Frequency of vitamin D insufficiency in healthy children between 1 and 16 years of age in Turkey

Background: The aim of this study was to establish the frequencies of vitamin D deficiency and insufficiency among healthy children aged 1–16 years and also to determine the factors affecting the levels of vitamin D in Turkey. Methods: A total of 849 healthy individuals whose ages ranged from 1 to 16 years were included in the study. Serum 25(OH)D, calcium, phosphorous and alkaline phosphatase l levels were measured at the end of the winter period. The approximate daily calcium intake was calculated by using a 1‐week diet history. Results: We determined that the prevalence of vitamin D deficiency (<20 ng/mL) was 8% and that of vitamin D insufficiency (20–29 ng/mL) was 25.5% in the population investigated. The average daily intake of calcium was especially low in the >8‐year‐old age group (<1300 mg/day). Conclusion: Vitamin D insufficiency was found to be very common in the population investigated. The daily calcium intake was below the adequate levels especially in school children. Vitamin D supplementation after the first year of life could be beneficial especially for school children and adolescents. The government must develop public policies for the fortification of milk, milk products, and fruit juices with vitamin D.     

Sociodemographic and clinical characteristics associated with vitamin D status in newly diagnosed pediatric cancer patients

Abstract

Vitamin D deficiency and insufficiency are associated with serious sequelae in childhood cancer survivors. However, data on vitamin D deficiency in children with newly diagnosed cancer are scarce and the role of sociodemographic factors and vitamin D supplementation is largely unknown. We assessed vitamin D status and its socio-demographic and clinical correlates in 163 children with newly diagnosed cancer, using 25-hydroxy vitamin D (25(OH)D) concentrations and assessed longitudinal changes following vitamin D supplementation. Sixty-five percent of the patients with newly diagnosed cancer had low 25(OH)D concentrations. Fifty-two patients (32%) were vitamin D deficient (≤20?ng/mL 25(OH)D concentration), and 53(33%) were insufficient (21-29?ng/mL 25(OH)D concentration). Age over 10 (P?=?0.019), Hispanic ethnicity (P?=?0.002), and female sex (P?=?0.008) were significantly associated with lower 25(OH)D concentration at diagnosis. Vitamin D supplementation resulted in significant increase in 25(OH)D concentrations (P?<?0.001). However, following supplementation in the longitudinal analysis, this increase was less pronounced in Hispanic patients vs. non-Hispanic (P?=?0.007), and in children with solid tumors vs. hematological malignancies (P?=?0.003). Vitamin D deficiency and insufficiency are common in children with newly diagnosed cancer. Hispanic patients, females and older children were at higher risk for vitamin D deficiency and insufficiency. Although supplementation appeared to increase 25(OH)D concentrations over time, this increase was not as pronounced in certain subsets of patients. Prospective trials of the effects of vitamin D supplementation on bone health in children with newly diagnosed cancer are warranted, particularly in Hispanics and patients with solid tumors.     

Vitamin D insufficiency and deficiency in pediatric renal transplant recipients

Vitamin D deficiency is prevalent in the pediatric CKD population. Recognizing that renal transplant recipients have CKD, we assessed the prevalence of vitamin D insufficiency and deficiency in pediatric renal transplant recipients, compared to a healthy pediatric population. We prospectively studied 25(OH)D levels in 29 pediatric renal transplant recipients and 45 control patients over one yr. The overall prevalence of vitamin D insufficiency and deficiency was common in both populations, at 76% (95% CI: 61, 87%) in the pediatric renal transplant recipients and 91% (95% CI: 80, 98%) in the control group. In the paired renal transplant samples, the mean 25(OH)D level was 52.3 ± 17.9 nmol/L in the winter and 65.6 ± 18.8 nmol/L in the summer (95% CI diff.: 3.9, 22.7), in keeping with a significant seasonal difference. The mean dietary intake of vitamin D in the renal transplant recipients, assessed by three‐day dietary record, was 5.7 μg/day, with a vitamin D intake below the EAR in the majority. We did not find an association between vitamin D intake and 25(OH)D levels in this study, likely due to the low dietary intake of vitamin D within the transplant population, identifying a potential area for intervention and improvement.     

