• Journal of Korean Public Health Nursing
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• v.31 no.1
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• pp.84-96
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• 2017

Purpose: Vitamin D is a fundamental element for bone metabolism. Recently vitamin D deficiency has been implicated in various diseases such as a cardiovascular disease, diabetes, and cancers. The aim of this study was to identify the risk factors associated with serum vitamin D deficiency among women office workers. Methods: We selected 369 women office workers using the secondary data of the 5th National Health & Nutrition Examination Survey 2010-2012. Data was analyzed by logistic regression of complex sampling design. Results: Women office workers with vitamin D deficiency, defined serum 25-hydroxyvitamin D concentration < 10ng/mL, were 12.5%. The risk factors for vitamin D deficiency were 20s aged group, married state and more than 40 working hours a week. The risk of vitamin D deficiency was decreased in those with alcohol drinking 1 to 4 times a month. The education level, income, region, smoking, physical activity and sun exposure time did not affect the risk of vitamin D deficiency significantly. Conclusion: Development of vitamin D deficiency prevention educational programs are required for women office workers who more than 40 hours a week in 20s. It should be considered health education including sun exposure duration and behavior.

• Asian Spine Journal
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• v.12 no.6
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• pp.1127-1145
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• 2018

Several theories have been proposed to explain the etiology of adolescent idiopathic scoliosis (AIS) until present. However, limited data are available regarding the impact of vitamin D insufficiency or deficiency on scoliosis. Previous studies have shown that vitamin D deficiency and insufficiency are prevalent in adolescents, including AIS patients. A series of studies conducted in Hong Kong have shown that as many as 30% of these patients have osteopenia. The 25-hydroxyvitamin D3 level has been found to positively correlate with bone mineral density (BMD) in healthy adolescents and negatively with Cobb angle in AIS patients; therefore, vitamin D deficiency is believed to play a role in AIS pathogenesis. This study attempts to review the relevant literature on AIS etiology to examine the association of vitamin D and various current theories. Our review suggested that vitamin D deficiency is associated with several current etiological theories of AIS. We postulate that vitamin D deficiency and/or insufficiency affects AIS development by its effect on the regulation of fibrosis, postural control, and BMD. Subclinical deficiency of vitamin K2, a fat-soluble vitamin, is also prevalent in adolescents; therefore, it is possible that the high prevalence of vitamin D deficiency is related to decreased fat intake. Further studies are required to elucidate the possible role of vitamin D in the pathogenesis and clinical management of AIS.

• Clinical and Experimental Pediatrics
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• v.58 no.11
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• pp.427-433
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• 2015

Purpose: We investigated the vitamin D status of preterm infants to determine the incidence of vitamin D deficiency. Methods: A total of 278 preterm infants delivered at Kyungpook National University Hospital between January 2013 and May 2015 were enrolled. The serum concentrations of calcium, phosphorous, alkaline phosphatase, and 25-hydroxyvitamin D (25-OHD) were measured at birth. We collected maternal and neonatal data such as maternal gestational diabetes, premature rupture of membranes, maternal preeclampsia, birth date, gestational age, and birth weight. Results: Mean gestational age was $33^{+5}{\pm}2^{+2}$ weeks of gestation and mean 25-OHD concentrations were $10.7{\pm}6.4ng/mL$. The incidence of vitamin D deficiency was 91.7%, and 51.1% of preterm infants were classified as having severe vitamin D deficiency (25-OHD<10 ng/mL). The serum 25-OHD concentrations did not correlate with gestational age. There were no significant differences in serum 25-OHD concentrations or incidence of severe vitamin D deficiency among early, moderate, and late preterm infants. The risk of severe vitamin D deficiency in twin preterm infants was significantly higher than that in singletons (odds ratio, 1.993; 95% confidence interval [CI], 1.137-3.494, P=0.016). In the fall, the incidence of severe vitamin D deficiency decreased 0.46 times compared to that in winter (95% CI, 0.227-0.901; P=0.024). Conclusion: Most of preterm infants (98.9%) had vitamin D insufficiency and half of them were severely vitamin D deficient. Younger gestational age did not increase the risk of vitamin D deficiency, but gestational number was associated with severe vitamin D deficiency.

