Prevalence and Determinants of Vitamin D Deficiency in Children Aged 0–5 years in Jiangsu Province of China: A Cross-Sectional Multicenter Study

Abstract Objectives To explore the vitamin D status and its related factors in infants and preschool. Methods This was a large population-based multicenter study in which the representative children aged 0–5 years were recruited from 12 Children's Health Care Centers by a stratified cluster random-sampling method in 10 cities of Jiangsu Province, China. Kruskal-wallis test was used to describe median differences by continuous variables and chi-square test was used to examine differences in categorical variables. The associations between characteristics and risk factors with vitamin D deficiency and 25(OH)D level were used to evaluate by binary logistic regression and general linear model regression. Results A total of 5289 children (2786 boys and 2503 girls) were investigated. The prevalence of deficiency vitamin D were 30.1%, The overall level of 25(OH)D was 64.0 (46.3 ∼ 83.0) nmol/ml. 0–5 year old children with higher odds of vitamin D deficiency and lower 25(OH)D level were more likely to be at older age, girls, survey in spring, location in southern of Jiangsu province, preference for meat and sweets, meat intake > 150.0 g/d, time of sleeping < 10 h/d and outdoor activity < 2 h/d (all P < 0.05). However, those with lower odds of vitamin D deficiency and higher 25(OH)D level were more likely to be the number of parity≥ 2 times, milk intake ≥ 250 ml/d, vitamin D supplementation from birth to 6 months, the initial time of vitamin D supplementation after birth ≤ 1 months, vitamin D supplementation and calcium supplementation in the last 3 months, and daily dose of vitamin D supplementation > 400 IU (all P < 0.05). Conclusions Most 0–5 year old children in Jiangsu province have poor vitamin D levels. The 25(OH)D levels and vitamin D deficiency were associated with age, gender, parity, season of survey, region of residence, daily intake of milk, meat, vitamin D and calcium supplementation, the initial time of vitamin D supplementation after birth, preference for eating meat and sweets, time of sleeping and outdoor activity every day for children. Funding Sources This work was funded by the construction fund for key subjects of women and children of Jiangsu Province (FXK201203).

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To Supplement or not to Supplement? The Rationale of Vitamin D Supplementation in Systemic Lupus Erythematosus

The Open Rheumatology Journal ◽

10.2174/1874312901812010226 ◽

2018 ◽

Vol 12 (1) ◽

pp. 226-247 ◽

Cited By ~ 1

Author(s):

Alessandra Nerviani ◽

Daniele Mauro ◽

Michele Gilio ◽

Rosa Daniela Grembiale ◽

Myles J. Lewis

Keyword(s):

Systemic Lupus Erythematosus ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Lupus Erythematosus ◽

Clinical Manifestations ◽

Vitamin D Supplementation ◽

Current Evidence ◽

Systemic Lupus ◽

Vitamin D Receptors ◽

Vitamin D Levels

Background: Systemic Lupus Erythematosus (SLE) is a systemic autoimmune disease characterised by abnormal activation of the immune system, chronic inflammation and organ damage. Lupus patients are more prone to be vitamin D deficient. However, current evidence is not conclusive with regards to the role played by vitamin D in SLE development, progression, and clinical manifestations. Objective: Here, we will summarise the current knowledge about vitamin D deficiency prevalence, risk factors, molecular effects, and potential pathogenic role in SLE. We will focus on the link between vitamin D deficiency and lupus clinical manifestations, and on the clinical trials assessing the effects of vitamin D supplementation in SLE. Method: A detailed literature search was performed exploiting the available databases, using “vitamin D and lupus/SLE” as keywords. The relevant interventional trials published over the last decade have been considered and the results are reported here. Conclusion: Several immune cells express vitamin D receptors. Thus, an immunomodulatory role for vitamin D in lupus is plausible. Numerous observational studies have investigated the relationship between vitamin D levels and clinical/serological manifestations of SLE with contrasting results. Negative correlations between vitamin D levels and disease activity, fatigue, renal and cardiovascular disease, and anti-dsDNA titres have been described but not conclusively accepted. In experimental models of lupus, vitamin D supplementation can improve the disease. Interventional trials have assessed the potential therapeutic value of vitamin D in SLE, but further larger studies are needed.

