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Licensed Unlicensed Requires Authentication Published by De Gruyter March 22, 2017

Evaluation of vitamin D prophylaxis in 3–36-month-old infants and children

  • Alper Ozcan EMAIL logo , Mustafa Kendirci , Meda Kondolot , Fatih Kardas and Leyla Akın

Abstract

Background:

Vitamin D (VD) deficiency (VDD) is still a population-based health problem that affects people at different ages. The aim of this study was to evaluate VD prophylaxis for the prevention of VDD in (3–36)-month-old infants and children.

Methods:

Infants and children aged between 3 and 36 months, with different etiologies, admitted to outpatient and inpatient clinics from October 2010 to October 2011 at the Children’s Hospital of Erciyes University, were enrolled for the study. Their VD intake (if used; time of initiation, dosage and compliance) and nutritional status (breast-fed, formula or complementary fed) were noted. In order to study seasonal VD changes, the levels of serum calcium, phosphorus and magnesium, alkaline phosphatase activity (PLA), plasma parathyroid hormone (PTH) and 25 hydroxyvitamin 25(OH)D levels were measured at the beginning of VD supplementation during the four seasons.

Results:

A total of 316 subjects were enrolled in the study, consisting of 202 (63.9%) outpatient and 114 (26.1%) inpatient groups. From these subjects, 304 (96.2%) were supplemented with VD; whereas 12 (3.8%) were not. Out of the subjects supplemented with VD, 237 (75%) initiated VD after the second week of life, 267 (87.8%) were given three drops of VD daily and 209 (66.1%) had taken VD regularly. The plasma 25(OH)D levels were found to be lower in the inpatient group than the outpatient group (29.35 ng/mL and 34.35 ng/mL, respectively). The plasma 25(OH)D levels were lower during the spring and winter. VDD and VD insufficiency (VDI) was found in 31 (9.8%) and 30 (9.5%) subjects, respectively.

Conclusions:

The plasma 25(OH)D levels were lower in inpatient and breast-fed only subjects and in winter and spring. The national VD augmentation program seems to be beneficial for the prevention of VDD, but VDD/VDI seems to still be an important health problem.


Corresponding author: Alper Ozcan, MD, Pediatrician, Department of Pediatrics, School of Medicine, Erciyes University, Kayseri, Turkey, Phone: +0505-705-22-66, Fax: +90-352-4375825

Acknowledgments

This work was presented at the 16th National Pediatric Endocrinology and Diabetes Congress, Samsun, 6–10 October 2012 (oral presentation).

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

References

1. Hollick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancer and cardiovascular disease. Am J Clin Nutr 2004;80:1678–88.10.1093/ajcn/80.6.1678SSearch in Google Scholar

2. Palermo NE, Hollick MF. Vitamin D, bone health, and other health benefits in pediatric patients. J Pediatr Rehabil Med 2014;7:179–92.10.3233/PRM-140287Search in Google Scholar

3. Brunvand L, Haga P, Tangsrud SE, Haug E. Congestive heart failure caused by vitamin D deficiency. Acta Pediatr 1995;84:106–8.10.1111/j.1651-2227.1995.tb13499.xSearch in Google Scholar

4. Yin K, Agrawal DK. Vitamin D and inflammatory diseases. J Inflamm Res 2014;7:69–87.10.2147/JIR.S63898Search in Google Scholar

5. Shah BR, Finberg L. Single-day therapy for nutritional vitamin D deficiency: a preferred method. J Pediatr 1994;125:487–90.10.1016/S0022-3476(05)83303-7Search in Google Scholar

6. Wacker M, Hollick MF. Sunlight and Vitamin D: A global perspective for health. Dermatoendocrinol 2013;5:51–108.10.4161/derm.24494Search in Google Scholar PubMed PubMed Central

7. Kiess W, Bae YJ, Penke M, Geserick M, Kratzsch J. Vitamin D in health and disease: the global threat of vitamin D deficient rickets. J Pediatr Endocrinol Metab. 2016;29:391–3.10.1515/jpem-2016-0054Search in Google Scholar PubMed

