VITAMIN D TRENDS IN THE PEDIATRIC ORTHOPAEDIC POPULATION: A SURVEY

Background: Vitamin D deficiency is a global issue, affecting adults and children of all ages, races and genders. Within the last decade, multiple studies have demonstrated the potential health benefits of vitamin D supplementation including improved bone health, reduced fracture risk, protection from autoimmune disease, and decreased cancer risk. Because of the prevalence of vitamin D deficiency in pediatric populations despite recent evidence of increased vitamin D supplementation in the US, our goal is to assess the knowledge of current vitamin D recommendations among Pediatric Society of North America (POSNA) members. It is our purpose to use the data to increase awareness and understanding of vitamin D amongst all pediatric providers. Methods: Our survey was distributed to 1316 POSNA members via a series of 2 email requests in which they were invited to participate in the survey on the Survey Monkey website. Their participation was entirely voluntary and they agreed to participate by responding positively on the first page of the survey. The data was depersonalized and analyzed via chi square and Fisher’s exact testing. Results: 395 responses were recorded. 9 participants opted out of the survey. 69% of participants rated their vitamin D knowledge as fair to good. 68% of participants have been in practice over ten years and represented most US geographic regions fairly equally. Most estimate that over 25% of their practice is vitamin D deficient with about a 50% compliance rate of supplementation. Over 30% of participants feel vitamin D management is mostly the role of the pediatrician, however 64% of participants discuss or check vitamin D levels in their practice for patients with repeat fractures, medical comorbidities, or nonunions most commonly. Conclusion: Survey participants demonstrated a wide variety of responses indicating their understanding of vitamin D testing and supplementation. Although providers estimate a high deficiency rate, many do not routinely check vitamin D. When they do check, there is no standard indication for testing or supplementation and many believe this to be the role of the pediatrician or endocrinologist. More studies are needed to provide a standardized protocol for vitamin D testing/supplementation in the pediatric orthopaedic literature.

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Role of Vitamin D in Autism Spectrum Disorder

Current Pharmaceutical Design ◽

10.2174/1381612825666191122092215 ◽

2020 ◽

Vol 25 (41) ◽

pp. 4357-4367 ◽

Cited By ~ 2

Author(s):

Loai Alzghoul

Keyword(s):

Autism Spectrum Disorder ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Autism Spectrum ◽

Vitamin D Supplementation ◽

Spectrum Disorder ◽

Vitamin D Levels

: Autism spectrum disorder (ASD) is a pervasive developmental disorder with heterogeneous etiology. Vitamin D can function as a fat-soluble vitamin as well as a hormone, and can exert its effect through both genomic and non-genomic mechanisms. In the last decades, several studies have examined the relationship between vitamin D levels and ASD. These studies demonstrated that low vitamin D status in early development has been hypothesized as an environmental risk factor for ASD. Both in vivo and in vitro studies have demonstrated that vitamin D deficiency in early life can alter brain development, dysregulates neurotransmitter balance in the brain, decreases body and brain antioxidant ability, and alters the immune system in ways that resemble pathological features commonly seen in ASD. In this review, we focused on the association between vitamin D and ASD. In addition, the above-mentioned mechanisms of action that link vitamin D deficiency with ASD were also discussed. Finally, clinical trials of vitamin D supplementation treatment of ASD have also been discussed.

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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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Role of Vitamin D in Reducing the Frequency of Asthma Attacks in Patients with Frequent Exacerbation of Asthma

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i53b33675 ◽

2021 ◽

pp. 11-16

Author(s):

Mubeen Ahmed Memon ◽

Sheeba Faryal Ansari ◽

Mumtaz Ali Lakho ◽

Mukhtiar Hussain Jaffery ◽

Syed Zulfiquar Ali Shah ◽

...

Keyword(s):

