Tracking of vitamin D status from childhood to early adulthood and its association with peak bone mass

Abstract

To our knowledge, there are few longitudinal studies of vitamin D status from childhood to early adulthood, and it is uncertain whether vitamin D predicts peak bone mass in young adults. The purpose of this longitudinal study was to evaluate the long-term stability of vitamin D status from ages 6 to 20 y in healthy individuals and to study associations between serum 25-hydroxyvitamin D [25(OH)D] at different developmental stages and bone mass measured at age 20 y. Participants were offspring of the Western Australian Pregnancy Cohort (Raine) study. Serum 25(OH)D was assessed at ages 6, 14, 17, and 20 y, and whole-body bone mineral content (BMC) and bone mineral density (BMD) were measured at age 20 y through the use of dual-energy X-ray absorptiometry (DXA). Our analysis included 821 participants (385 females) who had ≥3 serum 25(OH)D measures and DXA data. We used latent class growth analysis and identified 4 vitamin D status trajectories: consistently lower ( = 259), decreasing ( = 125), increasing ( = 138), and consistently higher ( = 299). There were significant correlations between serum 25(OH)D concentrations at different time points in both sexes ( = 0.346-0.560, < 0.001), with stronger correlations at adjacent time points. In males, but not in females, serum 25(OH)D at ages 6, 17, and 20 y was positively associated with total-body BMC and BMD at age 20 y [covariate-adjusted increments of 40.7-53.9 g and 14.7-18.6 mg/cm, respectively, per 25 nmol/L 25(OH)D]; when 25(OH)D at all 4 ages was included in the same model, the concentration at age 6 y remained significant. Males in the "consistently higher" trajectory had 3.2-3.4% higher total body BMC and BMD than those who were in the "consistently lower" trajectory, accounting for age and anthropometric and lifestyle factors. Within both sexes, there are moderate associations between vitamin D status measured in prepuberty, adolescence, and early adulthood. Vitamin D status in childhood is a significant predictor of peak bone mass in male but not female subjects.

No improvement in vitamin D status in German infants and adolescents between 2009 and 2014 despite public recommendations to increase vitamin D intake in 2012

“…In 2012, Germany, Austria, and Switzerland increased their vitamin D intake recommendations twofold for toddlers, and even fourfold for children and adolescents, in comparison to previous recommendations [from 5 µg (200 IU) vitamin D to 20 µg (800 IU) per day] [ 18 ] (D–A–CH 2012). These changes were based on the increasing awareness of the high prevalence of vitamin D deficiency influencing growth and development in children and adolescents [ 1 , 2 , 4 , 7 , 8 , 11 , 13 , 19 , 35 – 39 ].…”

“…The last decade has witnessed a tremendous interest in vitamin D, based on the awareness of a worldwide high prevalence of vitamin D deficiency. Particularly high-risk groups, such as infants, children, pregnant women and lactating mothers, elderly people, or individuals who cover their bodies for cultural reasons, are affected [ 1 – 8 ]. Vitamin D, long known for being essential in building and maintaining the integrity of the skeleton, has only in the last decade been recognized for its involvement in multiple other functions.…”

Global prevalence and disease burden of vitamin D deficiency: a roadmap for action in low‐ and middle‐income countries

“…Although numerous studies have addressed the relationship between vitamin D status and indicators of bone health (e.g., bone mineral content, fractures, and intestinal calcium absorption) in children and adolescents without rickets (e.g., Refs. ), working group members did not identify new evidence related to these outcomes that warranted a modification to the general agreement on 25(OH)D cut‐points or dietary intake recommendations for young children.…”

Tobacco smoke exposure is an independent predictor of vitamin D deficiency in US children

“…Vitamin D is the principal promoter of bone mineralization, which is the process of depositing calcium and phosphate in osteoid matrix for either bone repair or the formation of new bones[ 8 , 9 ]. Vitamin D is particularly crucial during the period of growth in children and adolescents for optimal bone mineralization for the attainment of peak bone mass necessary for healthy bones throughout life[ 10 , 11 ]. Vitamin D sufficiency is also crucial in growing children and adolescents for the extra-skeletal functions of vitamin D such as its improvement of glycemic control through the augmentation of insulin production[ 12 ], and the reduction of fasting plasma glucose, hemoglobin A1c, and insulin resistance[ 13 ]; improvement in cardiovascular function through the augmentation of myocardial contractility[ 14 ]; augmentation of both innate and adaptive immune systems through the enhancement of T H 2 cell responses by jointly inhibiting T H 1 cells and stimulating the differentiation of naïve T-cells into T H 2 cells[ 15 , 16 ].…”