Document Detail


Prevalence of vitamin D deficiency among healthy infants and toddlers.
MedLine Citation:
PMID:  18524739     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To determine the prevalence of vitamin D deficiency and to examine whether 25-hydroxyvitamin D (25OHD) concentration varies as a function of skin pigmentation, season, sun exposure, breastfeeding, and vitamin D supplementation.
DESIGN: Cross-sectional sample.
SETTING: Urban primary care clinic.
PARTICIPANTS: Healthy infants and toddlers (N = 380) who were seen for a routine health visit.
OUTCOME MEASURES: Primary outcomes were serum 25OHD and parathyroid hormone levels; secondary measures included data on sun exposure, nutrition, skin pigmentation, and parental health habits. Wrist and knee radiographs were obtained for vitamin D-deficient participants.
RESULTS: The prevalence of vitamin D deficiency (< or =20 ng/mL) was 12.1% (44 of 365 participants), and 146 participants (40.0%) had levels below an accepted optimal threshold (< or =30 ng/mL). The prevalence did not vary between infants and toddlers or by skin pigmentation. There was an inverse correlation between serum 25OHD and parathyroid hormone levels (infants: r = -0.27, P < .001; toddlers: r = -0.20, P = .02). In multivariable models, breastfeeding without supplementation among infants and lower milk intake among toddlers were significant predictors of vitamin D deficiency. In vitamin D-deficient participants, 3 participants (7.5%) exhibited rachitic changes on radiographs, whereas 13 (32.5%) had evidence of demineralization.
CONCLUSIONS: Suboptimal vitamin D status is common among otherwise healthy young children. Predictors of vitamin D status vary in infants vs toddlers, information that is important to consider in the care of these young patients. One-third of vitamin D-deficient participants exhibited demineralization, highlighting the deleterious skeletal effects of this condition.
Authors:
Catherine M Gordon; Henry A Feldman; Linda Sinclair; Avery LeBoff Williams; Paul K Kleinman; Jeannette Perez-Rossello; Joanne E Cox
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Archives of pediatrics & adolescent medicine     Volume:  162     ISSN:  1538-3628     ISO Abbreviation:  Arch Pediatr Adolesc Med     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-06-05     Completed Date:  2008-07-03     Revised Date:  2011-11-02    
Medline Journal Info:
Nlm Unique ID:  9422751     Medline TA:  Arch Pediatr Adolesc Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  505-12     Citation Subset:  AIM; IM    
Affiliation:
Divisions of Adolescent Medicine and Endocrinology, Children's Hospital Boston, 300 Longwood Ave, Boston, MA 02115, USA. catherine.gordon@childrens.harvard.edu
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MeSH Terms
Descriptor/Qualifier:
Child Welfare / statistics & numerical data*
Child, Preschool
Female
Humans
Infant
Infant Welfare / statistics & numerical data*
Infant, Newborn
Knee / radiography
Life Style
Male
Nutritional Status
Prevalence
Primary Health Care*
Questionnaires
Risk Factors
United States / epidemiology
Urban Population / statistics & numerical data*
Vitamin D / analogs & derivatives,  blood
Vitamin D Deficiency / blood,  epidemiology*
Wrist / radiography
Grant Support
ID/Acronym/Agency:
M01 RR002172-246237/RR/NCRR NIH HHS; MO1-RR-2172/RR/NCRR NIH HHS; P30 DK040561-13/DK/NIDDK NIH HHS; T71MC00009//PHS HHS
Chemical
Reg. No./Substance:
1406-16-2/Vitamin D; 64719-49-9/25-hydroxyvitamin D
Comments/Corrections
Comment In:
Arch Pediatr Adolesc Med. 2008 Jun;162(6):583-4   [PMID:  18524751 ]
Arch Pediatr Adolesc Med. 2008 Dec;162(12):1193; author reply 1194   [PMID:  19047550 ]

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