The effect of vitamin D status on bone marker levels during childhood and adolescence

An adequate vitamin D status is essential during childhood and adolescence, for its important role in cell growth, skeletal structure and development. It also reduces the risk of conditions such as CVD, osteoporosis, diabetes mellitus, infections and autoimmune disease. As comparable data on the European level are lacking, assessment of vitamin D concentrations was included in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study. Fasting blood samples were obtained from a subsample of 1006 adolescents (470 males; 46·8 %) with an age range of 12·5–17·5 years, selected in the ten HELENA cities in the nine European countries participating in this cross-sectional study, and analysed for 25-hydroxycholecalciferol (25(OH)D) by ELISA using EDTA plasma. As specific reference values for adolescents are missing, percentile distribution were computed by age and sex. Median 25(OH)D levels for the whole population were 57·1 nmol/l (5th percentile 24·3 nmol/l, 95th percentile 99·05 nmol/l). Vitamin D status was classified into four groups according to international guidelines (sufficiency/optimal levels ≥ 75 nmol/l; insufficiency 50–75 nmol/l; deficiency 27·5–49·99 nmol/l and severe deficiency < 27·5 nmol/l). About 80 % of the sample had suboptimal levels (39 % had insufficient, 27 % deficient and 15 % severely deficient levels). Vitamin D concentrations increased with age (P < 0·01) and tended to decrease according to BMI. Geographical differences were also identified. Our study results indicate that vitamin D deficiency is a highly prevalent condition in European adolescents and should be a matter of concern for public health authorities.

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Possible Health Implications and Low Vitamin D Status during Childhood and Adolescence: An Updated Mini Review

International Journal of Endocrinology ◽

10.1155/2010/472173 ◽

2010 ◽

Vol 2010 ◽

pp. 1-7 ◽

Cited By ~ 21

Author(s):

Dimitrios Papandreou ◽

Pavlos Malindretos ◽

Zacharoula Karabouta ◽

Israel Rousso

Keyword(s):

Cardiovascular Disease ◽

Vitamin D ◽

Developing Countries ◽

Life Span ◽

Vitamin D Deficiency ◽

Chronic Diseases ◽

Adult Life ◽

Childhood And Adolescence ◽

Vitamin D Status ◽

Calcium Insufficiency

Vitamin D deficiency is common in the developing countries and exists in both childhood and adult life. The great importance of Vitamin D is the moderation of calcium (Ca) and phosphorus (P) homeostasis as well as the absorption of Ca. While insufficiency of vitamin D is a significant contributing factor to risk of rickets in childhood, it is possible that a more marginal deficiency of vitamin D during life span contribute to osteoporosis as well as potentially to the development and various other chronic diseases such as cardiovascular disease, cancer and diabetes. This paper reviews the metabolism, epidemiology, and treatment of vitamin D and calcium insufficiency as well as its relation to various diseases during childhood and adolescence.

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Abstract P290: The Association of Maternal Pre-pregnancy Weight With Childhood and Adolescent Blood Pressure and the Modifying Role of Vitamin D

Circulation ◽

10.1161/circ.141.suppl_1.p290 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Mingyu Zhang ◽

Guoying Wang ◽

Xiaobin Wang ◽

Noel T Mueller

Keyword(s):