Vitamin D deficiency and its relationship with cardiac iron and function in patients with transfusion-dependent thalassemia at Chiang Mai University Hospital

Background: Vitamin D deficiency is common in patients with thalassemia. Vitamin D deficiency could be related to cardiac dysfunction. Increased parathyroid hormone (PTH) is also known to be associated with heart failure. Objectives: To determine the prevalence of Vitamin D deficiency and to explore the impact of Vitamin D deficiency on cardiac iron and function in patients with transfusion-dependent thalassemia. Method: A cross-sectional study in patients with Transfusion-dependent thalassemia was conducted. Patients with liver disease, renal disease, type 1 diabetes, malabsorption, hypercortisolism, malignancy, and contraindication for MRI were excluded. Calcium, phosphate, PTH, vitamin D-25OH were measured. CardiacT2^* and liver iron concentration (LIC) and left ventricular ejection fraction (LVEF) were determined. Results Sixty-one (33M/28F) patients with Transfusion-dependent thalassemia were enrolled. The prevalence of Vitamin D deficiency was 50.8%. Patients with cardiac siderosis had tendency for lower D-25OH than those without siderosis (15.9 (11.7–20.0) vs. 20.2 (15.85–22.3) ng/mL); p = 0.06). Serum calcium, phosphate, PTH, LIC, cardiac T2^*, and LVEF were not different between the groups with or without Vitamin D deficiency. Patients with Vitamin D deficiency had significantly lower hemoglobin levels compared to those without Vitamin D deficiency (7.5 (6.93–8.33) vs. 8.1 (7.30–8.50) g/dL; p = 0.04). The median hemoglobin in the last 12 months was significantly correlated with D-25OH. Cardiac T2^* had significant correlation with PTH. Conclusion: Vitamin D deficiency is prevalent in patients with Transfusion-dependent thalassemia. Vitamin D level is correlated with hemoglobin level. Vitamin D status should be routinely assessed in these patients. Low PTH is correlated with increased cardiac iron. This study did not demonstrate an association between Vitamin D deficiency and cardiac iron or function in patients with Transfusion-dependent thalassemia.     

Vitamin D status and predictors of hypovitaminosis D in Italian children and adolescents: a cross-sectional study

Hypovitaminosis D affects children and adolescents all around the world. Italian data on vitamin D status and risk factors for hypovitaminosis D during pediatric age are lacking. Six hundred fifty-two children and adolescents (range 2.0–21.0 years) living in the northwestern area of Tuscany were recruited at the Department of Pediatrics, University Hospital Pisa. None of them had received vitamin D supplementation in the previous 12 months. 25-hydroxyvitamin D (25-OH-D) and parathyroid hormone (PTH) levels were analyzed in all subjects. Severe vitamin D deficiency was defined as serum levels of 25-OH-D?<?25.0 nmol/L (10.0 ng/mL) and vitamin D deficiency as?<?50.0 nmol/L (20.0 ng/mL). Serum 25-OH-D levels of 50.0–74.9 nmol/L (20.0–29.9 ng/mL) indicated vitamin D insufficiency, whereas 25-OH-D levels?≥?75.0 nmol/L (30.0 ng/mL) were considered sufficient. Hypovitaminosis D was defined as 25-OH-D levels?<?75.0 nmol/L (30.0 ng/mL). The median serum 25-OH-D level was 51.8 nmol/L, range 6.7–174.7 (20.7 ng/mL, range 2.7–70.0), with a prevalence of vitamin D deficiency, insufficiency, and sufficiency of 45.9, 33.6, and 20.5 %, respectively. The prevalence of severe vitamin D deficiency was 9.5 %. Adolescents had lower median 25-OH-D levels (49.8 nmol/L, range 8.1–174.7; 20.0 ng/mL, range 3.2–70.0) than children (55.6 nmol/L, range 6.8–154.6; 22.3 ng/mL, range 2.7–61.9, p?=?0.006). Non-white individuals (n?=?37) had median serum 25-OH-D levels in the range of deficiency (28.2 nmol/L, range 8.1–86.2; 11.3 ng/mL, range 3.2–34.5), with 36/37 having hypovitaminosis D. Logistic regression showed significant increased risk of hypovitaminosis D in the following: blood samples taken in winter (odds ratio (OR) 27.20), spring (OR 26.44), and fall (OR 8.27) compared to summer; overweight (OR 5.02) and obese (OR 5.36) subjects compared to individuals with normal BMI; low sun exposure (OR 8.64) compared to good exposure, and regular use of sunscreens (OR 7.06) compared to non-regular use. Gender and place of residence were not associated with vitamin D status. The 25-OH-D levels were inversely related to the PTH levels (r?=??0.395, p?<?0.0001). Sixty-three out of the 652 (9.7 %) subjects showed secondary hyperparathyroidism. Conclusion Italian children and adolescents who were not receiving vitamin D supplementation had high prevalence of hypovitaminosis D. Careful identification of factors affecting vitamin D status is advisable to promptly start vitamin D supplementation in children and adolescents.     