8. Sezer OB, Buluş D, Hızlı Ş, Andıran N, Yılmaz D, et al. Low 25-hydroxyvitamin D level is not an independent risk factor for hepatosteatosis in obese children. J Pediatr Endocrinol Metab 2016;29:783–8.10.1515/jpem-2015-0426Search in Google Scholar PubMed

9. Vieth R. Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. Am J Clin Nutr 1999;69:842–56.10.1093/ajcn/69.5.842Search in Google Scholar PubMed

10. Misra M, Pacaud D, Petryk A, Collett-Solberg PF, Kappy M. Vitamin D deficiency in children and its management: review of current knowledge and recommendations. Pediatrics 2008;122:398–417.10.1542/peds.2007-1894Search in Google Scholar PubMed

11. Steven A, Abrams M. Nutritional rickets: an old disease returns. Nutr Rev 2002;60:111–5.10.1301/00296640260085840Search in Google Scholar

12. Ozkan B, Doneray H, Karacan M, Vançelik S, Yildirim ZK, et al. Prevelance of vitamin D deficiency rickets in the Easthern part of Turkey. Eur J Pediatr 2009;168:95–100.10.1007/s00431-008-0821-zSearch in Google Scholar

13. Kendirci M, Cevruk I, Keskin M, Hatipoglu N, Kurtoglu S, et al. Prevalence of rickets in healthy infants aged 4–12 months. Horm Res 2006;65:135.Search in Google Scholar

14. Greer FR. Vitamin D deficiency – It’s more than rickets. J Pediatr 2003;143:422–3.10.1067/S0022-3476(03)00465-7Search in Google Scholar

15. Spence JT, Serwint JR. Secondary prevention of vitamin D-deficiency rickets. Pediatrics 2004;113:70–2.10.1542/peds.113.1.e70Search in Google Scholar

16. Chesney RW. Requirements and upper limits of vitamin D intake in the term neonate, infant, and older child. J Pediatr 1990;116:159–66.10.1016/S0022-3476(05)82868-9Search in Google Scholar

17. Health Canada; Canadian Paediatric Society; Dietitians of Canada; Breastfeeding Committee for Canada. Nutrition for healthy infants: recommendations from birth to six months. Can J Pract Res 2012;73:204.Search in Google Scholar

18. Oberhelman SS, Meekins ME, Fischer PR, Lee BR, Singh RJ, et al. Maternal vitamin D supplementation to improve the vitamin D status of breast-fed infants: a randomized controlled trial. Mayo Clin Proc 2013;88:1378–87.10.1016/j.mayocp.2013.09.012Search in Google Scholar PubMed PubMed Central

19. Centers for Disease Control and Prevention (CDC). Vitamin D Expert Panel Meeting, Final Report. Center for Disease Control: Atalanta, GA, 2001:11–2.Search in Google Scholar

20. Pehlivan I, Hatun S, Aydogan M, Babaoğlu K, Gökalp AS. Maternal vitamin D deficiency and vitamin D supplementation in healthy infants. Turk J Pediatr 2003;45:315–20.Search in Google Scholar

21. Ala-Houhala M, Parviainen MT, Pyykkö K, Visakorpi JK. Serum 25-hydroxyvitamin D levels in Finnish children aged 2 to 17 years. Acta Paediatr Scand 1984;73:232–6.10.1111/j.1651-2227.1984.tb09934.xSearch in Google Scholar PubMed

22. Morita R, Yamamoto I, Takada M, Ohnaka Y, Yuu. Hypervitaminosis D. Nippon Rinsho 1993;51:984–8.Search in Google Scholar

23. Özkan B, Hatun S, Bereket A. Vitamin D intoxication. Turk J Pediatr 2012;54:93–8.Search in Google Scholar

24. Joiner TA, Foster C, Shope T. The many faces of vitamin D deficiency rickets. Pediatr Rev 2000;21:296–302.10.1542/pir.21.9.296Search in Google Scholar

25. Blok BH, Grant CC, McNeil AR, Reid IR. Characteristics of children with florid vitamin D deficient rickets in the Auckland region in 1998. N Z Med J 2000;113:374–6.Search in Google Scholar