Blood Pressure ◽

Vitamin D ◽

Cord Blood ◽

Medical Center ◽

Childhood And Adolescence ◽

Vitamin D Status ◽

Linear Regression Models ◽

Child Bmi ◽

Pregnancy Weight

Introduction: High blood pressure (BP) is the leading modifiable risk factor of cardiovascular diseases. High maternal pre-pregnancy body mass index (BMI) may be one of earliest risk factors for high child BP, but evidence supporting this hypothesis is limited. Vitamin D was recently found to protect against elevated BP in childhood, yet no studies to our knowledge have examined if Vitamin D could be a modifiable target for mitigating the association of pre-pregnancy BMI and child BP. Methods: We analyzed longitudinal data of 719 mother-child pairs in the Boston Birth Cohort enrolled from 1998-2012 at the Boston Medical Center. We calculated child systolic BP (SBP) percentile according to a US reference and defined low Vitamin D as cord blood 25(OH)D concentration <11 ng/mL. We examined the change in child SBP percentile per 5-kg/m 2 increment in pre-pregnancy BMI using linear regression models with GEE estimates. We adjusted for confounders (see Figure footnote) and assessed mediation by further adjusting for child BMI-z score. Results: Our analytic sample included 451 (63%) African American/Haitian mothers, 361 (50%) girls, and 304 (42%) children with low cord blood Vitamin D. A 5-kg/m 2 increment in maternal pre-pregnancy BMI was associated with a 1.99 (95% CI: 1.08, 2.90) percentile increase in child SBP (during childhood [3-12 years]: 1.85, 95% CI: 0.97, 2.73; during adolescence [13-18 years]: 4.22, 95% CI: 1.19, 7.25). Cord blood Vitamin D status modified the associations (P-interaction = 0.023) (Figure, Panel A). Results were attenuated in the mediation analysis, but the interaction remained significant (Figure, Panel B). Conclusion: Higher maternal pre-pregnancy BMI is associated with higher offspring BP in childhood and adolescence, and this association is partially mediated by child weight. The inter-generational association disappeared if mother-newborn cord blood had high Vitamin D. Optimizing maternal Vitamin D status during pregnancy may help prevent the inter-generational cycle of cardiovascular risk.

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Vitamin D status of apparently healthy schoolgirls from two different socioeconomic strata in Delhi: relation to nutrition and lifestyle

British Journal Of Nutrition ◽

10.1017/s0007114507831758 ◽

2007 ◽

Vol 99 (4) ◽

pp. 876-882 ◽

Cited By ~ 100

Author(s):

Seema Puri ◽

Raman K. Marwaha ◽

Neha Agarwal ◽

Nikhil Tandon ◽

Rashmi Agarwal ◽

...

Keyword(s):

Physical Activity ◽

Vitamin D ◽

Hypovitaminosis D ◽

Childhood And Adolescence ◽

Vitamin D Status ◽

Indian Children ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D ◽

Socioeconomic Strata ◽

Apparently Healthy

Forty to fifty per cent of skeletal mass, accumulated during childhood and adolescence, is influenced by sunlight exposure, physical activity, lifestyle, endocrine status, nutrition and gender. In view of scarce data on association of nutrition and lifestyle with hypovitaminosis D in Indian children and adolescents, an in-depth study on 3127 apparently healthy Delhi schoolgirls (6–18 years) from the lower (LSES, n 1477) and upper socioeconomic strata (USES, n 1650) was carried out. These girls were subjected to anthropometry and clinical examination for hypovitaminosis D. Girls randomly selected from the two strata (LSES, n 193; USES, n 211) underwent detailed lifestyle, dietary, biochemical and hormonal assessment. Clinical vitamin D deficiency was noted in 11·5 % girls (12·4 % LSES, 10·7 % USES). USES girls had significantly higher BMI than LSES counterparts. Prevalence of biochemical hypovitaminosis D (serum 25-hydroxyvitamin D < 50 nmol/l) was seen in 90·8 % of girls (89·6 % LSES, 91·9 % USES, NS). Mean intake of energy, protein, fat, Ca, vitamin D and milk/milk products was significantly higher in USES than LSES girls. Conversely, carbohydrate, fibre, phytate and cereal intakes were higher in LSES than USES girls. Physical activity and time spent outdoors was significantly higher in LSES girls (92·8 v. 64 %, P = 0·000). Significant correlation between serum 25-hydroxyvitamin D and estimated sun exposure (r 0·185, P = 0·001) and percentage body surface area exposed (r 0·146, P = 0·004) suggests that these lifestyle-related factors may contribute significantly to the vitamin D status of the apparently healthy schoolgirls. Hence, in the absence of vitamin D fortification of foods, diet alone appears to have an insignificant role.

