Vitamin D Deficiency in Children with a Chronic Illness–Seasonal and Age-Related Variations in Serum 25-hydroxy Vitamin D ConcentrationsReport as inadecuate




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Introduction

Children and adolescents with a chronic illness have potential risk factors for vitamin D deficiency. An optimal vitamin D status might have multiple health effects. This study evaluated vitamin D status and its association with age, gender, and season in a large cohort of chronically ill Finnish patients at a tertiary pediatric outpatient clinic. A cross-sectional register-based study was carried out, involving altogether 1351 children 51% boys, age range 0.2–18 years, who visited the outpatient clinic during 2007–2010 and had their vitamin D status S-25-OHD determined. A post-doc analysis was conducted to identify predisposing and preventing factors for vitamin D deficiency.

Results

Almost half 47% of the S-25-OHD values were consistent with subnormal vitamin D status S-25-OHD <50 nmol-L while only 12% were >80 nmol-L. Age and season were the most important determinants for S-25-OHD concentration. Mean S-25-OHD concentration differed between age groups Kruskal-Wallis; p<0.001, adolescents being at highest risk for vitamin D insufficiency. Young age and vitamin D supplementation were preventive factors for deficiency, while non-Finnish ethnic background was a predisposing factor. S-25-OHD showed significant seasonal variation in children older than 6 years. In the whole cohort, S-25-OHD was on average 13 nmol-L higher in summer than in winter, and the prevalence of vitamin D deficiency  =  S-25-OHD <37.5 nmol-l varied from 11% in summer to 29% in winter.

Conclusions

The finding that almost half of the studied Finnish children with a chronic illness had suboptimal vitamin D status is alarming. Inferior vitamin D status was noted in adolescents compared with younger children, suggesting that imbalance between intake and requirement evolves with age. Although less common during summer, subnormal vitamin D status was still observed in 28% of those evaluated in summer. Clinicians should identify individuals at risk and actively recommend vitamin D supplementation.



Author: Elisa Holmlund-Suila , Panu Koskivirta , Tuula Metso, Sture Andersson, Outi Mäkitie, Heli T. Viljakainen

Source: http://plos.srce.hr/



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