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Vitamin D and Atherosclerotic Cardiovascular Disease

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2019-00194 ◽

2019 ◽

Vol 104 (9) ◽

pp. 4033-4050 ◽

Cited By ~ 6

Author(s):

Thomas F Hiemstra ◽

Kenneth Lim ◽

Ravi Thadhani ◽

JoAnn E Manson

Keyword(s):

Cardiovascular Disease ◽

Vitamin D ◽

General Population ◽

Vitamin D Deficiency ◽

Randomized Trials ◽

Cardiovascular Health ◽

Vitamin D Supplementation ◽

High Dose ◽

Atherosclerotic Cardiovascular Disease ◽

Vitamin D Levels

Abstract Context A large body of experimental and observational data has implicated vitamin D deficiency in the development of cardiovascular disease. However, evidence to support routine vitamin D supplementation to prevent or treat cardiovascular disease is lacking. Design and Results A comprehensive literature review was performed using PubMed and other literature search engines. Mounting epidemiological evidence and data from Mendelian randomization studies support a link between vitamin D deficiency and adverse cardiovascular health outcomes, but randomized trial evidence to support vitamin D supplementation is sparse. Current public health guidelines restrict vitamin D intake recommendations to the maintenance of bone health and prevention of fractures. Two recently published large trials (VITAL and ViDA) that assessed the role of moderate- to high-dose vitamin D supplementation as primary prevention for cardiovascular outcomes in the general population had null results, and previous randomized trials have also been generally negative. These findings from general population cohorts that are largely replete in vitamin D may not be applicable to chronic kidney disease (CKD) populations, in which the use of active (1α-hydroxylated) vitamin D compounds is prevalent, or to other high-risk populations. Additionally, recent trials in the CKD population, as well as trials using vitamin D analogs, have been limited. Conclusions Current randomized trials of vitamin D supplementation do not support benefits for cardiovascular health, but the evidence remains inconclusive. Additional randomized trials assessing larger numbers of participants with low baseline vitamin D levels, having longer follow-up periods, and testing higher vitamin D dosages are needed to guide clinical practice.

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P652 Underweight patients with Crohn’s disease and without vitamin D supplementation are at high risk of vitamin D deficiency

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.780 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S536-S537

Author(s):

D Vranesic Bender ◽

V Domislović ◽

M Brinar ◽

D Ljubas Kelečić ◽

I Karas ◽

...

Keyword(s):

Vitamin D ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Vitamin D Deficiency ◽

Vitamin D Supplementation ◽

Lower Range ◽

Total Study Population ◽

Vitamin D Levels ◽

Significant Difference ◽

Underweight Patients

Abstract Background Vitamin D deficiency is frequently present in inflammatory bowel disease (IBD) with a higher incidence in Crohn’s disease (CD) than in ulcerative colitis (UC). Given the involvement of the alimentary tract, many factors can contribute to vitamin D deficiency. The aim of the study was to investigate the association of vitamin D deficiency according to body mass index (BMI) in adult patients with IBD. Methods A cross-sectional study was conducted on a cohort of 152 IBD patients, 68.1% (n = 104) CD and 31.9% (n = 48) UC. The mean age of the total study population was 37.3±11.8 years and 57.3% (n = 87) were male. All patients were adult, Caucasian and without vitamin D supplementation. Patients were recruited during one year period. Results Out of all IBD patients, 60.5% (n = 92) had vitamin D deficiency, 32.2%, (n = 49) insufficiency and 7.2% (n = 11) sufficiency. According to BMI categories there were 12.5% (n = 19) obese patients, 27.6% (n = 42) overweight, 51.3% (n = 78) with normal body weight, and 8.6% (n = 13) underweight. There was a significant difference in vitamin D levels according to different BMI categories in terms of underweight patients having the lowest vitamin D levels; underweight 29.84±11.94 mmol/l, normal 46 ± 20.7 mmol/l, overweight 48±20.1 mmol/l, obese 51±15.3 mmol/l. In addition, there was a significant correlation of vitamin D levels and BMI values (Rho = 0.212, 95% CI 0.069–0.345, p = 0.004), which was more clearly observed in the lower range of BMI values (Figure 1). Male underweight patients had lower levels of vitamin D compared with female patients (26.6 ± 9 vs. 34.7 ± 5.6, p < 0.05). Both patients with CD and UC had significant positive correlation of vitamin D levels and BMI values (UC Rho=0.40, 95% CI 0.16–0.59, p = 0.001, UC Rho = 0.27, 95% CI 0.01–0.05, p = 0.044). However, when comparing vitamin D levels according to phenotype, a significant difference in vitamin D levels was observed in underweight CD (28.4 ± 11.1) comparing to underweight UC patients (40.6 ± 10.6), p < 0.05. In logistic regression analysis, CD phenotype was risk factor for vitamin D deficiency (OR 2.18 95% CI 1.01–4.72, β = 1.22, p = 0.04). Conclusion Our results on untreated IBD patients show a high proportion of vitamin D deficiency both in CD and UC, and significant correlation of vitamin D levels and BMI values, especially in the lower range of BMI values. Moreover, underweight CD patients have lower vitamin D levels comparing to UC. This suggests the need for regular vitamin D monitoring and supplementation especially in IBD patients at risk.

