scholarly journals 25-hydroxyvitamin D and health service utilization for asthma in early childhood

Author(s):  
Jessica Omand ◽  
Teresa To ◽  
Deborah O'Connor ◽  
Patricia Parkin ◽  
Catherine Birken ◽  
...  

IntroductionAsthma is the most common chronic illness of childhood and a common reason for hospital admission. Studies suggest that low vitamin D levels may be associated with health service utilization (HSU) for childhood asthma. Objectives and ApproachThe primary objective was to determine if vitamin D serum levels in early childhood were associated with HSU for asthma including: a) total HSU, b) hospital admissions, c) emergency department visits and d) outpatient sick visits. Secondary objectives were to determine whether vitamin D supplementation in pregnancy or childhood were associated with HSU for asthma. Prospective cohort study of children participating in the TARGet Kids! practice based research network. HSU was determined by linking each child's provincial health insurance number to health administrative databases. Multivariable quasi Poisson and logistic regression were used to evaluate the associations. Results2926 healthy children ages 0-6 years had 25-hydroxyvitamin D data available and were included in the primary analysis. Mean (IQR) 25-hydroxyvitmain D level was 84 nmol/L (65-98 nmol/L), 218 and 1267 children had 25-hydroxyvitamin D levels <50 nmol/L and <75 nmol/L, respectively. In the adjusted models, there were no associations between 25-hydroxyvitamin D (continuously or dichotomized at 50 and 75 nmol/L), vitamin D supplementation in pregnancy or childhood and HSU for asthma. Conclusion/ImplicationsHigher vitamin D blood values do not appear to be associated with HSU for asthma in this population of healthy urban children.

2017 ◽  
Vol 20 (10) ◽  
pp. 1816-1824 ◽  
Author(s):  
Jessica A Omand ◽  
Teresa To ◽  
Deborah L O’Connor ◽  
Patricia C Parkin ◽  
Catherine S Birken ◽  
...  

AbstractObjectiveUpper respiratory tract infections (URTI) are the most common and costly condition of childhood. Low vitamin D levels have been hypothesized as a risk factor for URTI. The primary objective was to determine if serum vitamin D levels were associated with health-service utilization (HSU) for URTI including hospital admission, emergency department visits and outpatient sick visits. The secondary objectives were to determine whether oral vitamin D supplementation in pregnancy or childhood was associated with HSU for URTI.DesignCohort study. HSU was determined by linking each child’s provincial health insurance number to health administrative databases. Multivariable quasi Poisson regression was used to evaluate the association between 25-hydroxyvitamin D, vitamin D supplementation and HSU for URTI.SettingToronto, Canada.SubjectsChildren participating in the TARGet Kids! network between 2008 and 2013.ResultsHealthy children aged 0–5 years (n 4962) were included; 52 % were male and mean 25-hydroxyvitamin D was 84 nmol/l (range 11–355 nmol/l). There were 105 (2 %), 721 (15 %) and 3218 (65 %) children with at least one hospital admission, emergency department visit or outpatient sick visit for URTI, respectively. There were no statistically significant associations between 25-hydroxyvitamin D or vitamin D supplementation and HSU for URTI.ConclusionsA clinically meaningful association between vitamin D (continuously and dichotomized at <50 and <75 nmol/l) and HSU for URTI was not identified. While vitamin D may have other benefits for health, reducing HSU for URTI does not appear to be one of them.


2018 ◽  
Vol 53 (8) ◽  
pp. 1018-1026 ◽  
Author(s):  
Jessica A. Omand ◽  
Teresa To ◽  
Deborah L. O'Connor ◽  
Patricia C. Parkin ◽  
Catherine S. Birken ◽  
...  

2015 ◽  
Vol 6 (4) ◽  
pp. 308-316 ◽  
Author(s):  
L. N. Anderson ◽  
Y. Chen ◽  
J. A. Omand ◽  
C. S. Birken ◽  
P. C. Parkin ◽  
...  

The association between vitamin D and wheezing in early childhood is unclear. The primary objective of this study was to evaluate the association between vitamin D exposure, during both pregnancy and childhood, and early childhood wheezing. Secondary objectives were to evaluate the associations between vitamin D exposures and asthma and wheezing severity. We conducted a cohort study of children (0–5 years) recruited from 2008 to 2013 through the TARGet Kids! primary-care research network. Vitamin D exposures included maternal vitamin D supplement use during pregnancy, child vitamin D supplementation and children’s 25-hydroxyvitamin D (25(OH)D) concentrations. The outcomes measured were parent-reported childhood wheezing, diagnosed asthma and wheezing severity. Vitamin D supplement and wheezing data were available for 2478 children, and blood samples were available for 1275 children. Adjusted odds ratios (aOR) were estimated using logistic regression adjusted for age, sex, ethnicity, body mass index, birth weight, outdoor play, breastfeeding duration, daycare status, parental smoking and family history of asthma. Vitamin D supplementation during pregnancy was associated with lower odds of childhood wheezing (aOR=0.65; 95% CI: 0.46–0.93). In early childhood, neither 25(OH)D (aOR per 10 nmol/l=1.01; 95% CI: 0.96–1.06) nor vitamin D supplementation (aOR=1.00; 95% CI: 0.81–1.23) was associated with wheezing. No significant associations were observed with diagnosed asthma or wheezing severity. Vitamin D supplementation during pregnancy was associated with reduced odds of wheezing, but child vitamin D supplementation and childhood 25(OH)D were not associated with reduced wheezing. The timing of exposure may be important in understanding the association between vitamin D and childhood wheezing.


