The Spectrum of Vitamin D Deficiency: Description of a Family

2017 ◽  
Vol 125 (07) ◽  
pp. 478-484 ◽  
Author(s):  
Francesco Vierucci ◽  
Marta Del Pistoia ◽  
Emioli Randazzo ◽  
Francesco Massart ◽  
Giovanni Federico
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
High Risk ◽  
Global Health ◽  
Vitamin D Deficiency ◽  
Family Members ◽  
Vitamin D Supplementation ◽  
Nutritional Rickets ◽  
Clinical Pictures ◽  
Global Health Problem

Abstract Background Vitamin D deficiency represents a global health problem, affecting children and adolescents worldwide. Objects To confirm that vitamin D deficiency can present as a spectrum of clinical pictures. Methods We diagnosed nutritional rickets in a 10-month-old infant of Senegal origin with several risk factors for vitamin D deficiency. As many of these factors affected also his cohabitant relatives, we evaluate infant’s family members (mother and 4 brothers) looking for other vitamin D deficiency-related comorbidities. Results 3 brothers had asymptomatic vitamin D deficiency and 2 of them (9.8 and 13.4 years-old) showed secondary hyperparathyroidism. The fourth brother (11.3 years-old) had nutritional rickets. Their mother was affected by osteomalacia. None of them received vitamin D supplementation. Conclusion Vitamin D deficiency may present as a spectrum of clinical pictures, representing a continuum ranging from asymptomatic/subtle conditions to overt rickets/osteomalacia. Immigrant families are at high risk for vitamin D deficiency at every age. If a case of symptomatic vitamin D deficiency is recognized, then the evaluation of the all family members is recommended, as they can have the same and/or other risk factors for vitamin D deficiency.

Demographic Characteristics, Risk Factors, and Presenting Features of Children with Symptomatic Nutritional Rickets: A French Series

2020 ◽  
Vol 93 (5) ◽  
pp. 304-312
Author(s):  
Claire Flot ◽  
Valérie Porquet-Bordes ◽  
Justine Bacchetta ◽  
Anya Rothenbuhler ◽  
Anne Lienhardt-Roussie ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Pediatric Population ◽  
Vitamin D Supplementation ◽  
Demographic Characteristics ◽  
Total Serum ◽  
Nutritional Rickets ◽  
Total Serum Calcium ◽  
Vitamin D Levels ◽  
25 Hydroxy Vitamin D

<b><i>Aim:</i></b> To describe the demographic characteristics, risk factors, and presenting features of children with symptomatic nutritional rickets in France. <b><i>Methods:</i></b> This is a retrospective study of 38 children diagnosed with nutritional rickets from 1998 to 2019. <b><i>Results:</i></b> We observed a higher frequency of rickets in males (74 vs. 26%), in young children (median age at diagnosis: 23 months; 82% were younger than 5 years), and in children with a non-Caucasian ethnic background (89%). Most children were exclusively breastfed (78%) without adequate vitamin D supplementation (89%). The most common presentations were bowed legs (63%), hypocalcemic seizures (21%), and growth retardation (11%). Approximately half (62%) of the children were hypocalcemic. The children presenting with hypocalcemic seizures were significantly younger (0.8 vs. 2.2 years; <i>p</i> = 0.041) and had lower total serum calcium levels (1.44 vs. 2.17 mmol/L; <i>p</i> &#x3c; 0.0001), higher phosphatemia (1.43 vs. 1.23 mmol/L; <i>p</i> = 0.020), and lower 25-hydroxy vitamin D levels (3 vs. 7 ng/mL; <i>p</i> = 0.020) but similar parathyroid hormone levels (357 vs. 289 ng/mL; <i>p</i> = 0.940) compared to rickets cases who did not experience hypocalcemic seizures. A dilated cardiomyopathy was detected in 14% of the children who had undergone echocardiography. <b><i>Conclusion:</i></b> Nutritional rickets remains endemic in the pediatric population and its most severe forms can have life-threatening sequelae. Health practitioners need to be cognizant of these facts to raise awareness and screen high-risk populations.

Successful public health action to reduce the incidence of symptomatic vitamin D deficiency

2012 ◽  
Vol 97 (11) ◽  
pp. 952-954 ◽  
Author(s):  
Robert John Moy ◽  
Eleanor McGee ◽  
Geoff D Debelle ◽  
Ian Mather ◽  
Nicholas J Shaw
Keyword(s):  
Vitamin D ◽  
High Risk ◽  
Vitamin D Deficiency ◽  
Incidence Rate ◽  
Uptake Rate ◽  
Public Awareness ◽  
Vitamin D Supplementation ◽  
Minority Population ◽  
Vitamin Supplement ◽  
Vitamin D Levels