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Vitamin D status and 3-month Glasgow Outcome Scale scores in patients in neurocritical care: prospective analysis of 497 patients

Journal of Neurosurgery ◽

10.3171/2017.2.jns163037 ◽

2018 ◽

Vol 128 (6) ◽

pp. 1635-1641 ◽

Cited By ~ 3

Author(s):

Jian Guan ◽

Michael Karsy ◽

Andrea A. Brock ◽

Ilyas M. Eli ◽

Gabrielle M. Manton ◽

...

Keyword(s):

Vitamin D ◽

Logistic Regression ◽

Vitamin D Deficiency ◽

Glasgow Outcome Scale ◽

Neurocritical Care ◽

Care Center ◽

Hypovitaminosis D ◽

Simplified Acute Physiology Score ◽

Vitamin D Supplementation ◽

Vitamin D Levels

OBJECTIVEVitamin D deficiency has been associated with a variety of negative outcomes in critically ill patients, but little focused study on the effects of hypovitaminosis D has been performed in the neurocritical care population. In this study, the authors examined the effect of vitamin D deficiency on 3-month outcomes after discharge from a neurocritical care unit (NCCU).METHODSThe authors prospectively analyzed 25-hydroxy vitamin D levels in patients admitted to the NCCU of a quaternary care center over a 6-month period. Glasgow Outcome Scale (GOS) scores were used to evaluate their 3-month outcome, and univariate and multivariate logistic regression was used to evaluate the effects of vitamin D deficiency.RESULTSFour hundred ninety-seven patients met the inclusion criteria. In the binomial logistic regression model, patients without vitamin D deficiency (> 20 ng/dl) were significantly more likely to have a 3-month GOS score of 4 or 5 than those who were vitamin D deficient (OR 1.768 [95% CI 1.095–2.852]). Patients with a higher Simplified Acute Physiology Score (SAPS II) (OR 0.925 [95% CI 0.910–0.940]) and those admitted for stroke (OR 0.409 [95% CI 0.209–0.803]) or those with an “other” diagnosis (OR 0.409 [95% CI 0.217–0.772]) were significantly more likely to have a 3-month GOS score of 3 or less.CONCLUSIONSVitamin D deficiency is associated with worse 3-month postdischarge GOS scores in patients admitted to an NCCU. Additional study is needed to determine the role of vitamin D supplementation in the NCCU population.