2013 ◽  
Vol 17 (7) ◽  
pp. 1547-1554 ◽  
Author(s):  
Jessica A Omand ◽  
Pauline B Darling ◽  
Patricia C Parkin ◽  
Catherine S Birken ◽  
Marina Khovratovich ◽  
...  

AbstractObjectiveTo determine if children aged 1–6 years from non-Western immigrant families have lower serum 25-hydroxyvitamin D (25(OH)D) levels than children from Western-born families and examine which factors influence this relationship.DesignCross-sectional study.SettingToronto, Canada.SubjectsHealthy children (n1540) recruited through the TARGet Kids! practice-based research network. Serum 25(OH)D concentrations of non-Western immigrants were compared with those of children from Western-born families. Children from non-Western immigrant families were defined as those born, or their parents were born, outside a Western country. Univariate and multiple linear regression analyses were used to identify factors which might influence this relationship.ResultsMedian age was 36 months, 51 % were male, 86 % had ‘light’ skin pigmentation, 55 % took vitamin D supplements, mean cow's milk intake was 1·8 cups/d and 27 % were non-Western immigrants. Median serum 25(OH)D concentration was 83 nmol/l, with 5 % having 25(OH)D < 50 nmol/l. Univariable analysis revealed that non-Western immigrant children had serum 25(OH)D lower by 4 (95 % CI 1·3, 8·0) nmol/l (P= 0·006) and increased odds of 25(OH)D < 50 nmol/l (OR = 1·9; 95 % CI 1·3, 2·9). After adjustment for known vitamin D determinants the observed difference attenuated to 0·04 (95 % CI −4·8, 4·8) nmol/l (P= 0·99), with higher cow's milk intake (P< 0·0001), vitamin D supplementation (P< 0·0001), summer season (P= 0·008) and increased age (P= 0·04) being statistically significant covariates. Vitamin D supplementation was the strongest explanatory factor of the observed difference.ConclusionsThere is an association between non-Western immigration and lower 25(OH)D in early childhood. This difference appears related to known vitamin D determinants, primarily vitamin D supplementation, representing opportunities for intervention.


2021 ◽  
pp. 1-7
Author(s):  
Naomi Vather-Wu ◽  
Matthew D. Krasowski ◽  
Katherine D. Mathews ◽  
Amal Shibli-Rahhal

Background: Expert guidelines recommend annual monitoring of 25-hydroxyvitamin D (25-OHD) and maintaining 25-OHD ≥30 ng/ml in patients with dystrophinopathies. Objective: We hypothesized that 25-OHD remains stable and requires less frequent monitoring in patients taking stable maintenance doses of vitamin D. Methods: We performed a retrospective cohort study, using the electronic health record to identify 26 patients with dystrophinopathies with a baseline 25-OHD ≥30 ng/mL and at least one additional 25-OHD measurement. These patients had received a stable dose of vitamin D for ≥3 months prior to their baseline 25-OHD measurement and throughout follow-up. The main outcome measured was the mean duration time the subjects spent with a 25-OHD ≥30 ng/mL. Results: Only 19% of patients dropped their 25-OHD to <  30 ng/ml, with a mean time to drop of 33 months and a median nadir 25-OHD of 28 ng/mL. Conclusions: These results suggest that measurement of 25-OHD every 2–2.5 years may be sufficient in patients with a baseline 25-OHD ≥30 ng/mL and who are on a stable maintenance dose of vitamin D. Other patients may require more frequent assessments.


Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2443
Author(s):  
Wojciech Stefan Zgliczyński ◽  
Olga Maria Rostkowska ◽  
Beata Sarecka-Hujar

Background Vitamin D deficiency occurs in as much as 90–95% of the Polish population, although this condition is known to cause negative long-term health implications. The role of medical doctors in advising proper supplementation, monitoring and correcting the levels of 25-hydroxyvitamin D in individuals is of great importance and should be used to help mitigate its common deficits. The aim of this study was to evaluate knowledge, attitudes and practices of Polish physicians regarding vitamin D supplementation in order to identify areas for improvement and determinants for the knowledge gaps. Methods The study group comprised 701 medical doctors aged 32.1 ± 5.3 years on average, mostly women (71.61%). An original survey questionnaire was developed for the purpose of the study. Results The mean vitamin D knowledge score was 6.8 ± 2.3 (in a scale 0–13) and was related to gender (p < 0.001), type of specialization (p = 0.032), D3 supplements use (p < 0.001), recommending supplementation to patients (p = 0.005), to relatives and friends (p < 0.001) and to healthy adults (p < 0.001). In terms of self-administration, 14% of respondents take vitamin D all-year-round while 24% only in autumn and winter. 25% of respondents monitor their vitamin D (25-hydroxyvitamin D) serum concentration. Most participants (61%) did not recommend supplementing vitamin D to their patients on a regular basis. Conclusions The study indicates that medical doctors in Poland need to have more training and education on vitamin D supplementation in order to better address the problem of its deficits in the population.


2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Naowanit Nata ◽  
Jessada Kanchanasinitth ◽  
Pamila Tasanavipas ◽  
Ouppatham Supasyndh ◽  
Bancha Satirapoj

Background. Vitamin D deficiency is a common problem among patients on continuous ambulatory peritoneal dialysis (CAPD). Vitamin D supplementation leads to reduced serum parathyroid hormone levels and improved cardiovascular markers. Different doses and time intervals of oral vitamin D supplementation may differ in each patient on dialysis. The study aimed to evaluate the efficacy of weekly split and single dose of ergocalciferol at 60,000 IU on serum 25-hydroxyvitamin D (25(OH)D) among patients on CAPD. Methods. A randomized study was conducted among patients on CAPD with vitamin D deficiency or insufficiency (25(OH)D < 30 ng/mL). Patients were randomly assigned to two groups: the split dose group was given ergocalciferol 20,000 IU three times weekly and the single dose group was given ergocalciferol 60,000 IU once weekly for 8 weeks. Main outcomes measured serum 25(OH)D concentrations, serum calcium, serum phosphate, and intact parathyroid levels at 8 weeks after being enrolled. Results. Of 128 screened patients, 50 met the criteria for eligibility and were randomized. At 8 weeks after treatment, mean serum 25(OH)D concentrations significantly increased from baseline 22.7 ± 5.9 to 29.5 ± 9.5 ng/mL P = 0.004 in the split dose group and 22.9 ± 5.3 to 31.2 ± 12.3 ng/mL P = 0.003 in the single dose group. No significant change was found in increase of serum 25(OH)D between the two groups P = 0.561 . At the end of study, a similar proportion of patients in both groups reached the desirable serum concentration of 25(OH)D ≥ 30 ng/mL (60% in the single group vs. 40% in the split group, P = 0.258 ). No significant cases of hypercalcemia, hyperphosphatemia, or serious adverse events occurred during the study. Conclusion. Weekly single and split doses of ergocalciferol 60,000 IU achieved similar effects on serum 25(OH)D levels among patients on CAPD with vitamin D insufficiency or deficiency, suggesting that weekly single dose would be prescribed for adequate vitamin D repletion. This trial is registered with TCTR20200821005.


2015 ◽  
Vol 18 (02) ◽  
pp. 1550008 ◽  
Author(s):  
Negin Masoudi Alavi ◽  
Mahla Madani ◽  
Mohsen Taghizadeh ◽  
Mohammad Reza Sharif

Purpose: To investigate the effect of weekly single high dose vitamin D supplementation on serum 25-hydroxyvitamin D [25(OH)D], and non-specific musculoskeletal pain in female nurses. Methods: In this prospective study in Kashan/Iran, from April 1, 2014, through September 30, 2014, the 150 nurses with vitamin D deficiency received the weekly pearls of 50,000 units of vitamin D3 for 10 weeks. The serum level of 25(OH)D was measured before and after supplement therapy. The subjects were also asked to complete the Extended Nordic Musculoskeletal Questionnaire. All analyses were conducted with SPSS version 16. Results: After 10 weeks of intervention there was [Formula: see text][Formula: see text]ng/mL increase in 25(OH)D. The 82 nurses (54.7%) had 25(OH)D in normal range, while the 68 nurses (45.3%) were still vitamin D deficient. Weight could explain 15.4% increase in 25(OH)D. Before intervention 135 (90%), of nurses reported musculoskeletal pain in at least one region, after intervention this number decreased to 72.7%. There was a statistically significant improvement in musculoskeletal pain in neck, shoulders, upper back, lower back, hips/tights, knees, and ankles/feet after intervention. Conclusions: The weekly single high dose of vitamin D for 10 weeks could resolve vitamin D deficiency in about half of the patients. Patients with non-specific musculoskeletal pain might benefit from vitamin D supplementation.


2013 ◽  
Vol 53 (2) ◽  
pp. 367-374 ◽  
Author(s):  
Armin Zittermann ◽  
Jana B. Ernst ◽  
Jan F. Gummert ◽  
Jochen Börgermann

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