Vitamin D Deficiency in Children with a Chronic Illness–Seasonal and Age-Related Variations in Serum 25-hydroxy Vitamin D Concentrations

Holmlund-Suila, Elisa; Koskivirta, Panu; Metso, T.; Andersson, Sture; Mäkitie, Outi; Viljakainen, Heli

doi:10.1371/journal.pone.0060856

Cited by 30 publications

(42 citation statements)

References 40 publications

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“…In line with the studies on healthy children and children with chronic illnesses, we found a significant negative correlation between 25(OH)D and PTH. However, our results contradict those of other studies, which found no relationship between 25(OH)D and PTH in cancer patients, but in healthy controls.…”

Section: Discussioncontrasting

confidence: 99%

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Vitamin D status in children with leukemia, its predictors, and association with outcome

Jackmann

Mäkitie

Harila‐Saari

et al. 2020

Pediatric Blood & Cancer

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Background Children and adolescents with leukemia are potentially at high risk of vitamin D inadequacy, which may have clinical relevance for skeletal morbidity, infections, and cancer outcome. This study aimed to evaluate vitamin D status at the time of diagnosis to investigate its predictors and association with overall survival in children with leukemia. Procedure We included all 295 children and adolescents diagnosed with leukemia at our institution between 1990 and 2016 who had available serum sample from the time of diagnosis. We analyzed serum 25‐hydroxyvitamin D and parathyroid hormone levels and correlated them with clinical data. Results The 25‐hydroxyvitamin D level was deficient (< 25 nmol/L), insufficient (25‐50 nmol/L), sufficient (50‐75 nmol/L), and optimal (> 75 nmol/L) in 6.4%, 26.8%, 39.7%, and 27.1% of the children, respectively. Older age and a more recent time of sampling (calendar year) predicted lower 25‐hydroxyvitamin D level. In preschool children (age ≤6 years), lower 25‐hydroxyvitamin D level was also associated with acute myeloid leukemia, and a 25‐hydroxyvitamin D level < 50 nmol/L was associated with inferior overall survival. In school‐aged children (age > 6 years), the 25‐hydroxyvitamin D level showed significant seasonal variation. Conclusion It remains unclear whether vitamin D supplementation in pediatric leukemia patients will improve outcome.

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Section: Discussioncontrasting

confidence: 99%

“…Meanwhile, in agreement with other studies, older age was associated with a reduced 25(OH)D level in our cohort. The prevalence of vitamin D inadequacy in preschool children was 23.3%, compared with 45.4% in school children.…”

Section: Discussionsupporting

confidence: 94%

Vitamin D status in children with leukemia, its predictors, and association with outcome

Jackmann

Mäkitie

Harila‐Saari

et al. 2020

Pediatric Blood & Cancer

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“…We found that older age (>10 years) was significantly associated with both serum 25 (OH) D deficiency and reduced bone mass. These findings are similar to those described in children with chronic medical illness [36]. …”

Section: Discussionsupporting

confidence: 91%

Vitamin D Deficiency and Low Bone Mineral Density in Pediatric and Young Adult Intestinal Failure

Ubesie

Heubi²,

Kocoshis³

et al. 2013

J. pediatr. gastroenterol. nutr.

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Objectives To determine the prevalence and predisposing factors for vitamin D deficiency and low bone mineral density (BMD) in patients with intestinal failure (IF). Methods A retrospective review of patients with IF managed at the Cincinnati Children’s Hospital Medical Center. IF was defined as history of parenteral nutrition (PN) >30 days. Vitamin D deficiency was defined as serum 25-OH vitamin D [25(OH) D] < 20ng/dL. Reduced bone mineral density (BMD) was defined using dual x-ray absorptiometry (DXA) Z-score ≤− 2. A binary logistic regression model was used to test for association of significant risk factors and the outcome variables after univariate analyses. Results One hundred and twenty three patients with median age of 4 years (range 3–22 years) were evaluated. Forty-nine (39.8%) patients had at least a documented serum 25 (OH) D deficiency during the study interval while 10 out of 80 patients (12.5%) with DXA scans done had a low BMD Z-score. Age at study entry was associated with both 25 (OH) D deficiency (P= 0. 01) and low BMD Z-score (P = 0. 03). Exclusive PN at study entry was associated with reduced bone mass (P=0.03). There was no significant association between vitamin D deficiency and low BMD Z-score (P=0.31). Conclusion The risk of 25 (OH) D deficiency and low BMD Z-score increases with age among patients with IF. Strategies for monitoring and preventing abnormal bone health in older children receiving exclusive PN need to be developed and evaluated.