Two teenage males with hypocalcemia and elevated parathyroid hormone levels

Vitamin D deficiency is not a rare disorder, particularly in minority groups. The Institute of Medicine recommends serum 25-hydroxyvitamin (OH)D levels >20 ng/mL and The Endocrine Society recommends levels >30 ng/mL for good health. In contrast, the 2003-2006 National Health and Nutrition Examination Survey reported average total 25-(OH)D concentrations of 25.6 ± 0.4 ng/mL in whites, 19.5 ± 0.5 ng/mL in Mexican Americans, and 14.8 ± 0.4 ng/mL in blacks. Pediatric patients with vitamin D deficiency may be asymptomatic or may present either with rickets, hypocalcemia, or seizures.Pseudohypoparathyroidism (PHP) is a rare disorder characterized by parathyroid hormone (PTH) resistance with (type 1a) or without (type 1b) the Albright Hereditary Os-teodystrophy (AHO) phenotype of short stature, brachydactyly, and mental retardation. Patients with PHP have elevated PTH levels and may have hyperphosphatemia and hypocalcemia. However, the same laboratory values can be seen in children with vitamin D deficiency, and diagnostic confusion is common. We report two cases of vitamin D deficiency with presentations suggestive of PHP.     

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.     

Relationship between Vitamin D and Childhood Asthma: A Case–Control Study

Objective:

Studies determining the relationship between serum vitamin D status and childhood asthma have yielded controversial results. Findings indicated that vitamin D deficiency is associated with asthma and airway hyper responsiveness. The aim of this study was to assess the relationship between serum vitamin D status and childhood asthma.

Methods:

Data were obtained from 200 asthmatic children (age 3–12 years) and 200 healthy controls. Serum levels of 25(OH) vitamin D, total IgE, calcium, phosphorus, parathormone (PTH) and eosinophil count were measured in both asthmatic children and healthy controls. Also, the mean values of 25(OH) vitamin D were compared with asthma symptom severities.

Findings:

There was a significant decrease in the concentration of serum 25(OH) vitamin D in the asthmatic patients as compared with the controls (20.34±2.8 vs 25.39±4.1 ng/mL, 95%CI: 1.46–3.86, P=0.01). Out of total asthmatic subjects, 40 (20%) were vitamin D sufficient, 48 (24%) were insufficient, and 112 (56%) were deficient. Total IgE concentration was also significantly higher in asthmatic patients having vitamin D deficiency (132.4±20.1 IU/ml, 95%CI: 1.38–3.75, P=0.03). Comparing asthmatic patients with healthy controls, odds of having vitamin D level less than 20ng/mL was 2.47.

Conclusion:

Our findings suggest that vitamin D deficiency or insufficiency may be positively related to the prevalence of asthma in children.     