BackgroundIn response to a resurgence of symptomatic cases of vitamin D deficiency in a high-risk predominantly ethnic minority population, a programme of universal rather than targeted vitamin D supplementation was begun with a public awareness campaign about the importance of vitamin D.ObjectiveTo evaluate the effectiveness of this programme in reducing case numbers.MethodsCases of symptomatic vitamin D deficiency in children under 5 years resident in a primary care trust catchment area presenting at local hospitals were identified through laboratory records of low vitamin D levels which were cross-checked against medical records to confirm the diagnosis. Comparisons were made of the case incidence rate, level of public knowledge and vitamin supplement uptake rate at the onset of the programme in 2005 and 4 years later.ResultsThe number of cases of symptomatic vitamin D deficiency in those under 5 years fell by 59% (case incidence rate falling from 120/100 000 to 49/100 000) despite the supplement uptake rate rising only to 17%. Public awareness of vitamin D deficiency rose to near universal levels.ConclusionsA programme of universal rather than targeted Healthy Start vitamin D supplementation for pregnant and lactating women and young children has led to a substantial decrease in cases of symptomatic vitamin D deficiency in a high-risk population. Supplementation was also started at a younger age than in the national programme. This approach has implications for the delivery of vitamin D supplementation programmes in similar populations.

scholarly journals Prevalence of Cardio-metabolic Risk Factors among Young Saudi Women with Vitamin D Deficiency

2020 ◽  
pp. 46-55
Author(s):  
H. A. Al Kadi ◽  
E. Alissa
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Fasting Blood Glucose ◽  
Density Lipoprotein ◽  
Vitamin D Supplementation ◽  
Metabolic Risk Factors ◽  
Metabolic Risk Factor ◽  
Metabolic Risk ◽  
Saudi Women

Aims: The aim of this study was to determine the prevalence of cardio-metabolic risk factors in apparently healthy Saudi women with vitamin D deficiency. Study Design: A retrospective chart review. Place and Duration of Study: This study was conducted in the Center of Excellence for Osteoporosis Research (CEOR), King Abdulaziz University, Jeddah, Saudi Arabia, between June 2015 to October 2015. Methodology: Healthy women 20–40 years old, with no history of previous illnesses and not on any medications were included in this study. Data on anthropometric measurements as well as blood pressure (BP) were obtained. Body mass index (BMI) was calculated. Laboratory results including fasting blood glucose (FBG), fasting lipid profile, 25-hydroxyvitamin D3 (25(OH)D3) and parathyroid hormone (PTH) were also obtained. Vitamin D deficiency was defined as 25(OH)D3 concentration <50 nmol/l. Modified NCEP:ATPIII criteria were used to define cardio-metabolic risk factor cutoff points. Results: A total of 305 women were included in the current analysis. Mean (± S.D.) age of the study group was 28.4±6.1 years and median (IQR) 25(OH)D3 was 17.8 (11.9–28.2) nmol/l. Almost 97% of the study participants were vitamin D deficient and 70% had values below 25 nmol/l. 25(OH)D3 was significantly inversely associated with waist circumference, systolic and diastolic BP and PTH (P=0.011, <0.0001, <0.0001, <0.0001, respectively). Prevalence of cardio-metabolic risk factors were higher among participants who fell in the lowest tertile of 25(OH)D3 except total cholesterol and low density lipoprotein cholesterol, however only higher PTH was statistically significant (P=0.022). Conclusion: The results of the present study confirm the high prevalence of vitamin D deficiency among otherwise healthy Saudi women. The results also suggest that the prevalence of selected cardio-metabolic risk factors is higher among those with low vitamin D status. Prospective studies are needed to determine whether such deficiency will be of clinical significance with advancing age in this population, and whether vitamin D supplementation has beneficial effects.

Vitamin D and Vascular Disease

2020 ◽  
Vol 19 (3) ◽  
pp. 250-268 ◽  
Author(s):  
Ioanna Gouni-Berthold ◽  
Heiner K. Berthold
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Vitamin D Supplementation ◽  
Plasma Vitamin ◽  
Cvd Risk ◽  
Vitamin D Receptors ◽  
Cell Proliferation And Differentiation ◽  
Increased Risk ◽  
Vitamin D Levels

: Cardiovascular disease (CVD) is a major cause of morbidity and mortality worldwide. Vitamin D deficiency has been identified as a potential risk factor for a number of diseases unrelated to the classical skeletal pathophysiology, such as cancer and CVD, but the effects of vitamin D supplementation are less clear. Purpose of this narrative review is to discuss the evidence suggesting an association between vitamin D status and CVD as well as the results of supplementation studies. Vitamin D deficiency has been associated with CVD risk factors such as hypertension, dyslipidemia and diabetes mellitus as well as with cardiovascular events such as myocardial infarction, stroke and heart failure. While vitamin D deficiency might contribute to the development of CVD through its association with risk factors, direct effects of vitamin D on the cardiovascular system may also be involved. Vitamin D receptors are expressed in a variety of tissues, including cardiomyocytes, vascular smooth muscle cells and endothelial cells. Moreover, vitamin D has been shown to affect inflammation, cell proliferation and differentiation. While observational studies support an association between low plasma vitamin D levels and increased risk of CVD, Mendelian randomization studies do not support a causal association between the two. At present, high quality randomized trials do not find evidence of significant effects on CVD endpoints and do not support supplementation of vitamin D to decrease CVD events.