Vitamin D ◽

Corticosteroid Treatment ◽

Vitamin D Supplementation ◽

The Body ◽

P Value ◽

Care Hospital ◽

Asthma Exacerbations ◽

Vitamin D Levels ◽

Interventional Group

Introduction: Vitamin D deficiency is common among asthmatics with literature suggesting that its low levels in the body may trigger exacerbations and decrease the response to corticosteroid treatment. It has also shown to inhibit the production of cytokines, which in turn enhances the body’s response to corticosteroid treatment during an exacerbation. Therefore, maintenance of adequate levels of vitamin D in patients with asthma may reduce the risk of exacerbation and improve their general health. This study aims to explore the role of vitamin D supplementation in preventing asthma exacerbations. Methods: This single blind parallel arm interventional study was conducted in the pulmonology ward in a tertiary care hospital from June 2018 to April 2020. Two hundred (n= 200) participants with a history of frequent acute exacerbation of asthma were enrolled in the study via consecutive convenient non-probability technique. Participants were divided into two groups; the placebo and the interventional group that received 200,000 IU of vitamin D capsule. Results: Compared to day 0, mean episodes of exacerbation in the interventional group were significantly lower after 180 days (1.1 ± 0.4 vs. 0.61 ± 0.3; p-value <0.0001). Similarly, number of asthma attacks in past 7 days was significantly lower in intervention group after 180 days (4.4 ± 2.7 vs. 3.1 ± 1.5; p-value 0.0001) Conclusion: Vitamin D supplementation is a safe and cost-friendly approach to reducing asthma exacerbations. It may also help to improve the condition in severe asthmatics with low vitamin D levels.

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Assessment of vitamin D among Sudanese Patients with Hypothyroidism

10.30574/ijbpsa.2021.1.2.0024 ◽

2021 ◽

Vol 1 (2) ◽

pp. 057-061

Author(s):

Hasna Osman Fadalla Mohamed ◽

Omer Fadol Edris ◽

Gad Allah Modawe ◽

Suhair Abdelrahman Ahmed

Keyword(s):

Vitamin D ◽

Autoimmune Diseases ◽

Vitamin D Deficiency ◽

Vitamin D Supplementation ◽

Control Hospital ◽

Study Population ◽

Thyroid Profile ◽

Methods Analytical ◽

The Relationship

Background: Vitamin D deficiency is a worldwide health issue and its role as an immune modulator has recently been emphasized. Evidence increasingly indicates the important role of vitamin D in reducing the incidence of autoimmune diseases. However, at this time the search for its role in autoimmune diseases and thyroid is not critical. Objectives: The study aimed to assess the relationship between vitamin D deficiency in Sudanese patients with hypothyroidism. Methods: Analytical case control hospital based study, conducted in Fadil Hospital and Police Hospital, Khartoum city, Khartoum state. The study carried out from March 2018 to September 2018. A total of 100 subjects were enrolled in the study. Vitamin D deficiency was set at levels below 20 ng / ml. Thyroid hormones (TSH, T3 and T4) were assessed in all participants using auto analyzer TOSOH AIA 313,while vitamin D was estimated using ELIZA. The data were analyzed using SPSS version (21). Results: The study included 76(76%) females and 24(24%) males, no significance differences between thyroid profile among study population.75 (75%) deficiency of vitamin D and 25(25%) normal vitamin D. vitamin D deficiency was significantly lower in female than male with( p =0.001). Conclusion: The results indicated that patients with hypothyroidism suffer from vitamin D deficiency significantly associated with the degree and severity of hypothyroidism. This encourages the desirability of vitamin D supplementation and recommends the detection of vitamin D deficiency for all hypothyroidism patients.

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P–662 Study on D-vitamin, AMH and insulin interrelation in Polycystic Ovary Syndrome (PCOS) patients

Human Reproduction ◽

10.1093/humrep/deab130.661 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

A Coc. Lizarraga ◽

S Lindenberg ◽

G Juu. Almind ◽

F Lindenberg

Keyword(s):

Insulin Resistance ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Serum Vitamin ◽