• Nutrition Research and Practice
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• v.7 no.6
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• pp.495-502
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• 2013

Recent studies suggest that vitamin D deficiency and cardiometabolic disorders are becoming increasingly more prevalent across multiple populations. However, there is a lack of comprehensive data for Korean adults. We investigated the vitamin D status, the prevalence of vitamin D deficiency and its association with metabolic syndrome (MS) risk in Korean adults aged 20 years or older. The study subjects (n = 18,305) were individuals who participated in the Korean National Health Examination and Nutrition Survey (KNHANES) in 2008-2010. Vitamin D status (25-hydroxyvitamin D [25(OH)D]) was categorized as < 20, 21-29, and ${\geq}$ 30 ng/mL, which are the cut-off points for deficiency, insufficiency and normal limits. A wide variety of cardiometabolic risk factors were compared according to the vitamin D status. Vitamin D deficiency was found in 53.9% of men and 70.5% of women. Mean BMI, systolic BP, HbA1c and low density lipoprotein cholesterol (LDL-C) were highest in the vitamin D deficiency group in both genders. Further, the MS was most prevalent in the vitamin D deficiency group in both genders (12.3%, P = 0.002 in men and 9.2%, P < 0.001 in women). Compared to the vitamin D normal group, the adjusted odds ratio (ORs) (95% confidence interval [95% CI]) for MS in the vitamin D deficiency group were 1.46 (1.05-2.02) in men and 1.60 (1.21-2.11) in women, after adjusting for confounding variables. In conclusion, Vitamin D deficiency is a very common health problem in Korean adults and is independently associated with the increasing risk of MS.

• Child Health Nursing Research
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• v.24 no.2
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• pp.157-165
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• 2018

Purpose: The purpose of this study was to examine differences in the prevalence of vitamin D deficiency between male and female Korean adolescents and to investigate gender-specific factors associated with vitamin D deficiency. Methods: This cross-sectional descriptive study included 975 adolescents aged 12-18 years who participated in the fifth Korean National Health and Nutrition Examination Survey (2010~2011). Multiple logistic regression using complex sample analysis was performed to examine gender-specific factors associated with vitamin D deficiency with adjustments for covariates. Results: Among the participants, 82.9% had vitamin D deficiency. The prevalence of vitamin D deficiency was higher among female adolescents (88.4%) than their male counterparts (78.4%). A rural place of residence (OR, 0.40; 95% CI, 0.19~0.87; p=.021) and daily milk intake (OR, 0.23; 95% CI, 0.07~0.75; p=.015) were significant factors significantly associated with vitamin D deficiency in males, while body mass index (OR, 8.40; 95% CI, 1.05~67.04, p=.045) and having breakfast (OR, 0.22; 95% CI, 0.10~0.49; p<.001) showed significant relationships in females. Conclusion: The results of this study provide preliminary evidence for developing effective strategies to prevent vitamin D deficiency in Korean adolescents. The different factors influencing vitamin D deficiency in males and females should be considered when providing interventions.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.3
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• pp.233-241
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• 2019

Purpose: Vitamin D deficiency is a condition widespread throughout the world. Recent studies have suggested that vitamin D deficiency was associated with obesity and metabolic syndrome. The purpose of the study was to examine the relationship between vitamin D deficiency and nonalcoholic fatty liver disease (NAFLD) in adolescents. Methods: The data were obtained from the Korean National Health and Nutrition Examination Survey from 2008-2014. A total of 3,878 adolescents were included in the study. Vitamin D deficiency was defined as a 25-hydroxyvitamin D concentration <20 ng/mL and suspected NAFLD was defined as an alanine transaminase concentration >30 U/L. Results: Vitamin D deficiency was noted in 78.9% of the studied population. Age, body mass index, waist circumference, and blood pressure, glucose, cholesterol, and triglyceride levels were significantly higher in adolescents with suspected NAFLD than in adolescents without suspected NAFLD, while the mean vitamin D level was significantly lower in adolescents with suspected NAFLD. The multivariate-adjusted odds of suspected NAFLD were higher with increased age, male gender, obesity, and metabolic syndrome. Individuals with vitamin D deficiency were at higher risk of suspected NAFLD (odds ratio, 1.77; 95% confidence interval, 1.07-2.95) after adjusting for age, gender, obesity, and metabolic syndrome. Conclusion: Vitamin D deficiency was associated with suspected NAFLD, independent of obesity and metabolic syndrome, in adolescents.

