Serum Concentrations of Vitamin D Metabolites in Rachitic Libyan Children

Elzouki, Abdelaziz Y.; Markestad, Trond; Elgarrah, Maha; Elhoni, Neama; Aksnes, Lage

doi:10.1097/00005176-198911000-00019

Cited by 30 publications

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“…Several studies have documented changes in vitamin D metabolites during treatment of vitamin D-deficiency rickets. [15][16][17][18]20 In a study of immigrant children Ͻ2 years of age with vitamin D-deficiency rickets in Norway, median 1,25(OH) 2 D values increased threefold from 50 to 153 pg/mL (120-367 pmol/L) after one week of treatment with 1700 to 4000 IU per day of vitamin D. 15 Even before treatment, serum concentrations of 1,25(OH) 2 D in the Nigerian children with calcium deficiency rickets were markedly elevated and similar to the peak values reported during treatment in vitamin D-deficient children. In dietary calcium-deficient children treated with vitamin D, values rose to approximately twice those seen during the treatment of vitamin D deficiency.…”

Section: Discussionmentioning

confidence: 99%

“…12 Vitamin D sufficiency may also be defined as that range of 25(OH)D concentrations that, if increased, does not result in an elevation of 1,25-dihydroxyvitamin D (1,25-(OH) 2 D) concentrations. 13,14 In vitamin D deficiency, administration of vitamin D results in a pronounced rise in the serum 1,25(OH) 2 D concentration [15][16][17][18] with concentrations of 1,25(OH) 2 D directly correlating with 25(OH)D only until 25(OH)D concentrations are in the vitamin D sufficient range.…”

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Early response to vitamin D2 in children with calcium deficiency rickets

Thacher

Fischer

Isichei

et al. 2006

The Journal of Pediatrics

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Early response to vitamin D2 in children with calcium deficiency rickets

Thacher

Fischer

Isichei

et al. 2006

The Journal of Pediatrics

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“…Of these children, 83% were African American, and 96% were breastfed (24). (32)(33)(34)(35)(36)(37). In many of these reports, calcium intake was a potentially confounding factor.…”

Section: -Hydroxyvitamin D Concentrations In Vitamin D Deficiency Rmentioning

confidence: 99%

25-Hydroxyvitamin D: functional outcomes in infants and young children

Greer

2008

The American Journal of Clinical Nutrition

126

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Vitamin D deficiency occurs in the United States in exclusively breastfed infants who have high levels of skin pigmentation, inadequate vitamin D supplementation, and insufficient sunlight exposure. I review serum 25-hydroxyvitamin D [25(OH)D] concentrations and functional outcomes of vitamin deficiency in young children and breastfed and nonbreastfed infants. These outcomes include the presence or absence of vitamin D deficiency rickets, bone mineral content, and serum parathyroid hormone concentration. Daily vitamin D supplements of 400 IU/L keep serum 25(OH)D concentrations higher than 50 nmol/L and prevent rickets in infants and young children. The available evidence is not sufficient to support the use of bone mineral content or parathyroid hormone concentrations in infants and young children as functional outcomes to define deficient or sufficient levels of 25(OH)D. I therefore propose a research agenda to establish the functional definitions of vitamin D sufficiency or deficiency in infants and young children.Am J Clin Nutr 2008;88(suppl):529S-33S. INTRODUCTIONThe typical US diet contains few natural sources of vitamin D other than fatty fish and liver, which are foods not common in the diets of infants younger than 12 mo of age or young children aged 1-5 y. All US formulas for infants contain ͧ400 IU of vitamin D/L. Thus, infants who consume ͧ500 mL of formula per day receive 200 IU/d. The Institute of Medicine (1) considers this level adequate, but this is less than the 400 IU/d that the American Academy of Pediatrics (AAP; 2) and the Canadian Pediatric Society (3) currently recommend for infants and young children. For infants exclusively fed human milk, which has very little vitamin D (Ȃ22 IU/L; 4), the AAP recommends a vitamin D supplement of ͧ400 IU/d, but many breastfed infants in the United States do not take vitamin D supplements (2).The skin naturally produces vitamin D from the reaction of sunlight (ultraviolet B irradiation) with 7-dehydrocholesterol; however, the multitude of variables that affect skin synthesis of vitamin D make it difficult to recommend a specific amount of sunlight exposure for all infants and young children (2). Furthermore, because of the relation of sun exposure to skin cancer, the Centers for Disease Control and Prevention, with the support of many organizations (including the AAP, the American Academy of Dermatology, and the American Cancer Society), has launched a campaign to increase public awareness about sunlight exposure and the risks of various skin cancers (5). Moreover, the AAP and the American Academy of Dermatology recommend that infants younger than 6 mo not be exposed to the sun and that all children and adolescents use sunscreens and clothing to protect them from ultraviolet B radiation exposure and to prevent skin cancer (6).Newborn infants have a unique source of vitamin D: the mother, who transfers vitamin D to the fetus across the placenta (Figure 1 25-HYDROXYVITAMIN D CONCENTRATIONS IN NEWBORNSAccording to numerous investigators, 25(OH)D con...

