Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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Subclinical Vitamin D Insufficiency in Korean School-aged Children

  • Han, Sang Woo (Department of Pediatrics, Eulji General Hospital) ;
  • Kang, Ha Ra (Department of Pediatrics, Eulji General Hospital) ;
  • Kim, Han Gyum (Department of Medicine, Eulji University) ;
  • Kim, Joo Hyun (Department of Medicine, Eulji University) ;
  • Uhm, Ji Hyun (Department of Pediatrics, Eulji General Hospital) ;
  • Seo, Ji Young (Department of Pediatrics, Eulji General Hospital)
  • Received : 2013.09.26
  • Accepted : 2013.10.29
  • Published : 2013.12.30
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Abstract

Purpose: Recently, vitamin D insufficiency has increased and has been correlated to growth and puberty in children. This study was conducted to find the prevalence of subclinical vitamin D insufficiency and its influence on school-aged children in Korea. Methods: The subjects of this study were 397 children aged 7 to 15 years who had been tested for 25-OH vitamin D3 among the outpatients of the Department of Pediatrics in Eulji General Hospital from March 2007 to February 2011. Data for age, sex, comorbidities, serum 25-OH vitamin D3, height, weight, body mass index (BMI), and sunlight exposure time were collected before and after 3 months of vitamin D administration, retrospectively. Results: Vitamin D insufficiency was present in 343 (86%) of the subjects. In the vitamin D insufficient group, chronological age was $8.96{\pm}1.72$ years, mean height (z-score [z]) was $0.51{\pm}1.26$, mean BMI (z) was $0.81{\pm}2.20$, and bone age was $10.26{\pm}1.75$ years. In the vitamin D sufficient group, chronological age was $9.61{\pm}1.77$ years, mean height (z) was -$0.66{\pm}0.98$, mean BMI (z) was -$0.01{\pm}1.16$, and bone age was $9.44{\pm}2.12$ years. A paired t-test showed that three months after vitamin D administration, the mean 25-OH vitamin D3 level in the insufficient group increased to $24.38{\pm}10.03$ ng/mL and mean BMI (z) decreased to $0.67{\pm}1.06$. Conclusion: In Korean school-aged children, vitamin D insufficiency were relatively higher and may be closely related with higher BMI. Insufficient rise of the level of vitamin D after supplementation suggest the new supplementation guidelines, especially for Korean children.