孤独症谱系障碍患儿血清25(OH)D水平的检测

目的了解孤独症谱系障碍(ASD)患儿维生素D营养状况,探讨维生素D水平与ASD的关系。方法采用高效液相色谱-串联质谱法对117例新诊断的ASD患儿和109例健康对照儿童进行血清25(OH)D检测,并根据血清25(OH)D水平,将维生素D状况分为正常(30 ng/m L)、不足(10~30 ng/m L)和缺乏(10 ng/m L),比较两组儿童维生素D营养状况。结果 ASD患儿25(OH)D水平(19±9 ng/m L)明显低于对照组(36±13 ng/m L),差异有统计学意义(P0.01)。ASD患儿中维生素D缺乏和不足率为89.7%,明显高于对照组(52.3%),差异有统计学意义(P0.01)。结论 ASD患儿存在维生素D缺乏或不足,维生素D缺乏和不足有可能是ASD发病的环境/遗传因素。     

Vitamin D status in Norwegian children and adolescents with excess body weight

Lagunova Z, Porojnicu AC, Lindberg FA, Aksnes L, Moan J. Vitamin D status in Norwegian children and adolescents with excess body weight. Objectives: The prevalence of childhood and adolescent obesity has increased during the past decades. A high body mass index (BMI) is associated with a low vitamin D status. The purpose of this study was to determine the prevalence of vitamin D deficiency and insufficiency in Norwegian children and adolescents with excess body weight. Methods: Vitamin D status and seasonal variations of 25(OH)D and 1,25(OH)₂D were analyzed in 102 children and adolescents (70 girls and 32 boys), 8–19 yr of age, with overweight and obesity. Results: Overall, 50% of the children and adolescents included in the study had a low vitamin D status (25(OH)D <75 nmol/L) and 19% had vitamin D deficiency (25(OH)D <50 nmol/L). This was most prevalent in adolescents. Only 42% of teenagers had 25(OH)D levels ≥75 nmol/L vs. 72% of preteens. Both 25(OH)D and 1,25(OH)₂D showed seasonal variations. A peak in serum 25(OH)D concentrations was observed during the summer while the lowest values were seen during the spring. In contrast, serum 1,25(OH)₂D had a peak during the spring and the lowest concentrations during the winter. Conclusions: The prevalence of vitamin D deficiency and insufficiency is higher in obese and overweight adolescents than in overweight children. This might be related to low outdoor activities and low vitamin D intake in teenagers. Seasonal variations of both the vitamin D metabolites were observed.     

抽动障碍患儿血清25羟基维生素D水平的检测

目的了解抽动障碍(TD)患儿维生素D的营养状况,探讨维生素D水平与TD的关系。方法选取2016年11月至2017年5月诊断为TD的132例患儿为TD组,其中抽动秽语综合征患儿8例,慢性运动或发声抽动障碍患儿32例,暂时性抽动障碍患儿92例;另选取同期行体检的健康儿童144例为健康对照组。采集两组儿童外周静脉血3 m L,留取血清,采用高效液相色谱-串联质谱法检测两组儿童血清25羟基维生素D[25(OH)D]水平,根据血清25(OH)D水平,30 ng/m L为正常、10~30 ng/m L为不足、10 ng/m L为缺乏。结果 TD患儿血清25(OH)D水平明显低于健康对照组(P0.01);TD患儿血清25(OH)D不足或缺乏率明显高于健康对照组(P0.01);暂时性抽动障碍患儿血清25(OH)D水平高于抽动秽语综合征患儿(P0.05)。结论维生素D缺乏或不足可能是导致TD发病的因素之一;且维生素D水平高低可能与TD分型存在关联。     

Prevalence of vitamin D insufficiency among healthy school-age Cree children

BACKGROUND:

First Nations children are at higher risk for vitamin D deficiency and rickets.

OBJECTIVE:

To assess the prevalence of vitamin D deficiency and the correlations between fat mass, parathyroid hormone and dietary habits with serum vitamin D level in a random sample of Cree children eight to 14 years of age.

METHODS:

Serum 25-hydroxyvitamin D (25[OH]D) levels and additional information regarding anthropometrics and dietary habits were obtained from participants in two Cree communities. Vitamin D deficiency and insufficiency was defined as serum 25(OH)D levels <30 nmol/L and <50 nmol/L, respectively. Proportions to estimate the vitamin D status were weighted to account for the complex sampling design, and Pearson’s correlation coefficients were used to estimate the associations of milk and fish intake, parathyroid hormone and fat mass with serum 25(OH)D levels.