Serum Vitamin D ◽

Vitamin D Levels ◽

Group A ◽

D Values ◽

Group B

Abstract Study question Is vitamin D deficiency more prevalent in PCOS patients? Is there a link between vitamin D levels and metabolic status in PCOS subjects? Summary answer An inverse relationship between vitamin D levels and metabolic status was demonstrated and it is thought to be responsible of its pathogenesis. What is known already PCOS is a multifactorial condition, characterised by failure in oogenesis and anovulation. Obesity is a common condition linked to its clinical features and studies have reported inverse associations between BMI and severity of the condition. Furthermore, 67–85% of PCOS patients have vitamin D deficiency. Low levels of vitamin D have been found to be closely related to insulin resistance, obesity, or hyperandrogenism and there is a significant association between serum vitamin D levels and reproductive function. Other factors such as AMH have also been described as possibly involved in the pathophysiology. Study design, size, duration We performed a retrospective, analytical and observational study in the Copenhagen Fertility Center. Patients referred with cycle abnormalities, hirsutism, and infertility were evaluated. A total of 778 women were enrolled consecutively from January 2019 to October 2020. Subjects who had major medical disorders were excluded. We selected those in which vitamin D was measured in the baseline analysis selecting a total of 396 patients. The further analysis has been carried out from 100 randomly selected patients. Participants/materials, setting, methods Blood samples were drawn after overnight fasting. They were all assayed in the same laboratory. Biochemical parameters were analyzed using descriptive statistics. Same parameters were studied after dividing into vitamin D deficiency group or optimal levels using a multiple t-test. Correlation between variables was determined. Graphpad Prism program version 8 was used to perform the calculations. The level of statistical significance was set at P-value < 0.05. Main results and the role of chance A total of 100 subjects fulfilling the inclusion criteria were selected randomly from 396 PCOS women. Serum vitamin D concentrations were highly variable ranging from 16 nmol/L to 175 nmol/L. The prevalence of vitamin D deficiency was 24% and 41% of the subjects were classified as vitamin D insufficient. Only 35% of our patients had optimal vitamin D values. We compared data between the group with optimal values of vitamin D (Group A) versus the group with insufficient/deficient vitamin D values (Group B). We found statistical difference between groups in PTH values, being notably higher in group B compared with group A. Despite no statistically significant difference was obtained, it is important to highlight that the mean of SHBG was lower in group B and the mean of androstenedione, AMH, FAI and HOMA-IR were much higher in this group as well. Following the HOMA-IR criteria, 55% of patients had insulin resistance. Specifically, 26% had moderate insulin resistance and 29% severe insulin resistance. Levels of vitamin D were negatively correlated with FAI, AMH and HOMA-IR and positively correlated with HDL-Cholesterol and SHBG. Statistically significant differences were evidenced in the correlation between vitamin D and FAI and SHBG. Limitations, reasons for caution This is a retrospective observational study on a consecutive admitted patient group with a lack of a control group. Another limitation is the small sample size. It is difficult to generalize with other degrees of severity. We didn’t assess seasonal variability or if they were taking any vitamin D supplementation. Wider implications of the findings: Properly randomized clinical trials are mandatory to achieve more conclusive results about the role of vitamin D. Available evidence is promising but not sufficient to draw final conclusions. The aim is to better understand the pathophysiology of the condition and the factors involved and to find new target treatments. Trial registration number 1

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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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0809 A Randomized Double-blind, Placebo Controlled Trial With Cross-over, To Assess The Efficacy Of Correcting Vitamin D Deficiency In Improving The Symptoms Of Restless Legs Syndrome (RLS)

SLEEP ◽

10.1093/sleep/zsaa056.805 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A307-A308

Author(s):

J Wong ◽

D Gupta ◽

A Nadhim ◽

S Bhat ◽

P Polos

Keyword(s):

Vitamin D ◽

Iron Deficiency ◽

Vitamin D Deficiency ◽

Controlled Trial ◽

Activity Count ◽

Double Blind ◽

Vitamin D Levels ◽

Effect Of Treatment ◽

B Vitamin

Abstract Introduction Recent studies have shown an association of low Vitamin D levels and severity of RLS symptoms. However, effect of treatment of Vit D deficiency on RLS symptoms was not reported, nor were other exacerbating factors for RLS such as iron deficiency or OSA addressed in prior studies, but have been addressed in our study. Methods This is an ongoing study at the JFKMC Sleep Clinic. Eligible Patients with RLS include those with vitamin D 25,hydroxy deficiency (<20 ng/ml), or insufficiency (<30 ng/ml). Such patients will be enrolled in the study after comorbid conditions like iron deficiency and OSA have been adequately corrected. Randomization of the patients will be done by the JFK pharmacy so the patient and provider are blinded to the substance. Substance A or B could be either Vitamin D3 Capsule 50,000 IU, or placebo. Each patient takes A for 6 weeks and then crosses over to B for 6 weeks. Weekly iRLS questionnaires will be collected. Actiwatch Device, to assess activity count per minute, will be worn on the ankle at night for one week time periods: at baseline, at end of 6 weeks of taking A and then at the end of 6 weeks of taking B. Vitamin D levels will also be assessed after each course of supplementation and correlated with subjective and objective findings. Results Between July 7, 2019 to current, 50 consecutive patients seen in sleep clinic with RLS were assessed for vitamin D levels. Ages ranged from 23-86 years. 27 patients were female (54%). Two patients met inclusion criteria and have started their 13-week study. Conclusion This study will help to establish the role of Vitamin D deficiency as a risk factor for RLS, independent of ferritin levels, and comorbid OSA, in affected individuals. This may help to discover a potentially treatable form of RLS. Support No financial support.

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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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