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References

  1. Holick MF. Vitamin D: a millenium perspective. J Cell Biochem 2003;88:296-307. https://doi.org/10.1002/jcb.10338
  2. Holick MF. High prevalence of vitamin D inadequacy and implications for health. Mayo Clin Proc 2006;81: 353-73. https://doi.org/10.4065/81.3.353
  3. Kang B, Jung SY, Kim SK, Lee JE, Son BK, Kwon YS. Clinical features of seizures related to rickets in breastfed children. J Korean Child Neurol Soc 2012; 20:179-87.
  4. Cho HM, Choi CS, Sun GK, Kim EY, Kim KS, Kim YW. Two cases of rickets that developed as a result of by diet restriction due to atopic dermatitis. Korean J Pediatr Gastroenterol Nutr 2006;9:284-90.
  5. Huh SY, Gordon CM. Vitamin D deficiency in children and adolescents: epidemiology, impact and treatment. Rev Endocr Metab Disord 2008;9:161-70. https://doi.org/10.1007/s11154-007-9072-y
  6. Hatun S, Islam O, Cizmecioglu F, Kara B, Babaoglu K, Berk F, et al. Subclinical vitamin D deficiency is increased in adolescent girls who wear concealing clothing. J Nutr 2005;135:218-22. https://doi.org/10.1093/jn/135.2.218
  7. Rovner AJ, O'Brien KO. Hypovitaminosis D among healthy children in the United States: a review of the current evidence. Arch Pediatr Adolesc Med 2008;162: 513-9. https://doi.org/10.1001/archpedi.162.6.513
  8. Goldner WS, Stoner JA, Thompson J, Taylor K, Larson L, Erickson J, et al. Prevalence of vitamin D insufficiency and deficiency in morbidly obese patients: a comparison with non-obese controls. Obes Surg 2008;18:145-50. https://doi.org/10.1007/s11695-007-9315-8
  9. Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B. Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr 2006;84:18-28.
  10. Yoon JH, Park CS, Seo JY, Choi YS, Ahn YM. Clinical characteristics and prevalence of vitamin D insufficiency in children less than two years of age. Korean J Pediatr 2011;54:298-303. https://doi.org/10.3345/kjp.2011.54.7.298
  11. Kim MJ, Na B, No SJ, Han HS, Jeong EH, Lee W, et al. Nutritional status of vitamin D and the effect of vitamin D supplementation in Korean breast-fed infants. J Korean Med Sci 2010;25:83-9. https://doi.org/10.3346/jkms.2010.25.1.83
  12. Yang HR, Seo JW, Kim YJ, Kim JY, Ryoo E, Sim JG, et al. Recent concepts on vitamin D in children and adolescents. Korean J Pediatr 2009;52:1082-9. https://doi.org/10.3345/kjp.2009.52.10.1082
  13. Shin YH, Kim KE, Lee C, Shin HJ, Kang MS, Lee HR, et al. High prevalence of vitamin D insufficiency or deficiency in young adolescents in Korea. Eur J Pediatr 2012;171:1475-80. https://doi.org/10.1007/s00431-012-1746-0
  14. Gordon CM, DePeter KC, Feldman HA, Grace E, Emans SJ. Prevalence of vitamin D deficiency among healthy adolescents. Arch Pediatr Adolesc Med 2004;158:531-7. https://doi.org/10.1001/archpedi.158.6.531
  15. Abrams SA. Dietary guidelines for calcium and vitamin D: a new era. Pediatrics 2011;127:566-8. https://doi.org/10.1542/peds.2010-3576
  16. Neyestani TR, Hajifaraji M, Omidvar N, Eshraghian MR, Shariatzadeh N, Kalayi A, et al. High prevalence of vitamin D deficiency in school-age children in Tehran, 2008: a red alert. Public Health Nutr 2012;15:324-30. https://doi.org/10.1017/S1368980011000188
  17. Weng FL, Shults J, Leonard MB, Stallings VA, Zemel BS. Risk factors for low serum 25-hydroxyvitamin D concentrations in otherwise healthy children and adolescents. Am J Clin Nutr 2007;86:150-8.
  18. Hickey L, Gordon CM. Vitamin D deficiency: new perspectives on an old disease. Curr Opin Endocrinol Diabetes 2004;11:18-25. https://doi.org/10.1097/00060793-200402000-00006
  19. Lips P, Duong T, Oleksik A, Black D, Cummings S, Cox D, et al. A global study of vitamin D status and parathyroid function in postmenopausal women with osteoporosis: baseline data from the multiple outcomes of raloxifene evaluation clinical trial. J Clin Endocrinol Metab 2001;86:1212-21. https://doi.org/10.1210/jcem.86.3.7327
  20. Choi HS, Oh HJ, Choi H, Choi WH, Kim JG, Kim KM, et al. Vitamin D insufficiency in Korea--a greater threat to younger generation: the Korea National Health and Nutrition Examination Survey (KNHANES) 2008. J Clin Endocrinol Metab 2011;96:643-51. https://doi.org/10.1210/jc.2010-2133
  21. Villamor E, Marin C, Mora-Plazas M, Baylin A. Vitamin D deficiency and age at menarche: a prospective study. Am J Clin Nutr 2011;94:1020-5. https://doi.org/10.3945/ajcn.111.018168
  22. Kremer R, Campbell PP, Reinhardt T, Gilsanz V. Vitamin D status and its relationship to body fat, final height, and peak bone mass in young women. J Clin Endocrinol Metab 2009;94:67-73. https://doi.org/10.1210/jc.2008-1575
  23. Wortsman J, Matsuoka LY, Chen TC, Lu Z, Holick MF. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr 2000;72:690-3.
  24. Misra M, Pacaud D, Petryk A, Collett-Solberg PF, Kappy M; Drug and Therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society. Vitamin D deficiency in children and its management: review of current knowledge and recommendations. Pediatrics 2008;122:398-417. https://doi.org/10.1542/peds.2007-1894
  25. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al; Endocrine Society. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2011;96:1911-30. https://doi.org/10.1210/jc.2011-0385
  26. Harkness LS, Cromer BA. Vitamin D deficiency in adolescent females. J Adolesc Health 2005;37:75.
  27. Vashi PG, Lammersfeld CA, Braun DP, Gupta D. Serum 25-hydroxyvitamin D is inversely associated with body mass index in cancer. Nutr J 2011;10:51. https://doi.org/10.1186/1475-2891-10-51
  28. Viljakainen HT, Natri AM, Kärkkäinen M, Huttunen MM, Palssa A, Jakobsen J, et al. A positive dose-response effect of vitamin D supplementation on site-specific bone mineral augmentation in adolescent girls: a double-blinded randomized placebo-controlled 1-year intervention. J Bone Miner Res 2006;21:836-44. https://doi.org/10.1359/jbmr.060302
  29. Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr 2004;80(6 Suppl): 1678S-88S.

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