• Clinical and Experimental Pediatrics
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• v.52 no.10
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• pp.1082-1089
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• 2009

Vitamin D is an important fat-soluble vitamin that functions as a prohormone and affects bone mineralization and calcium homeostasis. Vitamin D deficiency causesboth musculoskeletal manifestations, including rickets, and extra-musculoskeletal symptoms. Because vitamin D is naturally present in only some foods, intake of daily foods cannot meet the dietary reference intake for vitamin D. Sunlight is the main source of vitamin D in humans therefore, the lack of sunlight can easily cause vitamin D deficiency in children and adolescents. Vitamin D deficiency can be diagnosed on the basis ofits typical clinical manifestation, laboratory tests, and radiologic findings. Detection of vitamin D deficiency in children or adolescents necessitates the simultaneous administration of vitamin D and calcium supplements. To prevent vitamin D deficiency, 200 IU of daily vitamin D intake is recommended in infants, and 400 IU of daily vitamin D intake is recommended in Korean children and adolescents.

• Journal of the Korean Society of School Health
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• v.30 no.2
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• pp.146-153
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• 2017

Purpose: The purpose of this study was to identify the association between physical activity and vitamin D deficiency status among Korean adolescents. Methods: This is cross-sectional analysis of Korean adolescents aged 10-18 years from the 5th Korea National Health and Nutrition Examination Survey(KNHANES 2010-2012; n=2,384). We estimated the prevalence of vitamin D deficiency and identified the correlations with the strength of physical activity. $x^2$ test, t-test, and multiple logistic regression using complex sample analysis were done. The odds ratio of vitamin D deficiency by physical activity was calculated using complex sample multivariate logistic regression analysis. Results: The prevalence of vitamin D deficiency was 78.2%. The mean serum 25 (OH) D level in deficiency group and non-deficiency group was 14.4ng/mL, 23.7ng/mL respectively. Differences by age strata (the prevalence ranging from 68.5% to 86.3%) and gender (78.6% for boy and 84.5% for girl) were identified. Among adolescents aged 16-18 or girl in vigorous physical activity, a significant correlation between vitamin D deficiency and physical activity was observed, whereas no significant correlation were found among adolescents in moderate physical activity. Conclusion: In conclusion, vigorous physical activity was associated with vitamin D deficit in Korean adolescents. Thus, intervention programs enhancing vigorous activity than moderate activity need to be developed in schools and community.

• Clinical and Experimental Pediatrics
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• v.56 no.10
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• pp.417-423
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• 2013

Vitamin D is an essential component of bone and mineral metabolism; its deficiency causes growth retardation and skeletal deformities in children and osteomalacia and osteoporosis in adults. Hypovitaminosis D (vitamin D insufficiency or deficiency) is observed not only in adults but also in infants, children, and adolescents. Previous studies suggest that sufficient serum vitamin D levels should be maintained in order to enhance normal calcification of the growth plate and bone mineralization. Moreover, emerging evidence supports an association between 25-hydroxyvitamin D (25[OH]D) levels and immune function, respiratory diseases, obesity, metabolic syndrome, insulin resistance, infection, allergy, cancers, and cardiovascular diseases in pediatric and adolescent populations. The risk factors for vitamin D insufficiency or deficiency in the pediatric population are season (winter), insufficient time spent outdoors, ethnicity (non-white), older age, more advanced stage of puberty, obesity, low milk consumption, low socioeconomic status, and female gender. It is recommended that all infants, children, and adolescents have a minimum daily intake of 400 IU ($10{\mu}g$) of vitamin D. Since the vitamin D status of the newborn is highly related to maternal vitamin D levels, optimal vitamin D levels in the mother during pregnancy should be maintained. In conclusion, given the important role of vitamin D in childhood health, more time spent in outdoor activity (for sunlight exposure) and vitamin D supplementation may be necessary for optimal health in infants, children, and adolescents.

• Journal of Digital Convergence
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• v.15 no.10
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• pp.357-366
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• 2017

The purpose of this study was identify the factors affecting serum vitamin D deficiency in korean women. This study used the data from the 5th Korea National Health and Nutrition Examinations Survey and analyzed the demographic characteristics, health related factors and serum vitamin D in women aged 19 and over. Data were analyzed using the IBM SPSS 18.0 program. As a result, vitamin D deficiency rate in Korean women was 81.4%. There were significant differences according to age, marital status, region, type of residence, family income, education level. The risk factors of vitamin D deficiency were age, marital status, region, without walking. According to the results of this study, further studies on the vitamin D deficiency factors by age group should be conducted and the stress relieve and physical activity of women should be promoted to prevent vitamin D deficiency.