 year and??6??7 year group??χ2 =18.10??P=0.47????and it was higher in 3??4 year group than that in ??4??5 year group??χ2 =110.43??P??0.05????higher in ??4??5 year group than that in ??5??6 or ??6??7 year group??χ2 was 106.11 and 87.75??P??0.05 for all??.The distribution of serum 25??OH??D in overweight and no-overweight group was 53.97??45.27??66.45??nmol/L and 52.64??42.85??63.80??nmol/L?? and they were 55.24??47.29??66.56??nmol/L and 52.71??43.11??63.92??nmol/L for obesity and no-obesity group??there existing significant difference for the distribution of 25??OH??D between every two groups??χ2 was 7.10 and 6.73??P??0.05??. Serum 25??OH??D and BMI showed positive correlation??r = 0.11??P??0.05??. Conclusion The overall insufficiency of serum 25??OH??D exists in preschool children in Suzhou area??and positive correlation exists between BMI and serum 25??OH??D in children. It suggests that we should reinforce the monitoring of serum 25??OH??D in preschool children??taking scientific measures to strengthen the intake and supplementation of vitamin D.     

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??Objective To explore features of the change of vitamin D level and bone mineral density in children with inflammatory bowel disease??IBD??. Methods From January 2014 to September 2014??thirty-two children with IBD??study group?? and thirty age and gender-matched healthy children??control group?? were enrolled in the study. The children of study group and control group were tested for bone alkaline phosphate??BALP????bone gla protein??BGP?? and 25??OH??D3 in blood serum by enzyme-linked immunosorbent assay??ELISA????and the clinical data such as calcium??phosphorus and albumin??ALB?? in blood serum were collected. Results There were 15 patients??9 males and 6 females?? with ulcerative colitis??UC?? and 17 patients??10 males and 7 females?? with Crohn’s disease??CD?? in the study group. There were 30 children??19 males and 11 females?? in control group. The level of BGP??U??332.5??P??0.444?? and BALP??U??350??P??0.637?? in blood serum showed no significant difference between the study group and the control group. 25??OH??D3 concentration??t??-2.876??P??0.006????BMD??U??39.5??P??0.05?? ??calcium??t??-6.654??P??0.05????phosphorus??U??216.5??P??0.007????and ALB ??U??25??P??0.05?? showed significant difference between the study group and the control group. In study group??25??OH??D3 concentration and BMD showed positive correlation??rs??0.504??P??0.005????while 25??OH??D3 and blood albumin levels showed negative correlation??rs??-0.315??P??0.019??. There was significant difference betweenUC/CD group and control group in Z score of BMD??U??29.5??P??0.05??U??10??P??0.05????but no statistical difference between UC and CD patients in Z score of BMD ??P??0.10??. Conclusion Most child patients with IBD have insufficient or lack of vitamin D and are more likely to have reduced bone mineral density.     

High prevalence of vitamin D insufficiency or deficiency in young adolescents in Korea

Recent studies suggest that vitamin D insufficiency or deficiency is not only a problem of older generations anymore but also an important health concern among younger generations. However, comprehensive data are lacking in Korean adolescents. We investigated the vitamin D (25-hydroxy vitamin D [25(OH)D]) status, the prevalence of vitamin D insufficiency or deficiency, and the association between vitamin D levels and insulin resistance and lipid profiles in a sample of 188 Korean adolescents aged 12-13?years who participated in a general health check-up at a tertiary hospital. Vitamin D deficiency was considered as serum concentrations <20?ng/mL (50?nmol/L); a level of 21-29?ng/mL (52-72?nmol/L) was considered to indicate vitamin D insufficiency, whereas a level of 30?ng/mL or greater (>75?nmol/L) was considered sufficient or optimum. In this cross-sectional study, vitamin D insufficiency or deficiency was found in 98.9?% of boys and 100?% of girls, whereas only 1.1?% of boys and 0?% of girls had a serum 25(OH)D level of greater than 30?ng/mL. In multivariate linear regression analysis, HOMA-IR, triglyceride, and LDL cholesterol were inversely associated with 25(OH)D concentrations. We found that vitamin D insufficiency or deficiency is a very common health problem in Korean adolescents, particularly in girls, and that serum 25(OH)D levels are inversely associated with insulin resistance and lipid profiles. These results suggest that more time spent in outdoor activity for sunlight exposure and higher vitamin D intake may be needed in younger adolescents in South Korea.     

Vitamin D insufficiency common in newborns, children and pregnant women living in Newfoundland and Labrador, Canada

Vitamin D deficiency is associated with poor bone health, colorectal cancer, type 1 diabetes and multiple sclerosis. Two national health-related societies in Canada have made recommendations for vitamin D supplementation, yet little research has been reported on the vitamin D status of Canadians. Lifestyle changes, such as sunscreen use, spending less time outdoors and insufficient intake of vitamin D-containing foods as well as northern latitude, may be affecting human vitamin D status. A cross-sectional analysis of 25-hydroxyvitamin D [25-(OH)D] was conducted in pregnant women, newborns (umbilical cord blood) and children. Samples were analysed by liquid chromatography mass spectrometry. Published ranges for 25-(OH)D were used to determine vitamin D status. The prevalence of 25-(OH)D deficiency for the three groups studied revealed most concentrations in the 25-(OH)D deficiency or insufficiency ranges. There were significant differences in all groups studied between seasons, with the exception of maternal blood and female cord blood samples. 25-(OH)D insufficiency was common in all groups for winter and summer, more so in winter. 25-(OH)D insufficiency was common in the three groups studied. The Newfoundland and Labrador population may be at increased risk for vitamin D insufficiency because of factors such as northern latitude and lifestyle issues. Further research on the vitamin D status of this population is important, considering the potential adverse health-related outcomes and the recommendations on supplementation being made.     

