Prospective study of vitamin D supplementation and rickets in China

Specker, Bonny; Ho, Mona; Oestreich, Alan E.; Yin, Tai-an; Shui, Qing-mei; Chen, Xue-Cun; Tsang, Reginald C.

doi:10.1016/s0022-3476(05)80236-7

Cited by 135 publications

(81 citation statements)

References 13 publications

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“…Earlier studies have shown seasonal variations in serum 25-hydroxyvitamin D (25-OHD; the major vitamin D metabolite in blood) concentrations in both pregnant women and their newborn infants, with low values in winter (Kuroda et al 1981;Verity et al 1981). Severe vitamin D deficiency in pregnancy can lead to intrauterine growth retardation (Brooke et al 1980), adverse effects on the appearance of neonatal ossification centres (Specker et al 1992) and congenital rickets (Moncrieff & Fadahunsi, 1974), confirming the potential impact of maternal vitamin D deficiency on fetal bone development.…”

Section: Seasonmentioning

confidence: 95%

Factors affecting newborn bone mineral content:in uteroeffects on newborn bone mineralization

Namgung

Tsang

2000

Proc. Nutr. Soc.

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55Abbreviations: AGA, appropriate-for-gestational age; BMC, bone mineral content; BMD, bone mineral density; ICTP, cross-linked carboxy-terminal telopeptide of type I collagen; IDM, infants of diabetic mothers; 1, Recently, we found evidence of decreased bone formation rates in infants who were small-for-gestational age (SGA) compared with infants who were appropriate-forgestational age; we reported reduced BMC, cord serum osteocalcin (a marker of bone formation) and 1,25-dihydroxyvitamin D (the active metabolite of vitamin D), but no alterations in indices of fetal bone collagen metabolism. In theory, reduced utero-placental blood flow in SGA infants may result in reduced transplacental mineral supply and reduced fetal bone formation. Infants of diabetic mothers (IDM) have low BMC at birth, and infant BMC correlated inversely with poor control of diabetes in the mother, specifically first trimester maternal mean capillary blood glucose concentration, implying that factors early in pregnancy might have an effect on fetal BMC. The low BMC in IDM may be related to the decreased transplacental mineral transfer. Cord serum ICTP concentrations were higher in IDM than in control subjects, implying increased intrauterine bone resorption. BMC is consistently increased with increasing body weight and length in infants. Race and gender differences in BMC appear in early life, but not at birth. Ethanol consumption and smoking by the mother during pregnancy affect fetal skeletal development.

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Section: Seasonmentioning

confidence: 95%

Factors affecting newborn bone mineral content:in uteroeffects on newborn bone mineralization

Namgung

Tsang

2000

Proc. Nutr. Soc.

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“…An intake of 100 IU is thought adequate to protect against rickets. (10,11) Serum 25(OH)D levels <27.5 nM are associated with vitamin D deficiency, which can lead to reduction in bone length and bone mass. (11) Vitamin D deficiency rickets has recently reappeared in temperate zones, associated with prolonged breast feeding by vitamin D-deficient mothers and lack of vitamin D supplementation.…”

Section: Vitamin D Requirementsmentioning

confidence: 99%

Vitamin D, Calcium Homeostasis, and Skeleton Accretion in Children

Weaver

2007

Journal of Bone and Mineral Research

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Overt vitamin D deficiency early in life has classically been associated with the etiology of rickets. Recent interest has focused on vitamin D insufficiency and calcium homeostasis and bone health. A review of the literature suggests that the relationship between vitamin D status and calcium utilization has some important differences with life stage and race. In contrast to adults, serum 1,25-dihydroxyvitamin D, but not serum 25-hydroxyvitamin D, predicts calcium absorption in growing children. PTH suppression with increasing serum 25-hydroxyvitamin D varies with race in adolescents. A limitation of our understanding of vitamin D status on calcium homeostasis in children relates to the cross-sectional nature of the evidence and interventions that typically use too little vitamin D supplementation to affect status. Vitamin D status has predicted changes in BMD during growth, and higher doses have been associated with increased bone area and BMC of the hip in pubertal girls with low baseline vitamin D status. Bone accretion is related to calcium status, sexual maturity, race, and genetics. Current cross-sectional studies in children suggest that vitamin D status is less important for bone accrual than for bone health in adults. Intervention studies are needed to identify responsive groups.

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“…In addition, low serum vitamin D levels are associated with a higher fracture risk in elderly people [3]. Furthermore, vitamin D deficiency is common in healthy children at a variety of different latitudes [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] and in children with type 1 diabetes mellitus (T1D), in whom the highly variable prevalence ranges between 15-65% at the end of winter [19][20][21].…”

Section: Introductionmentioning

confidence: 99%

“…The American Academy of Pediatrics (AAP) has defined vitamin deficiency as serum 25D below 27.5 nmol/L [22]. In infants and children, however, rickets is already seen at 25D levels below 37.5 nmol/L [8,23]. In adolescents 25D levels below 40 nmol/L are associated with unphysiologically high intact parathyroid hormone (iPTH) levels and low mean forearm bone mineral density [17].…”

Section: Introductionmentioning

confidence: 99%

High prevalence of vitamin D deficiency in children and adolescents with type 1 diabetes

Janner

Flueck

Mullis

2009

Bone

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SummaryBackground: Vitamin D is important for bone health. An inadequate supply of vitamin D to the body is associated with a higher fracture risk in the elderly. Young adults with type 1 diabetes are reported to have a lower peak bone mass than healthy individuals, which could possibly lead to an increased fracture risk in the future. The prevalence of vitamin D deficiency in healthy young people is high. Thus, optimal supply of vitamin D may be of particular importance for bone health in children with type 1 diabetes.Methods: In this prospective cross-sectional study we measured serum 25-hydroxy-vitamin D, iPTH, total and ionised calcium, phosphate, and alkaline phosphatase in 129 Swiss children and adolescents with type 1 diabetes.Results: Of the 129 subjects 78 (60.5%) were vitamin D deficient, defined as a 25-hydroxy-vitamin-D level below 50 nmol/L. During the winter this number rose to 84.1%. 25-hydroxy-vitamin-D levels showed marked seasonal fluctuations, whereas there was no correlation with diabetes control. Despite the high prevalence of vitamin D deficiency, we found a low prevalence of secondary hyperparathyroidism in vitamin D deficient diabetic children and adolescents.Conclusions: Prevalence of vitamin D deficiency in diabetic children and adolescents is high. Therefore, screening for vitamin D deficiency and supplementation in children with low vitamin D levels may be considered.

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Prospective study of vitamin D supplementation and rickets in China

Cited by 135 publications

References 13 publications

Factors affecting newborn bone mineral content:in uteroeffects on newborn bone mineralization

Factors affecting newborn bone mineral content:in uteroeffects on newborn bone mineralization

Vitamin D, Calcium Homeostasis, and Skeleton Accretion in Children

High prevalence of vitamin D deficiency in children and adolescents with type 1 diabetes

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