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Is there a benefit of vitamin D supplementation in deficient children and adolescents suffering from obesity? A meta-analysis

QJM ◽

10.1093/qjmed/hcaa063.001 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

M F Nassar ◽

E K Emam ◽

M F Allam

Keyword(s):

Vitamin D ◽

Children And Adolescents ◽

Vitamin D Deficiency ◽

Meta Analysis ◽

Vitamin D Supplementation ◽

Obese Children ◽

Intramuscular Dose ◽

Vitamin D Levels ◽

Pubmed Search ◽

Lower Vitamin

Abstract Background and objectives Both childhood obesity and vitamin D deficiency are common in the Middle East. This systematic review/meta-analysis aims to highlight the effect of vitamin D supplementation in deficient children suffering from obesity. Methods Published clinical studies on vitamin D supplementation in obese children and adolescents with vitamin D deficiency were identified through a comprehensive MEDLINE/PubMed search (from July 1966 to November 2017). Outcomes intended after vitamin D supplementation were improvements in vitamin D status, BMI alterations and appetite changes. The inclusion criteria were children aged 2 to 18 years of both sexes in clinical trials that specified the oral and/or intramuscular dose of vitamin D supplementation. Results Ten studies were retrieved, but only six were relevant. First, supplemented obese children and adolescents were compared to non-obese controls; thereafter, supplemented obese children and adolescents were compared to matching obese peers given placebo. Pooled risks from the two studies that evaluated the number of obese and non-obese children and adolescents who improved upon vitamin D supplementation revealed that obesity poses a risk for not benefiting from the vitamin D supplementation regardless of the dose and the duration of supplementation. Pooled results from the six retrieved studies that compared supplemented obese children and adolescents to matching non-obese or obese peers given placebo revealed significantly lower vitamin D levels in obese participants than in non-obese peers. Conclusion Vitamin D levels are significantly lower in obese children and adolescents with obesity, posing a risk for not benefiting from vitamin D supplementation regardless of the dose and duration of supplementation. Our results suggest that only with simultaneous weight adjustment strategies, vitamin D sufficiency would be achieved more effectively. Vitamin D supplementation in deficient children suffering from obesity.

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Baseline Characteristics Associated with Vitamin D Deficiency in Sickle Cell Disease and the Effect of Vitamin D Replacement

Blood ◽

10.1182/blood.v118.21.2139.2139 ◽

2011 ◽

Vol 118 (21) ◽

pp. 2139-2139

Author(s):

Soyoung Park ◽

Rebecca Kruse-Jarres ◽

Davis Ogitani

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Sickle Cell ◽

Total Bilirubin ◽

Reticulocyte Count ◽

Outdoor Activity ◽

Vitamin D Levels ◽

Significant Difference ◽

Pain Frequency ◽

Lower Vitamin

Abstract Abstract 2139 Background: African Americans have lower vitamin D levels than the general population, which is thought to be due to decreased utilization of ultraviolet rays to convert vitamin D into an active form. Sickle cell patients have even lower vitamin D levels than African American controls. Preliminary studies at Tulane University correlated low vitamin D levels with markers of hemolysis (decreased hemoglobin (Hgb), increased reticulocyte count and lactate dehydrogenase (LDH)). Our main question was whether vitamin D deficiency in sickle cell patients is due to lack of outdoor activity or diet, or increased vitamin D metabolism during bone marrow turnover secondary to hemolysis. Design and Methods: 80 adult sickle cell patients received pain, dietary, and outdoor activity level surveys. Vitamin D 25-hydroxy (25(OH)D), hemolytic lab markers (Hgb, Hct, LDH, total bilirubin, and reticulocyte count) were obtained. Results: Baseline Assessment: Vitamin D levels were available on 70 patients: 24.3% were normal or mildly deficient (≥20 ng/mL), 30% moderately deficient (10-<20 ng/mL), and 45.7% severely deficient (<10 ng/mL). We could not verify a correlation between LDH and 25(OH)D levels, but there was a trend towards increased total bilirubin in patients severely deficient in vitamin D (p = 0.06). Severely anemic patients (Hgb 5-<7 gm/dL) had significantly lower average 25(OH)D levels (p = 0.02). When comparing patients with moderately and severely deficient 25(OH)D levels to patients with no or mild deficiency, there was a significantly increased use of healthcare facilities (see Table 1). Though there was no significant difference in intake of fish, cheese, or eggs, there was a significant decrease in milk intake (see Table 1). There was no significant difference in days spent in bed or time spent outdoors (see Table 1). Subjectively, patients did not report increased frequency of mild to moderate pain, vasocclusive crises, or use of pain medications in the moderately and severely vitamin D deficient groups but they did report higher rates of hospitalization due to sickle cell crises (p = 0.03, 0.005 respectively). Effects of Vitamin D replacement: 56 patients took vitamin D replacement. After replacement, there was no difference in frequency of pain and pain medicine use, or days in the hospital and ER. However, pain levels appeared to be less intense (see Table 2). There was a trend towards fewer days spent in the hospital and ER (p = 0.089) in the 6 months following vitamin D replacement and there were significantly fewer Sickle Cell Day Hospital visits (p = 0.037). Conclusions: Though we could not correlate vitamin D deficiency with LDH as a marker of hemolysis, lower Hgb levels seemed to be predictive of more severe vitamin D deficiency. Patients with more severe vitamin D deficiency did not report to have increased pain frequency or pain medication use, but had more ER visits and hospitalizations. When vitamin D was replaced, it did not decrease pain frequency, but it did decrease severity. We conclude that vitamin D replacement could lessen pain in sickle cell patients and thus utilization. Disclosures: Kruse-Jarres: Bayer: Consultancy; Grifols: Consultancy; Talecris: Consultancy; Inspiration: Consultancy; NovoNordisk: Consultancy; Baxter: Consultancy.

