Low Vitamin D Status of Northern Italian Children in Pediatric Primary Care Setting: What to Do?

Mazzoleni, Stefano; Boscardin, Chiara; Toderini, Daniela

doi:10.9734/bjmmr/2014/4370

Cited by 1 publication

(4 citation statements)

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“…In a previous report [9] we have demonstrated that factors consistently associated with a low vitamin D status include non-white skin colour. In our DINOS Study none out of 18 non-white children without vitamin D supplementation had 25-OH-D > 30 ng/ml, in agreement with the literature [8, 12].…”

Section: Discussionmentioning

confidence: 99%

“…25-OH-D levels of groups A and B were compared month to month and quarter to quarter to exclude seasonal effects [6, 9].…”

Section: Methodsmentioning

confidence: 99%

“…Hypovitaminosis D is highly prevalent worldwide in children and adolescents [1–3], as well as in adults [4]. There are several studies on vitamin D status of children living in North Italy [5–13] but only one was an intervention study, using vitamin D3 (cholecalciferol) [11], and one in paediatric primary care setting [9]. In this research severe vitamin D deficiency (25-OH-D < 10 ng/ml) was rare as in other studies [14–17], but subclinical vitamin D deficiency or insufficiency frequently occurred, as previously described in otherwise healthy people [12, 14, 18, 19].…”

Section: Introductionmentioning

confidence: 99%

“…A recent study on Italian children with moderate vitamin D deficiency (25-OH-D 11–20 ng/ml) demonstrated that a dose of 400 IU vitamin D3/day is insufficient to restore adequate 25-OH-D levels [11]. Assuming that most children living in our research area had less or much less than the minimum desirable level of 25-OH-D [9] and considering that for every supplementary 100 IU/day we can expect an increase of 0.5–1.5 ng/ml in the serum level of 25-OH-D [11, 25–32], we considered that the recommended doses of 600–1000 IU/day would offer no benefit to children with 25-OH-D < 10 ng/ml and even < 20 ng/ml. On this theorical basis, given the high probability of having insufficient or deficient children, to reach the minimum desirable level in most children we decided to prescribe our patients > 12 months 1500 IU (= 37.5 microg) vitamin D3/day from November to April.…”

Section: Introductionmentioning

confidence: 99%

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Effect of vitamin D3 seasonal supplementation with 1500 IU/day in north Italian children (DINOS study)

2019

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BackgroundThe appropriate dose of vitamin D supplementation in children is still debated. We calculated that the recommended dose of 600–1000 IU vitamin D3/day is not sufficient to reach a serum 25-hydroxyvitamin D (25-OH-D) level of at least 30 ng/ml (75 nmol/l) in north Italian children > 12 months. The aim of this study was to analyse the effect of seasonal supplementation with 1500 IU (=37.5 μg) vitamin D3/day.MethodsDINOS (D-vitamIN Oral Supplementation) study was a pilot, monocentric, non-random case-control register study. It was conducted in a paediatric primary care setting near Padova (North Italy, 45°N latitude). The data of 203 children (girls:boys 1:1,33) aged 2–15 years, collected between November 2010 and January 2015, were analysed. Active group A (n = 82) were given 1500 IU vitamin D3/day from November to April; control Group B (n = 121) received no supplementation. The serum 25-OH-D test was part of a laboratory tests panel and performed using a chemiluminescence immunoassay method.ResultsSerum 25-OH-D mean level + standard deviation throughout the period was 32 + 13 ng/ml (80 + 32 nmol/l) in group A vs 22 + 10 ng/ml (55 + 25 nmol/l) in group B. In group A 12% had vitamin D deficiency 25-OH-D < 20 ng/ml (50 nmol/l) and 1.2% severe vitamin D deficiency 25-OH-D < 10 ng/ml (25 nmol/l). In group B 46% had vitamin D deficiency and 9% severe deficiency (P < 0.001). In group A mean levels were normal or near-normal all the year except in May. Group B reached mean 25-OH-D levels close to 30 ng/ml (75 nmol/l) only in late summer. The active group mean 25-OH-D level was normal in preschoolers and schoolers but not in adolescents. Non-white children had a three-times vitamin D deficiency probability despite supplementation.ConclusionsVitamin D supplementation with at least 1500 IU vitamin D3/day from November to April was found appropriate for children in North Italy. A prolongation until May could be useful. Higher doses and/or prolonged periods could be more appropriate especially in adolescents and in non-white children.Study registrationDINOS gained the approval of Padova Ethics Committee (n. 3960/U16/2016).Electronic supplementary materialThe online version of this article (10.1186/s13052-018-0590-x) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

“…25-OH-D levels of groups A and B were compared month to month and quarter to quarter to exclude seasonal effects [6, 9].…”

Section: Methodsmentioning

confidence: 99%