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The relation of vitamin D status with metabolic syndrome in childhood and adolescence: an update

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2014-0485 ◽

2015 ◽

Vol 28 (11-12) ◽

Cited By ~ 6

Author(s):

Anna S. Challa ◽

Stefania E. Makariou ◽

Ekaterini C. Siomou

Keyword(s):

Metabolic Syndrome ◽

Vitamin D ◽

Later Life ◽

Vitamin D Insufficiency ◽

Vitamin D Supplementation ◽

Childhood And Adolescence ◽

Vitamin D Status ◽

Cross Sectional ◽

Beneficial Effects ◽

Increased Risk

AbstractAmong children and adolescents, metabolic syndrome (MetS) is more common than previously believed. Hence, any information on the relation between vitamin D insufficiency/deficiency and insulin resistance (IR) in this population with risk of developing MetS is of great importance. This review analyzes and evaluates the existing evidence from cross-sectional, observational, and retrospective studies concerning the effect of vitamin D insufficiency/deficiency on MetS as a whole or on its various components. Most data show that insufficient vitamin D status is associated with increased prevalence of MetS or its individual components, mainly blood pressure and IR, often independent of overall obesity or abdominal adiposity. The implications of these findings could be associated with increased risk for developing cardiovascular disease and type 2 diabetes mellitus in later life. The very few randomized control trials examining any possible beneficial effects of vitamin D supplementation are also included.

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Association of Vitamin D Status With Liver and Kidney Disease: A Systematic Review of Clinical Trials, and Cross-Sectional and Cohort Studies

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000540 ◽

2019 ◽

pp. 1-13 ◽

Cited By ~ 2

Author(s):

Seyed Mostafa Parizadeh ◽

Majid Rezayi ◽

Reza Jafarzadeh-Esfehani ◽

Amir Avan ◽

Hamideh Ghazizadeh ◽

...

Keyword(s):

Vitamin D ◽

Kidney Disease ◽

Renal Disease ◽

Cohort Studies ◽

Cochrane Library ◽

Major Public Health Problem ◽

Vitamin D Status ◽

Cross Sectional ◽

Beneficial Effects ◽

Vitamin D Levels

Abstract. Background: Vitamin D deficiency (VDD) is a major public health problem. There are few comprehensive systematic reviews about the relationship between Vitamin D status and liver and renal disease in Iran. Methods: We systemically searched the following databases: Web of Science; PubMed; Cochrane Library; Scopus; Science Direct; Google Scholar and two Iranian databases (Scientific Information Database (SID) and IranMedex) up until November 2017 to identify all randomized control trials (RCTs), case control, cross-sectional and cohort studies investigating the association between vitamin D and any form of liver or kidney disease. Results: Vitamin D insufficiency, or deficiency (VDD), is highly prevalent in Iran, reports varying between 44.4% in Isfahan to 98% in Gorgan. There is also a high prevalence of VDD among patients with liver or kidney disease, and the administration of vitamin D supplements may have beneficial effects on lipid profile, blood glucose, liver function and fatty liver disease, and bone health. Low serum vitamin D levels are related with abnormalities in these laboratory and clinical parameters. Conclusion: VDD is prevalent in patients with chronic liver or renal disease in Iran. There appear to be several beneficial effects of vitamin D supplementation in vitamin D deficient patients with liver or kidney disease.