RESULTS:

Data from 52 healthy Cree children (mean [± SD] age 11.1±2.0 years; 27 boys) were included in the analyses. The median serum 25(OH)D level was 52.4 nmol/L (range 22.1 nmol/L to 102.7 nmol/L). Forty-three percent (95% CI 29% to 58%) and 81% (95% CI 70% to 92%) of Cree children had vitamin D levels <50 nmol/L and <75 nmol/L, respectively. Vitamin D intake was positively associated with serum 25(OH)D levels. Obese children had lower vitamin D levels; however, the difference was nonsignificant.

CONCLUSION:

There may be a substantial proportion of Cree children who are vitamin D deficient. Increasing age, lower dietary vitamin D intake and, possibly, higher body mass index were associated with decreased vitamin D levels; however, causality cannot be inferred.     

Serum vitamin D concentrations and associated severity of acute lower respiratory tract infections in Japanese hospitalized children

Background: Vitamin D is an immunomodulatory molecule related to innate immunity that may contribute to the increased occurrence of acute lower respiratory infection (ALRI) in children, one of the most common reasons for hospitalization and intensive care unit admission. In the present study, the association between vitamin D deficiency and the severity of respiratory infection was evaluated by determining serum concentrations of 25‐hydroxyvitamin D (25(OH)D) in a group of hospitalized children with ALRI. Methods: Of the 28 children admitted to Nihon University Nerima‐Hikarigaoka Hospital with ALRI over the period November 2008–May 2009, 26 were diagnosed as having bronchiolitis and two were found to have pneumonia. A competitive protein binding radioimmunoassay was used to determine serum 25(OH)D concentrations. Results: Mean 25(OH)D concentrations in breast‐fed children with ALRI (n = 7) were significantly lower than those in children with ALRI who were bottle fed/weaned (n = 6) or on a regular diet (n = 15; 14.6 ± 9.7, 28.9 ± 6.9 and 24.6 ± 8.8 ng/mL, respectively). There was a significant correlation between vitamin D deficiency (<15 ng/mL) and the need for supplementary oxygen and ventilator management. Conclusion: Significantly more children with ALRI who needed supplementary oxygen and ventilator management were vitamin D deficient. These findings suggest that the immunomodulatory properties of vitamin D may influence the severity of ALRI.     

Metabolic disturbances and cardiovascular risk factors in obese children with vitamin D deficiency

ObjectivesThe prevalence of obesity among children and adolescents has been rapidly increasing in recent years. Obese individuals are at risk of vitamin D deficiency. The aim of this study was to investigate the relationship between vitamin D deficiency and anthropometric measurements, cardiovascular risk factors, and glucose homeostasis in obese children.MethodsBetween June 2011 and January 2012, 40 obese and 30 non-obese children (between 7 and 14 years of age) were evaluated at Tepecik Training and Research Hospital. The following characteristics were recorded: height; weight; body mass index (BMI); total body fat content; fasting glucose, insulin, and lipid levels; basic biochemical parameters; complete blood count; bilateral carotid intima media thickness; liver ultrasound results; and left ventricular wall thickness were recorded. 25-hydroxy (OH) vitamin D levels were measured from serum.ResultsThe serum 25(OH) vitamin D level was low in 45 children (64.3%). The 24-h ambulatory blood pressure measurements, carotid intima-media thickness, and the prevalence of 25(OH) vitamin D deficiency were different between obese and non-obese children (P < 0.05). The incidence of dyslipidemia was not statistically different between obese and non-obese children (P > 0.05). Plasma 25(OH) vitamin D concentrations were negatively correlated with age, BMI, total body fat content, 24-h ambulatory blood pressure, and carotid intima-media thickness (P < 0.05). Plasma 25(OH) vitamin D levels were not correlated with fasting plasma glucose, HOMA-IR, triglycerides, total cholesterol, low-density cholesterol, and high-density cholesterol (P > 0.05).ConclusionVitamin D deficiency is more prevalent in obese children. Serum 25(OH)vitamin D was significantly associated with several cardiometabolic risk factors. There was no relationship between abnormal glucose homeostasis and dyslipidemia with vitamin D deficiency in obese children.     

