Vitamin D deficiency in children with a chronic illness-seasonal and age-related variations in serum 25-hydroxy Vitamin D concentrations.

Abstract

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.

• Authors: Elisa Holmlund-Suila, Panu Koskivirta, Tuula Metso, Sture Andersson, Outi Mäkitie, Heli T Viljakainen
• Journal: PloS one (PLoS One) Vol. 8 Issue 4 Pg. e60856 ( 2013) ISSN: 1932-6203 [Electronic] United States
• PMID: 23585857 (Publication Type: Journal Article)

Chemical References

• Vitamin D
• 25-hydroxyvitamin D

Topics

• Adolescent
• Child
• Child, Preschool
• Chronic Disease
• Cross-Sectional Studies
• Female
• Finland (epidemiology)
• Gastrointestinal Diseases (blood, complications, epidemiology)
• Humans
• Immune System Diseases (blood, complications, epidemiology)
• Infant
• Male
• Metabolic Diseases (blood, complications, epidemiology)
• Prevalence
• Seasons
• Sunlight
• Vitamin D (analogs & derivatives, blood)
• Vitamin D Deficiency (blood, complications, epidemiology)