26. Najada AS, Habashneh MS, Khader M. The frequency of nutritional rickets among hospitalized infants and its relation to respiratory diseases. J Trop Pediatr 2004;50:364–8.10.1093/tropej/50.6.364Search in Google Scholar PubMed

27. Pedersen P, Michaelsen KF, Molgaard C. Children with nutritional rickets referred to hospitals in Copenhagen during a 10-year period. Acta Pediatr 2003;92:87–90.10.1111/j.1651-2227.2003.tb00475.xSearch in Google Scholar PubMed

28. DeLuca HF, Cantorna MT. Vitamin D: its role and uses in immunology. Fed Am Soc Exp Biol J 2001;15:2579–85.Search in Google Scholar

29. Muhe L, Lulseged S, Mason KE, Simoes EA. Case control study of the role of nutritional rickets in the risk of developing pneumonia in Ethiopian children. Lancet 1997;349:1801–4.10.1016/S0140-6736(96)12098-5Search in Google Scholar

30. Lubani MM, al-Shab TS, al-Saleh QA, Sharda DC, Quattawi SA, et al. Vitamin D-deficiency rickets in Kuwait: the prevalence of a preventable disease. Ann Trop Pediatr 1989;9:134–9.10.1080/02724936.1989.11748616Search in Google Scholar

31. Agarwal KS, Mughal MZ, Upadhyay P, Berry JL, Mawer EB, et al. The impact of atmospheric pollution on vitamin D status of infants and toddlers in Delhi, India. Arch Dis Child 2002;87:111–3.10.1136/adc.87.2.111Search in Google Scholar

32. Thiele DK, Senti JL, Anderson CM. Maternal vitamin D supplementation to meet the needs of the breastfed infant: a systematic review. J Hum Lact 2013;29:163–70.10.1177/0890334413477916Search in Google Scholar

33. Van Schoor NM, Lips P. Worldwide vitamin D status. Best Pract Res Clin Endocrinol Metab 2011;25:671–80.10.1016/B978-0-12-809963-6.00059-6Search in Google Scholar

34. Lapatsanis D, Moulas A, Cholevas V, Soukakos P, Papadopoulou ZL, et al. Vitamin D: a necessity for children and adolescents in Greece. Calcif Tissue Int 2005;77:348–55.10.1007/s00223-004-0096-ySearch in Google Scholar

35. Zeghoud F, Delaveyne R, Rehel P, Chalas J, Garabédian M, Odièvre M. [Vitamin D and pubertal maturation. Value and tolerance of vitamin D supplementation during the winter season]. Arch Pediatr 1995;2:221–6.10.1016/0929-693X(96)81131-6Search in Google Scholar

36. Cole CR, Grant FK, Tangpricha V, Swaby-Ellis ED, Smith JL, et al. 25-Hydroxyvitamin D status of healthy, low-income, minority children in Atlanta, Georgia. Pediatrics 2010;125:633–9.10.1542/peds.2009-1928Search in Google Scholar PubMed PubMed Central

37. Zhu Z, Zhan J, Shao J, Chen W, Chen L, et al. High prevalence of vitamin D deficiency among children aged 1 month to 16 years in Hangzhou, China. BMC Public Health 2012;14:126.10.1186/1471-2458-12-126Search in Google Scholar PubMed PubMed Central

38. Andıran N, Çelik N, Akça H, Doğan G. Vitamin D deficiency in children and adolescents. J Clin Res Pediatr Endocrinol 2012;4:25–9.10.4274/jcrpe.574Search in Google Scholar PubMed PubMed Central

39. Rodriguez A, Santa Marina L, Jimenez AM, Esplugues A, Ballester F, et al. Vitamin D status in pregnancy and determinants in a Southern European cohort study. Paediatr Perinat Epidemiol 2016;30:217–28.10.1111/ppe.12281Search in Google Scholar PubMed

Received: 2016-6-4
Accepted: 2016-11-28
Published Online: 2017-3-22
Published in Print: 2017-5-1

©2017 Walter de Gruyter GmbH, Berlin/Boston

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