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High Prevalence of Vitamin D Deficiency Despite Supplementation in Premenopausal Women With Breast Cancer Undergoing Adjuvant Chemotherapy

Journal of Clinical Oncology ◽

10.1200/jco.2008.19.6162 ◽

2009 ◽

Vol 27 (13) ◽

pp. 2151-2156 ◽

Cited By ~ 96

Author(s):

Katherine D. Crew ◽

Elizabeth Shane ◽

Serge Cremers ◽

Donald J. McMahon ◽

Dinaz Irani ◽

...

Keyword(s):

Breast Cancer ◽

Vitamin D ◽

Black Women ◽

Adjuvant Chemotherapy ◽

Vitamin D Deficiency ◽

White Women ◽

Premenopausal Women ◽

Vitamin D Supplementation ◽

Mineral Density ◽

Vitamin D Levels

Purpose Vitamin D deficiency is associated with increased breast cancer risk and decreased breast cancer survival. The purpose of this study was to determine the prevalence of vitamin D deficiency, as measured by serum 25-hydroxyvitamin D (25-OHD), in premenopausal women at initiation of adjuvant chemotherapy for breast cancer and after 1 year of vitamin D supplementation. Patients and Methods The study included 103 premenopausal women from the northeastern United States with stages I to III breast cancer who received adjuvant chemotherapy and participated in a 1-year zoledronate intervention trial. All patients were prescribed vitamin D3 (cholecalciferol) 400 IU and calcium carbonate 1,000 mg daily. At baseline and at 6 and 12 months, bone mineral density (BMD) measurements were obtained and blood was collected and analyzed in batches for serum 25-OHD. Vitamin D deficiency was defined as serum 25-OHD less than 20 ng/mL, insufficiency as 20 to 29 ng/mL, and sufficiency as 30 ng/mL or greater. Results At baseline, 74% of women were vitamin D deficient (median, 17 ng/mL). Vitamin D deficiency was slightly less common in white women (66%) compared with black (80%) and Hispanic (84%) women. After vitamin D supplementation for 1 year, less than 15% of white and Hispanic women, and no black women, achieved sufficient 25-OHD levels. Vitamin D levels did not correlate with baseline BMD and were not altered by chemotherapy or bisphosphonate use. Conclusion Vitamin D deficiency is highly prevalent in women with breast cancer. The current recommended dietary allowance of vitamin D is too low to increase serum 25-OHD greater than 30 ng/mL. Optimal dosing for bone health and, possibly, improved survival has yet to be determined.

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Vitamin D Metabolism Is Significantly Impaired in COVID-19 Inpatients

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.572 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A281-A282

Author(s):

Alexandra Povaliaeva ◽

Liudmila Ya Rozhinskaya ◽

Ekaterina A Pigarova ◽

Larisa K Dzeranova ◽

Nino N Katamadze ◽

...

