Vitamin D insufficiency and its contributing factors in primary school-aged children in Indonesia, a sun-rich country

Pulungan, Aman B; Soesanti, Frida; Tridjaja, Bambang; Batubara, Jose Rl

doi:10.6065/apem.2040132.066

Cited by 34 publications

(60 citation statements)

References 28 publications

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“…To date, observation of vitamin D concentration in the Indonesian population was focusing on the population at risks such as children, adolescents, and pregnant women [17][18][19]. Although observation of vitamin D concentration in postmenopausal breast cancer patients has been done previously in Surabaya, Indonesia [20], the association between vitamin D level and breast cancer characteristics remains unexplored.…”

Section: Introductionmentioning

confidence: 99%

Vitamin D status in breast cancer cases following chemotherapy: A pre and post observational study in a tertiary hospital in Yogyakarta, Indonesia

Puspitaningtyas

Sulistyoningrum²,

Witaningrum³

et al. 2022

PLoS ONE

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Objectives To observe pre- and post-treatment vitamin D level and its association with treatment and concomitant factors in breast cancer patients treated with chemotherapy. Methods We performed a pre-post observational analysis that nested in an ongoing prospective cohort study of breast cancer patients at Dr. Sardjito General Hospital, Yogyakarta, Indonesia. 136 subjects were recruited from the main study. Information on subjects’ socio-demographic characteristics clinical status, and tumour profile was assessed at baseline. Number of chemotherapy cycles and chemotherapy-induced nausea vomiting (CINV) were also recorded. Vitamin D concentration was measured using ELISA methods at baseline and post-treatment. Vitamin D level of <20 ng/ml and <12 ng/ml were defined as deficiency and severe deficiency. Correlation between socio-demographic and clinical profile with baseline vitamin D was tested using Spearman correlation. Paired t-test was used to evaluate changes in post-treatment vitamin D concentration. The odds ratio for a subject to experience post-treatment vitamin D decrease was assessed based on number of chemotherapy cycles and CINV severity. Results The mean vitamin D level before chemotherapy was very low (8.80±3.64 ng/ml) in the whole panel. Higher AST level were associated with lower vitamin D level at baseline (r = -0.188, p = 0.028). Severe deficiency was found in 82.4% subjects at baseline and the rate increased to 89.0% after chemotherapy. Eighty-five cases showed a decrease level whereas 51 showed a slight improvement. Overall, a significant decrease of the vitamin D level was observed after chemotherapy (median change 3.13±4.03 ng/ml, p <0.001). Subjects who received >6 cycles of chemotherapy were less likely to experience a decreased level of post-treatment vitamin D (OR = 0.436, 95% CI = 0.196–0.968, p = 0.039). Conclusions Indonesian breast cancer patients showed pre-existing severe vitamin D deficiency and deterioration of vitamin D after chemotherapy. Future research is needed to explore its implication towards patients’ survival in the local setting. Evidence-based approach also needs to be taken to address this modifiable condition, including increasing awareness of the importance of maintaining vitamin D sufficiency both in patients and the general population.

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Section: Introductionmentioning

confidence: 99%

Vitamin D status in breast cancer cases following chemotherapy: A pre and post observational study in a tertiary hospital in Yogyakarta, Indonesia

Puspitaningtyas

Sulistyoningrum²,

Witaningrum³

et al. 2022

PLoS ONE

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“…The most common reported risk factors for VDD in the region were female sex,25 27 33 34 37 39 40 42 44 45 49 50 older children,22 27 31 37 40 49 51 urban living,27 37 38 44 51 52 covered-up clothing for religious purposes,37 39 53 exposure to sunlight <30 min/day35 39 40 54 and obesity31 37 42 44 45 (table 1). Subgroup analysis by gender and residence are presented in figure 5 and online supplemental file 5, respectively.…”

Section: Resultsmentioning

confidence: 99%

Vitamin D deficiency in South-East Asian children: a systematic review

et al. 2022

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ObjectiveTo describe the prevalence and determinants of vitamin D deficiency (VDD) among healthy children aged between 0 and 18 years living in South-East Asia (SEA).DesignWe systematically searched Ovid MEDLINE and Ovid EMBASE for observational studies assessing VDD among healthy children in the SEA region as the primary or secondary outcome from database inception to 6 April 2021. PubMed was used for e-pubs and publications not indexed in Medline. Publications that included abstracts in English were included. We performed a systematic review to describe the prevalence of VDD in SEA children.ResultsOur initial search identified 550 publications with an additional 2 publications from manual screening. Of those, 21 studies from 5 different countries (Thailand, Indonesia, Vietnam, Malaysia and Cambodia) were summarised and included in forest plots. The prevalence of VDD (<50 nmol/L) ranged from 0.9% to 96.4%, with >50% of newborns having VDD, and severe VDD (<30 nmol/L) ranged from 0% to 55.8%. Female sex and urban living were the most common determinants of VDD.ConclusionsVDD among healthy children living in the SEA region is common. Efforts to detect VDD and the implementation of preventive measures, including education on safe sun exposure and oral vitamin D supplementation or food fortification, should be considered for key target groups, including adolescent females and pregnant and lactating women to improve the vitamin D status of newborns.Protocol registration numberThis study is registered with PROSPERO (CRD42020181600).

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“…Second, the difference in the amount of sunlight exposure by sex is another possible reason. Pulungan et al [ 24 ] reported that sun exposure duration was a major cause of vitamin D deficiency in children. Tsugawa et al [ 25 ] reported that the serum 25(OH)D level was lower in girls than in boys during puberty, which might have been attributed to a greater amount of outdoor exercise in boys than in girls.…”

Section: Discussionmentioning

confidence: 99%

Low serum 25-hydroxyvitamin D level is associated with obesity and atherogenesis in adolescent boys

Naganuma

Koyama

Arisaka

et al. 2022

Ann Pediatr Endocrinol Metab

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Vitamin D insufficiency and its contributing factors in primary school-aged children in Indonesia, a sun-rich country

Abstract: Vitamin D insufficiency and its contributing factors in primary school-aged children inIndonesia, a sun-rich country Running title: Vitamin D insufficiency in primary school-aged children in Indonesia

Cited by 34 publications

References 28 publications

Vitamin D status in breast cancer cases following chemotherapy: A pre and post observational study in a tertiary hospital in Yogyakarta, Indonesia

Vitamin D status in breast cancer cases following chemotherapy: A pre and post observational study in a tertiary hospital in Yogyakarta, Indonesia

Vitamin D deficiency in South-East Asian children: a systematic review

Low serum 25-hydroxyvitamin D level is associated with obesity and atherogenesis in adolescent boys

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