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??Vitamin D may play an important role in extraskeletal system beyond its traditional effect on the skeleton. Emerging evidence supports an association between 25-hydroxyvitamin D3 ??25??OH??D3?? levels and brain development??immune function??obesity??metabolic syndrome??insulin resistance??infection??allergy??cancers??and cardiovascular diseases in pediatric and adolescent populations. Mary studies have influenced the definition of vitamin D deficiency and what level of vitamin D should be regarded as optimal. Given the important role of vitamin D in childhood health??more time spent in outdoor activity and vitamin D supplementation may be necessary for optimal health in infants??children??and adolescents.     

血流感染儿童维生素D营养状况的评价

目的 观察血流感染患儿与健康儿童血清25(OH)D 水平的差别。方法 采用病例对照研究方法,选取2010 年1 月至2013 年12 月间住院治疗且双份血培养阳性的60 例血流感染患儿为血流感染组,另选取60 例同年龄段同时期行健康体检的儿童为健康对照组。化学发光法检测两组儿童血清25(OH)D 水平,比较两组儿童不同水平25(OH)D 的构成比。结果 血流感染组患儿血清25(OH)D 水平明显低于健康对照组(P<0.01);血流感染组维生素D 正常(8%)、不足(22%)的构成比均显著低于健康对照组(分别为35%、43%,P<0.05),而缺乏(42%)、严重缺乏(28%)的构成比均显著高于健康对照组(分别为13%、8%,P<0.01)。结论 维生素D 不足在儿童中普遍存在,血流感染患儿血清25(OH)D 水平显著低于健康儿童。     

Higher prevalence of vitamin D deficiency in mothers of rachitic than nonrachitic children

Vitamin D deficiency [serum 25-hydroxyvitamin D <25 nmol/L (<10 ng/mL)] was identified in 92% of rachitic Arab children and 97% of their mothers compared with 22% of nonrachitic children and 52% of their mothers. There was a positive correlation between maternal and child vitamin D levels. We conclude that mothers of rachitic children should be investigated and treated for vitamin D deficiency.     

早产儿维生素D及骨代谢指标水平的相关性研究

目的探讨早产、维生素D和骨代谢指标水平的相关性。方法收集2012年11月至2013年10月于中国医科大学附属盛京医院出生的814例新生儿为研究对象,其中24例为妊娠28~32周的早产儿(重度早产组),134例为妊娠32~36周的早产儿(轻度早产组),656例为妊娠满37周的足月儿(足月产组)。使用25-(OH)-D、骨保护素(osteoprotegerin,OPG)、甲状旁腺激素(parathyroid hormone,PTH)和Ⅰ型胶原C末端肽(C-telopeptides typeⅠcollagen,CTX)对应的ELISA试剂盒完成25羟基维生素D(25-(OH)-D)血清浓度及骨代谢标志物浓度的测定。结果足月产组体重、身长、头围、胸围大于重度和轻度早产组(P<0.01)。三组间的维生素D和PTH水平差异有统计学意义(P<0.01)。重度早产组与足月产组、重度早产组与轻度早产组中的OPG水平存在差异,且有统计学意义(P<0.01)。早产组中,25-(OH)-D浓度与OPG、CTX的浓度呈正相关(r=0.563,P<0.01;r=0.581,P<0.001),与PTH浓度呈负相关(r=-0.621,P<0.001),OPG与PTH的浓度呈负相关(r=-0.518,P<0.001),与CTX浓度呈正相关(r=0.653,P<0.001),PTH与CTX浓度呈负相关(r=-0.520,P<0.001)。结论成骨活动障碍及破骨活动亢进可能是导致早产儿易患代谢性骨病的关键因素,维生素D缺乏可能是代谢性骨病的原因之一。监测血清25-(OH)-D和骨代谢指标水平能较好地反映新生儿(特别是早产儿)的骨代谢状态。     

Hipovitaminosis D y factores asociados a los 4 años en el norte de España

Introduction

Vitamin D is an essential prohormone in calcium and phosphorus homeostasis. Recent studies show a high frequency of insufficiency/deficiency of vitamin D in the general population worldwide. Our objective was to estimate the prevalence of circulating vitamin D [25(OH)D3] deficiency and insufficiency in children and examine the associated factors.