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“…Similarly, monitoring 25OHD concentrations as a public health policy for all individuals is impractical; fortunately, high-risk groups can easily be identified based on clinical profile ( table 2 ). [58] . Consensus guidelines for vitamin D supplementation have been drafted from a variety of pediatric/ endocrine groups [16,[59][60][61][62] .…”

Section: Evidencementioning

confidence: 99%

“…Children with chronic illnesses and conditions affecting vitamin D synthesis/absorption/metabolism may also benefit from supplementation and may require higher doses [58] but are not in the remit of this consensus on NR. …”

Section: Candidates For Preventative Vitamin D Supplementation Beyondmentioning

confidence: 99%

Global Consensus Recommendations on Prevention and Management of Nutritional Rickets

Munns¹,

Shaw²,

Kiely³

et al. 2016

Horm Res Paediatr

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362

477

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Background: Vitamin D and calcium deficiencies are common worldwide, causing nutritional rickets and osteomalacia, which have a major impact on health, growth, and development of infants, children, and adolescents; the consequences can be lethal or can last into adulthood. The goals of this evidence-based consensus document are to provide health care professionals with guidance for prevention, diagnosis, and management of nutritional rickets and to provide policy makers with a framework to work toward its eradication. Evidence: A systematic literature search examining the definition, diagnosis, treatment, and prevention of nutritional rickets in children was conducted. Evidence-based recommendations were developed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system that describes the strength of the recommendation and the quality of supporting evidence. Process: Thirty-three nominated experts in pediatric endocrinology, pediatrics, nutrition, epidemiology, public health, and health economics evaluated the evidence on specific questions within five working groups. The consensus group, representing 11 international scientific organizations, participated in a multiday conference in May 2014 to reach a global evidence-based consensus. Results: This consensus document defines nutritional rickets and its diagnostic criteria and describes the clinical management of rickets and osteomalacia. Risk factors, particularly in mothers and infants, are ranked, and specific prevention recommendations including food fortification and supplementation are offered for both the clinical and public health contexts. Conclusion: Rickets, osteomalacia, and vitamin D and calcium deficiencies are preventable global public health problems in infants, children, and adolescents. Implementation of international rickets prevention programs, including supplementation and food fortification, is urgently required. nology, pediatrics, nutrition, epidemiology, public health, and health economics evaluated the evidence on specific questions within five working groups. The consensus group, representing 11 international scientific organizations, participated in a multiday conference in May 2014 to reach a global evidence-based consensus. Results: This consensus document defines nutritional rickets and its diagnostic criteria and describes the clinical management of rickets and osteomalacia. Risk factors, particularly in mothers and infants, are ranked, and specific prevention recommendations including food fortification and supplementation are offered for both the clinical and public health contexts. Conclusion: Rickets, osteomalacia, and vitamin D and calcium deficiencies are preventable global public health problems in infants, children, and adolescents. Implementation of international rickets prevention programs, including supplementation and food fortification, is urgently required. Key WordsRickets · Nutrition · Vitamin D · Calcium · Consensus recommendations Abstract Background: Vitamin D and ca...

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Vitamin D Deficiency in Children with a Chronic Illness–Seasonal and Age-Related Variations in Serum 25-hydroxy Vitamin D Concentrations

Cited by 30 publications

References 40 publications

Vitamin D status in children with leukemia, its predictors, and association with outcome

Vitamin D status in children with leukemia, its predictors, and association with outcome

Vitamin D Deficiency and Low Bone Mineral Density in Pediatric and Young Adult Intestinal Failure

Global Consensus Recommendations on Prevention and Management of Nutritional Rickets

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