Keyword(s):

Vitamin D ◽

Secondary Hyperparathyroidism ◽

Vitamin D Deficiency ◽

Serum Calcium ◽

Vitamin D Supplementation ◽

Vitamin D Metabolites ◽

Lung Involvement ◽

Hydroxylase Activity ◽

Vitamin D Metabolism ◽

Vitamin D Levels

Abstract Objective: to assess the state of vitamin D metabolism in patients hospitalized with COVID-19 infection. Materials and methods: We examined 49 patients, which were hospitalized for inpatient treatment of COVID-19 infection from May to June 2020. Study group included 24 men (49%) and 25 women (51%), median age 58 years [48; 70], BMI 26.4 kg/m2 [24.3; 30.5]. All patients were diagnosed with pneumonia due to SARS-CoV-2 with median percent of lung involvement equal to 29% [14; 37], 22 patients (45%) required oxygen support upon admission. Median SpO2 was equal to 95% (92; 97), median NEWS score was equal to 3 [2; 6]. Participants were tested for vitamin D metabolites (25(OH)D3, 1,25(OH)2D3, 3-epi-25(OH)D3, 24,25(OH)2D3 and D3) by UPLC-MS/MS, free 25(OH)D and vitamin D-binding protein by ELISA, as well as PTH by electrochemiluminescence immunoassay and routine biochemical parameters of blood serum (calcium, phosphorus, albumin) at the time of admission. Results: patients had in general very low 25()D3 levels - median 10.9 ng/mL [6.9; 15.6], corresponding to a pronounced vitamin D deficiency in half of the patients. Levels of 24,25(OH)2D3 were also low – 0.5 ng/mL [0.2; 0.9], and resulting vitamin D metabolite ratios (25(OH)D3/24,25(OH)2D3) were high-normal or elevated in most patients – 24.1 [19.0; 39.2], indicating decreased activity of 24-hydroxylase. Levels of 1,25(OH)2D3, on the contrary, were high-normal or elevated - 57 pg/mL [46; 79], which, in accordance with 25(OH)D3/1,25(OH)2D3 ratio (219 [134; 266]) suggests an increase in 1α-hydroxylase activity. Median level of 3-epi-25(OH)D3 was 0.7 ng/mL [0.4; 1.0] and D3 metabolite was detectable only in 6 patients. Median DBP level was 432 mg/L [382; 498], median free 25(OH)D was 5.6 pg/mL [3.3; 6.7], median calculated free 25(OH)D was 2.0 pg/mL [1.4; 3.3]. Most patients had albumin-adjusted serum calcium level in the lower half of reference range (median 2.24 mmol/L [2.14; 2.34]). Seven patients had secondary hyperparathyroidism and one patient had primary hyperparathyroidism, the rest of the patients had PTH levels within the normal range.25(OH)D3 levels showed significant negative correlation with percent of lung involvement (r = -0.36, p<0.05) and positive correlation with SpO2 (r = 0.4, p<0.05). 1,25(OH)2D3 levels correlated positively with 25(OH)D3 levels (r = 0.38, p<0.05) and did not correlate significantly with PTH levels (p>0.05). Conclusion: Our data suggests that hospitalized patients with COVID-19 infection have significant impairment of vitamin D metabolism, in particular, an increase in 1α-hydroxylase activity, which cannot be fully explained by pre-existing conditions such as vitamin D deficiency and secondary hyperparathyroidism. The observed profound vitamin D deficiency and association of vitamin D levels with markers of disease severity indicate the importance of vitamin D supplementation in these patients.