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Vitamin D Deficiency in Patients with Acute Myocardial Infarction: An Italian Single-Center Study

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000220 ◽

2015 ◽

Vol 85 (1-2) ◽

pp. 23-30 ◽

Cited By ~ 19

Author(s):

Aneta Aleksova ◽

Rita Belfiore ◽

Cosimo Carriere ◽

Salam Kassem ◽

Salvatore La Carrubba ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Primary Source ◽

Sun Exposure ◽

Female Gender ◽

Developed Countries ◽

Vitamin D Status ◽

High Exposure

Abstract. Background: Hypovitaminosis D is a vitamin deficiency that has been increasing in developed countries; it was also suggested as an emerging risk factor for developing of atherosclerosis and acute myocardial infarction. The primary source of vitamin D is its cutaneous synthesis under exposure to sunlight. It has been suggested that 30 min of sun exposure twice weekly leads to sufficient vitamin D synthesis. The residents of Trieste (Italy) are well-known for their high exposure to sunlight in all seasons. We aimed to investigate the vitamin D status in subjects with acute myocardial infarction living in this area. Methods: Vitamin D status was identified in 478 subjects diagnosed with acute myocardial infarction. Results: The median serum 25-hydroxyvitamin D concentration was 14.5 [7.8 - 22.7] ng/mL. Vitamin D deficiency and insufficiency were present in 324 (68 %) and 107 (22 %) subjects, respectively. Vitamin D deficiency was less frequent among subjects enrolled in the period from July to the end of September (p < 0.001). In a multivariate analysis vitamin D deficiency was predicted by older age (p = 0.02), female gender (p = 0.002), higher body mass index (p = 0.05), autumn/winter sampling (p < 0.001), increased parathyroid hormone (p = 0.03) and alkaline phosphatase (p = 0.003). Conclusions: We observed very high prevalence of vitamin D deficiency among subjects with myocardial infarction in all seasons of enrollment. However, it was lower in the summer when sun exposure is higher. The exposure to sunlight may be a cost-saving therapeutic strategy for the management of vitamin D deficiency.

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Vitamin D Deficiency/Insufficiency and Challenges in Developing Global Vitamin D Fortification and Supplementation Policy in Adults

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000117 ◽

2012 ◽

Vol 82 (4) ◽

pp. 237-259 ◽

Cited By ~ 9

Author(s):

Moshe Ben-Shoshan

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Search Strategy ◽

Epidemiologic Studies ◽

Vitamin D Supplementation ◽

Vitamin D Status ◽

Societal Burden ◽

Time Period ◽

New Guidelines ◽

In Cis

This review summarizes studies discussing vitamin D status in adults and reveals that vitamin D deficiency/insufficiency is highly prevalent in adults and that current fortification and supplementation policies are inadequate. Background and aims: Studies suggest a crucial role for adequate vitamin D status in various health conditions including bone metabolism, cancer, cardiovascular diseases, and allergies. However, relatively little is known about poor vitamin D status and unmet needs in adults. This report aims to highlight the contribution of epidemiologic studies (through the identification of health effects and societal burden) to the development of vitamin D fortification and supplementation policies and reveal unmet global challenges in adults. Methods: In order to assess worldwide vitamin D status in adults, the search strategy combined the medical literature database MEDLINE (using PubMed) for the time period between January 1, 1980 and February 28, 2011, using the key words vitamin D deficiency and insufficiency, and included articles in which access to full text was possible and in which healthy adults were assessed according to one of four commonly used vitamin D threshold classifications. Results: This report reveals that vitamin D deficiency occurs in 4.10 % [95 % CI (confidence interval), 3.93 %, 4.27 %] to 55.05 % (54.07 %, 56.03 %) of adults, while insufficiency occurs in 26.07 % (24.82 %, 27.33 %) to 78.50 % (77.85 %, 79.16 %), depending on the classification used. However, lack of overlap in CIs and high value of I2 statistics indicate considerable heterogeneity between studies. Further, certain populations (i. e. dark-skinned individuals, immigrants, and pregnant women) may be at higher risk for poor vitamin D status. Conclusion: Current policies for vitamin D supplementation and fortification are inadequate and new guidelines are required to improve vitamin D status in adults.

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