Vitamin D deficiency: a global health problem 1

2008 ◽  
Vol 32 (4) ◽  
pp. -
Author(s):  
Stefan Pilz ◽  
Harald Dobnig ◽  
Astrid Fahrleitner-Pammer ◽  
Günter Polt ◽  
Winfried März
Keyword(s):  
Vitamin D ◽  
Global Health ◽  
Vitamin D Deficiency ◽  
Health Problem ◽  
Global Health Problem

Vitamin D-Mangel: Ein globales Gesundheitsproblem / Vitamin D deficiency: a global health problem

2008 ◽  
Vol 32 (4) ◽  
pp. 200-208 ◽  
Author(s):  
Stefan Pilz ◽  
Harald Dobnig ◽  
Astrid Fahrleitner-Pammer ◽  
Günter Polt ◽  
Winfried März
Keyword(s):  
Vitamin D ◽  
Global Health ◽  
Vitamin D Deficiency ◽  
Health Problem ◽  
Global Health Problem

scholarly journals SUN-083 Screening of Vitamin D and Calcium Concentrations in Neonates of Mothers at High Risk of Vitamin D Deficiency

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Sheikh Arif Maqbool Kozgar ◽  
Paul Chay ◽  
Craig Frank Munns
Keyword(s):  
Vitamin D ◽  
High Risk ◽  
Vitamin D Deficiency ◽  
Reference Range ◽  
Financial Burden ◽  
Venous Blood ◽  
Reference Interval ◽  
Vitamin D Insufficiency ◽  
Vitamin D Supplementation ◽  
Serum 25Ohd

Abstract Objective: The aim of this study was to determine, retrospectively, the serum 25OHD and calcium concentrations of screened neonates of mothers at high risk of 25OHD deficiency (maternal 25OHD &lt; 25 nmol/L or unknown vitamin D concentrations and risk factors for vitamin D deficiency) and critically analyse whether their measurements contributes to the management of these neonates. Methods: Serum 25OHD and calcium concentrations from 600 samples of umbilical cord blood or venous blood collected from neonates over a 12-month period were analysed. 25OHD concentrations were reported for all while both the corrected calcium concentrations and vitamin D concentrations were available for 569 samples. Results: There was little or no evidence of association between neonatal 25OHD concentrations and gender, gestational age or birth weight. There was a high prevalence of vitamin D insufficiency (27.6%, 30–50 nmol/L) and deficiency (21.3%, &lt; 30 nmol/L) in neonates from high-risk maternal groups. There was a statistically positive but weak correlation (ρ = 0.22, P &lt; 0.0001) between serum calcium and 25OHD concentrations. Only 7 neonates out of 569 (1.2%) had calcium levels in the hypocalcaemic range; however, a significant number (47.6%) were reported to be in the hypercalcaemic range. Nearly all of these were venous samples collected in first 24 hours after birth. We calculated the reference interval for corrected calcium from our data of venous samples in first 24 hours and the upper limit was significantly higher (2.38–3.04 mmol/L) than the standard reference range used. Conclusion: Vitamin D deficiency is prevalent in neonates of high-risk mothers but the risk of hypocalcaemia due to vitamin D deficiency at birth is low. Screening neonates entails blood testing which can cause distress to neonates and their parents, substantial impost on staff and financial burden on the health care system. 25OHD deficiency is corrected relatively easily in neonates with supplementation and vitamin D supplementation of neonates from birth without routine screening appears to offer better value of care. Also, the data from this study suggest that the paediatric reference range for corrected calcium concentrations in neonates is higher and the paediatric reference range should be reconsidered.

scholarly journals The Significance of Measuring Vitamin D Serum Levels in Women with Uterine Fibroids

2020 ◽  
Author(s):  
Michał Ciebiera ◽  
Mohamed Ali ◽  
Lillian Prince ◽  
Stanisław Zgliczyński ◽  
Grzegorz Jakiel ◽  
...  
Keyword(s):  
Public Health ◽  
Vitamin D ◽  
High Risk ◽  
Vitamin D Deficiency ◽  
Treatment Guidelines ◽  
Uterine Fibroids ◽  
Serum Levels ◽  
Vitamin D Supplementation ◽  
Health Concern ◽  
Benign Tumors

Abstract Uterine fibroids (UFs) are benign tumors originating from smooth muscle cells and are considered a common pathology that affects numerous women which is a notable socio-economic problem. Several UF risk factors have been identified including black race, obesity, and vitamin D deficiency. Vitamin D is steroid compound with pleiotropic effects on the human body. Vitamin D deficiency is a major public health concern worldwide. Several studies have shown that the majority of UF patients experienced hypovitaminosis D. In addition, sufficient vitamin D serum levels are associated with the reduced risk of UFs. In this review, we present available data highlighting the importance of measuring vitamin D serum levels in women with UFs and women at a high risk for UF development. We proposed a preliminary clinical instruction of 25-hydroxyvitamin D measurements and vitamin D supplementation for clinicians who are involved in the treatment of patients with UFs. Achieving sufficient serum levels of vitamin D might be of interest in patients with UFs. Screening, supplementation, treatment guidelines, and public health strategies for vitamin D deficiency in women with UFs as well as women at a high risk of UF development might be of potential importance as well.

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