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Anxiety Symptoms Among Lebanese Health-care Students: Prevalence, Risk Factors, And Relationship With Vitamin D Status

Journal of Health Sciences ◽

10.17532/jhsci.2021.1191 ◽

2021 ◽

Author(s):

José-Noel Ibrahim ◽

Léa Audi

Keyword(s):

Health Care ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Rating Scale ◽

Vitamin D Supplementation ◽

Anxiety Symptoms ◽

Vitamin D Status ◽

Health Care Students ◽

Vitamin D Levels ◽

Social Difficulties

Introduction: Various emotions may arise in the context of extensive curriculum of paramedical education. Their association to biological aspects such as Vitamin D status is to be examined with regard to the prevalence of Vitamin D deficiency in the region. This research aims to evaluate the prevalence of anxiety symptoms and their relationship with Vitamin D status among Lebanese health-care students.Methods: A total of 157 university students aged 18-25 years old completed a questionnaire related to medical and psychiatric history, nutritional intake, lifestyle habits, and social difficulties. Anxiety symptoms were assessed by Hamilton Anxiety Rating Scale. Vitamin D serum levels were analyzed using ELISA technique.Results: Anxiety symptoms were present in 37.5% of students with 2.5% presenting severe anxiety. Anxiety symptoms were significantly associated to health problems (p = 0.0038), social difficulties (p = 0.001), and a family history of psychiatric disorders (p < 0.0001). Low Vitamin D levels were detected in 49.3% of participants; 77.5% having a Vitamin D insufficiency while the rest presenting a Vitamin D deficiency. Students with anxiety symptoms had significantly lower Vitamin D levels as compared to those having no anxiety manifestations (17.9 ng/mL ± 7.9 vs. 24.2 ng/mL ± 9.9, p = 0.0023). However, no significant correlation was registered between anxiety symptoms scores and Vitamin D levels.Conclusion: Anxiety symptoms were found to be relatively prevalent among health-care students and associated to low Vitamin D levels. Further studies are warranted to clarify the beneficial effect of Vitamin D supplementation in the prevention, management, and treatment of anxiety symptoms among health-care students.

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Effect of Vitamin D supplementation and outdoor activity on serum 25-Hydroxyvitamin D among children in North China: an observational study

10.21203/rs.3.rs-30985/v1 ◽

2020 ◽

Author(s):

Xuguang Zhang ◽

Yanping Chen ◽

Shanshan Jin ◽

Xinxin Bi ◽

Dongkai Chen ◽

...

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Lower Risk ◽

North China ◽

Pediatric Population ◽

Hypovitaminosis D ◽

Vitamin D Supplementation ◽

High Latitudes ◽

Vitamin D Status ◽

Outdoor Activity

Abstract Background Living at high latitudes is one of the risk factors for vitamin D deficiency in children. However, evidence on vitamin D improvement for this pediatric population to date is limited. This study aims at evaluating the effect of different supplementation methods and outdoor activity time on the vitamin D status of children in North China. Methods A total of 55,925 children aged 1 month to 18 years old were recruited from pediatric outpatient departments from July 2016 to June 2017. Data on demographics, anthropometric measurements, vitamin D supplementation, and outdoor time were recorded. The serum levels of 25-hydroxycholecalciferol (25(OH)D) were determined by high performance liquid chromatography tandem–mass spectrometry. Logistic regression analysis was performed to assess the association of vitamin D supplementation or outdoor time with blood vitamin D status, adjusted for age, gender, BMI for age, and seasons. Results The overall rate of hypovitaminosis D was 65.60%. Of the children’s outdoor time, 35.63%, 31.95%, and 32.42% were below 30 min/d, 30–60 min/d and over 60 min/d, respectively. Furthermore, the proportion of iatrogenic supplementation, voluntary supplementation and no vitamin D supplementation among the children was 16.48%, 32.87%, and 50.65%, respectively. After adjusted for confounding factors, vitamin D supplementation was associated with a lower risk of hypovitaminosis D, with OR (95% CI) of 0.191 (0.180, 0.202) in children with iatrogenic supplementation and 0.423 (0.404, 0.443) in those with voluntary supplementation, compared with children without vitamin D supplementation. In addition, longer outdoor time was associated with a lower risk of hypovitaminosis D [0.479 (0.456, 0.504) for 60 min/d, 0.737 (0.701, 0.776) for 30–60 min/d], independent of vitamin D supplementation. Conclusions High prevalence of vitamin D deficiency was found in children living at high latitudes. Vitamin D supplementation and outdoor time are all negatively associated with children’s vitamin D deficiency. Routine 25(OH)D testing combined with vitamin D supplementation might be an effective approach to prevent hypovitaminosis D among children living at high latitudes.

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