Association of serum 25(OH)Vit-D levels with risk of pediatric fractures: a systematic review and meta-analysis

Yang, Guozi; Lee, Wayne; Hung, Alec Lik-Hang; Tang, May; Li, X.; Kong, Alice Pik‐Shan; Leung, Ting Fan; Yung, Patrick Shu‐Hang; To, Kenneth K.W.; Cheng, Jack; Lam, Tsz Ping

doi:10.1007/s00198-020-05814-1

Cited by 18 publications

(20 citation statements)

References 53 publications

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“…However, in the same study, children with lower vitamin D levels were at a higher risk of developing more severe fractures. In addition, a recent systematic review and meta-analysis that included 17 case-control and 6 cross-sectional studies (2929 fracture cases and 5000 controls) demonstrated that serum 25(OH) D ≤ 50 nmol/L (or 20 ng/mL) was associated with increased fracture risk in children [ 25 ]. In the present study, our patient group showed a high prevalence of vitamin D deficiency (<20 ng/mL) in children with fractures compared to the controls (53.0% vs. 32.9%).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Vitamin D Deficiency in Children with Fractures: Before and during the COVID-19 Outbreak

Lee

Hong

et al. 2022

International Journal of Clinical Practice

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Background. Although it is generally agreed that vitamin D is important for bone health, the role of vitamin D in preventing fractures in children and adolescents remains unclear. Therefore, this study aimed to investigate the prevalence of vitamin D deficiency and insufficiency in healthy Korean children with fractures. Our secondary aim was to compare serum vitamin D levels before and during the coronavirus disease 2019 (COVID-19) outbreak. Methods. We evaluated 334 patients with fractures who were surgically treated at our institution between 2018 and 2019 before the onset of COVID-19 (group I). In addition, we collected data on the serum 25(OH)D levels of 210 patients who visited our pediatric department for evaluation of short stature (group II) and the serum 25(OH)D levels of the patients with fractures during the COVID-19 pandemic period (group III). A serum 25(OH)D level of <20 ng/mL was considered deficient, between 20 and 32 ng/mL was insufficient, and ≥32 ng/mL was considered sufficient. Results. The mean age was 8.1 ± 3.5 years in group I, 8.2 ± 3.7 years in group II, and 8.6 ± 3.5 years in group III. The prevalence of vitamin D deficiency was 53.0% in group I and 32.9% in group II. The mean serum 25(OH)D level was lower in group I than in group II (20.0 ± 7.3 ng/ml vs. 23.2 ± 6.9 ng/ml, p < 0.001 ). The mean serum 25(OH)D level of younger patients (<10 years) in group III was lower than that of the younger patients in the prepandemic period (21.4 ± 7.2 ng/mL vs. 19.2 ± 6.8 ng/mL, p = 0.037 ). Conclusions. We observed a high prevalence of vitamin D deficiency/insufficiency in children with fractures who required surgical treatment. During the COVID-19 pandemic, the serum vitamin D levels became even lower, especially in younger children.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Vitamin D Deficiency in Children with Fractures: Before and during the COVID-19 Outbreak

Lee

Hong

et al. 2022

International Journal of Clinical Practice

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“…20 In spite of its role in calcium homeostasis and the known link between 25(OH)D deficiency and rickets, the association between 25(OH)D deficiency and fracture risk has not been fully established. 4,[21][22][23][24][25][26][27][28][29][30] Some studies have examined the high prevalence of 25(OH)D deficiency among children with fractures, and a few of them compared children with fractures to "non-fractured" control subjects. 20,31 A recent meta-analysis by Yang et al 24 found an association between 25(OH)D insufficiency and a higher risk for fractures in children while other studies reported no association between vitamin D deficiency and fractures in children and adolescents.…”

Section: Discussionmentioning

confidence: 99%

“…4,[21][22][23][24][25][26][27][28][29][30] Some studies have examined the high prevalence of 25(OH)D deficiency among children with fractures, and a few of them compared children with fractures to "non-fractured" control subjects. 20,31 A recent meta-analysis by Yang et al 24 found an association between 25(OH)D insufficiency and a higher risk for fractures in children while other studies reported no association between vitamin D deficiency and fractures in children and adolescents. 26,27 In some of the studies, the differences were subtle and only detected through complex multivariable analyses.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Hypovitaminosis D and Fractures Among Adolescents With Overweight or Obesity

Segal

Ziv

Meisman

et al. 2022

Clin Pediatr (Phila)

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Adolescents with overweight/obesity are at risk for vitamin D insufficiency and deficiency. Both overweight/obesity and vitamin D insufficiency/deficiency may predispose to fractures. We enrolled 103 participants (53.3% females, 15.9 ± 2.2 years) in a retrospective case-control study to determine whether an association exists between fractures and a low 25-hydroxyvitamin D (25[OH]D) among adolescents whose body mass index (BMI) ≥ 85 percentile. Cases (n = 28) sustaining a low/medium impact fracture were matched to controls (n = 75) without a fracture history. A conditional-logistic regression analysis addressing the common vitamin D insufficiency/deficiency cutoffs was used. Overweight, obesity, and significant obesity rates were 10.7%, 53.4%, and 35.9%, respectively. Mean (±SD) 25(OH)D was 16.5 ± 6.4 ng/mL. In all, 25(OH)D insufficiency rates (level <20 ng/mL) were 70.5%. Matched cases and controls had similar 25(OH)D insufficiency/deficiency rates ( P > .05). Controlling for race and seasonality showed no association between fractures and 25(OH)D insufficiency/deficiency ( P > .05). These data suggest that fractures are not associated with low 25(OH)D levels among adolescents whose BMI ≥ 85th percentile.

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“…After endogenous synthesis or intestinal absorption, cholecalciferol (vitamin D 3 ) is firstly metabolized in the liver by 25-hydroxylases producing 25-hydroxyvitamin D 3 (25(OH)D 3 ), which is used as a clinical biomarker for assessing vitamin D status [5] , [6] , [7] , [8] . It is generally agreed that a lower level 25(OH)D 3 is associated with an increased risk of fractures [7] , [9] , [10] . Then, 25(OH)D 3 is converted, primarily by the kidney, to its the most active form, 1α,25(OH) 2 D 3 , which is the ligand of the vitamin D receptor in target tissues [11] .…”

Section: Introductionmentioning

confidence: 99%

Simultaneous determination of vitamin D metabolites 25(OH)D3 and 1α,25(OH)2D3 in human plasma using liquid chromatography tandem mass spectrometry

Ni²,

Lv³

et al. 2022

Journal of Mass Spectrometry and Advances in the Clinical Lab

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Association of serum 25(OH)Vit-D levels with risk of pediatric fractures: a systematic review and meta-analysis

Cited by 18 publications

References 53 publications

Prevalence of Vitamin D Deficiency in Children with Fractures: Before and during the COVID-19 Outbreak

Prevalence of Vitamin D Deficiency in Children with Fractures: Before and during the COVID-19 Outbreak

Relationship Between Hypovitaminosis D and Fractures Among Adolescents With Overweight or Obesity

Simultaneous determination of vitamin D metabolites 25(OH)D3 and 1α,25(OH)2D3 in human plasma using liquid chromatography tandem mass spectrometry

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