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??Objective??To study and analyze the serum 25-hydroxyvitamin D level in children aged from 0 to 14 years old in Shenyang. Methods??A total of 2416 cases of health children were chosen during January 2016 to December 2016. The level of 25??OH??D was determined by high-performance liquid chromatography tandem mass spectrometry. The data were dealt with SPSS19.0. Results??The level of 25??OH??D in 2416 children was??24.63±10.74?? μg/L??in whom the deficiency rate was 18.6%??the insufficiency rate was 16.7%??the sufficiency rate was 64.7%. With the increasing of the age??the level of 25??OH??D had a decreasing tendency. The total abnormal rate of 25??OH??D was 62.5% in??5-year-old group. The serum 25??OH??D level reached the highest in August and September and the lowest in March and April. Conclusion??The nutrition status of 25??OH??D is great in children aged 0 to 5 years old in Shenyang area. However??it is not optimistic in??5-year-old group. Therefore it is necessary to raise the awareness of the nutrition status of 25??OH??D in??5-year-old group. Thus the serum 25-??OH??D level changes significantly with seasons??and should be supplied scientifically and reasonably.     

Diet, clothing, sunshine exposure and micronutrient status of Arab infants and young children

Vitamin C and D levels in Arab women and their newborn infants have been shown to be low. We investigated the prevalence of and risk factors for possible hypovitaminosis C and D in a convenience sample of 51 hospitalized children without clinical features of vitamin C or D deficiency. The mean age was 15.4 months. The serum vitamin C concentration was low in the mothers but normal in the children. Both mothers and children had low serum 25-hydroxyvitamin D (25-OHD) concentrations. Fifty per cent of the mothers and 22% of the infants and children had hypovitaminosis D (serum 25-OHD level < 25 nmol/l). Infants who received dietary vitamin D supplementation had a higher mean (SD) serum 25-OHD concentration than the unsupplemented group (62.5 (29.8) vs 38.5 (27.3), p = 001). Cutaneous light exposure in these children was poor. The children's serum 25-OHD concentration correlated with dietary vitamin D supplementation and maternal serum 25-OHD levels. The results suggest normal vitamin C status but a possible high prevalence of hypovitaminosis D in Arab children and their mothers in UAE. Health education to encourage greater sunshine exposure and improvement in maternal vitamin D stores and the availability of adequate vitamin D supplements would improve children's vitamin D status. The study indicates that hypovitaminosis D continues to be an important maternal and child health problem, despite the abundant sunshine.     

Vitamin D Deficiency in a Tropical Country — Treatment and Prevention in Children

Vitamin D has an important role to play in skeletal and extraskeletal health. Inspite of being a sun rich country, India has widespread vitamin D deficiency. Vitamin D deficiency can lead to serious consequences like hypocalcemic seizures and increased risk of respiratory tract infections in neonates and infants. International expert groups advocate universal supplementation for non-formula fed infants, pregnant and lactating women and those at risk of deficiency. A body of literature on vitamin D status in India is being generated, which may guide clinical practice in our country. Treatment of deficiency must be undertaken with minimally effective doses to avoid the risk of toxicity. Sensible sunshine exposure should be encouraged to facilitate vitamin D production from natural sources.     

佝偻病维生素D受体基因多态性与25-羟维生素D3相关性

目的：研究1~3岁佝偻病患儿中维生素D受体基因多态性FokⅠ位点与佝偻病相关性,初步探讨维生素D受体基因多态性FokⅠ位点在佝偻病发病中的作用。方法：病例组（佝偻病患儿）62例与对照组（正常健康儿童）60例,用ELISA方法检测血清25-羟维生素D3水平,比较两组之间血清25-羟维生素D3水平。用聚合酶链反应-限制性片段长度多态性（PCR-RFLP）检测病例组和对照组维生素D受体基因多态性FokⅠ位点,比较两组之间基因型和等位基因分布频率。结果病例组血清25-羟维生素D3水平较对照组明显降低,差异有统计学意义（9.1±4.1 ng/mL vs 16.1±6.9 ng/mL;P＜0.05）。维生素D受体基因多态性FokⅠ位点病例组FF基因型明显高于对照组（53% vs 25%）,基因型分布频率差异有统计学意义（χ2=10.221,P＜0.05）,病例组F等位基因频率明显高于对照组（73% vs 57%）,等位基因分布频率差异有统计学意义（χ2=7.511,P＜0.05）。结论维生素D受体基因多态性FokⅠ位点与佝偻病有相关性,提示其在佝偻病遗传易感性方面起重要作用。［中国当代儿科杂志,2010,12（7）：544-546］     

Vitamin D metabolites in idiopathic infantile hypercalcaemia.

Metabolites of vitamin D were measured in plasma from 83 patients with idiopathic infantile hypercalcaemia syndrome who were mentally handicapped but had normal calcium values at the time of the study. No significant difference was detected in the mean plasma concentrations of 25-hydroxyvitamin D2, 1,25-dihydroxyvitamin D, 24,25-dihydroxyvitamin D3, or 25,26-dihydroxyvitamin D3 between patients and age matched controls. The mean plasma concentration of 25-hydroxyvitamin D3 was significantly lower in patients than controls but this may be a secondary phenomenon related to less sunlight exposure. In addition, two hypercalcaemic patients with this syndrome were studied during the first year of life, and were found to have normal concentrations of vitamin D metabolites. These findings do not support a role for abnormal vitamin D metabolism in the pathogenesis of this syndrome.