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“…Vitamin D–deficiency rickets is characterized by low circulating levels (typically <5 ng/mL) of 25-hydroxyvitamin D [25(OH)D], impaired intestinal calcium absorption, secondary hyperparathyroidism, and an exaggerated increase in serum 1,25-dihydroxyvitamin D [1,25(OH) 2 D] concentration after administration of vitamin D.(1–4) Although, worldwide, vitamin D deficiency is the principal cause of rickets, in some countries, such as Nigeria and Bangladesh, nutritional rickets results primarily from inadequate calcium intake. (5,6) Untreated Nigerian children with nutritional rickets have normal or only slightly reduced 25(OH)D values,(7) high fractional calcium absorption,(8) low dietary calcium intake,(7) markedly elevated 1,25(OH) 2 D concentrations, and a better response to treatment with calcium than with vitamin D.(9) These findings indicate that dietary calcium deficiency plays a more important role in the pathogenesis of rickets in Nigerian children than does vitamin D deficiency.…”

Section: Introductionmentioning

confidence: 99%

Comparison of metabolism of vitamins D2 and D3 in children with nutritional rickets

Thacher

Fischer

Obadofin

et al. 2010

Journal of Bone and Mineral Research

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Children with calcium-deficiency rickets may have increased vitamin D requirements and respond differently to vitamin D2 and vitamin D3. Our objective was to compare the metabolism of vitamins D2 and D3 in rachitic and control children. We administered an oral single dose of vitamin D2 or D3 of 1.25 mg to 49 Nigerian children—28 with active rickets and 21 healthy controls. The primary outcome measure was the incremental change in vitamin D metabolites. Baseline serum 25-hydroxyvitamin D [25(OH)D] concentrations ranged from 7 to 24 and 15 to 34 ng/mL in rachitic and control children, respectively (p < .001), whereas baseline 1,25-dihydroxyvitamin D [1,25(OH)2D] values (mean ± SD) were 224 ± 72 and 121 ± 34 pg/mL, respectively (p < .001), and baseline 24,25-dihydroxyvitamin D [24,25(OH)2D] values were 1.13 ± 0.59 and 4.03 ± 1.33 ng/mL, respectively (p < .001). The peak increment in 25(OH)D was on day 3 and was similar with vitamins D2 and D3 in children with rickets (29 ± 17 and 25 ± 11 ng/mL, respectively) and in control children (33 ± 13 and 31 ± 16 ng/mL, respectively). 1,25(OH)2D rose significantly (p < .001) and similarly (p = .18) on day 3 by 166 ± 80 and 209 ± 83 pg/mL after vitamin D2 and D3 administration, respectively, in children with rickets. By contrast, control children had no significant increase in 1,25(OH)2D (19 ± 28 and 16 ± 38 pg/mL after vitamin D2 and D3 administration, respectively). We conclude that in the short term, vitamins D2 and D3 similarly increase serum 25(OH)D concentrations in rachitic and healthy children. A marked increase in 1,25(OH)2D in response to vitamin D distinguishes children with putative dietary calcium-deficiency rickets from healthy children, consistent with increased vitamin D requirements in children with calcium-deficiency rickets. © 2010 American Society for Bone and Mineral Research.

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Serum Concentrations of Vitamin D Metabolites in Rachitic Libyan Children

Cited by 30 publications

References 0 publications

Early response to vitamin D2 in children with calcium deficiency rickets

Early response to vitamin D2 in children with calcium deficiency rickets

25-Hydroxyvitamin D: functional outcomes in infants and young children

Comparison of metabolism of vitamins D2 and D3 in children with nutritional rickets

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