Vitamin D status in children in the South Marmara Region in Turkey

Year 2024, , 160 - 167, 31.07.2024

Aynur Karaca , Hakan Altın

https://doi.org/10.16899/jcm.1459152

Abstract

Aim: The aim of our study was to investigate the age, gender and seasonal differences in vitamin D levels in children and to determine the prevalence of vitamin D deficiency.
Materials and Methods: Between January 2022 and December 2023, the records of children aged 0-17 years who underwent serum 25-hydroxyvitaminD (25 (OH) D) levels in the pediatric outpatient clinics of our hospital were retrospectively reviewed. Children were divided into four groups according to age (0-1, 2-5, 6-11 and 12-17 years); three groups according to 25 (OH) D levels (vitamin D deficiency (below 12 ng/mL), vitamin D insufficiency (between 12-20 ng/mL) and vitamin D sufficiency (above 20 ng/mL)); and four groups according to seasons.
Results: The 25(OH)D levels of 41899 children, 19738 (47.1%) boys and 22161 (52.9%) girls, was 18.6 ng/mL (3-145); and was lower in girls than boys (16.8 ng/mL (3-136) in girls and 20.3 ng/mL (3-145) in boys p<0.001). Vitamin D deficiency was 22.8% (15.5% in boys and 29.2% in girls, p<0.001) and vitamin D insufficiency was 32.9% (32.9% in boys and 32.9% in girls, p=0.970). In 55.6% of our patients 25 (OH) D levels was below 20 ng/mL (48.4% of males and 62.1% of females, p<0.001). 25(OH)D levels decreased with increasing age and were ordered by season as winter Conclusion: The lowest 25 (OH) D levels were found in adolescents, especially in female adolescents in winter and spring. Therefore, we think that vitamin D deficiency prevention public health strategies should be developed for this group.

Keywords

Vitamin D deficiency, Vitamin D insufficiency, 25 (OH) D, Children

Türkiye'nin Güney Marmara Bölgesi'ndeki Çocukların D Vitamini Durumu

Abstract

Amaç: Çalışmamızın amacı çocuklarda D vitamini düzeylerindeki yaş, cinsiyet ve mevsimsel farklılıkları araştırmak ve D vitamini eksikliği prevalansını belirlemektir.
Gereç ve Yöntemler: Ocak 2022-Aralık 2023 tarihleri arasında hastanemiz çocuk polikliniklerinde serum 25-hidroxi vitamin D (25 (OH) D) düzeyi ölçümü yapılan 0-17 yaş arası çocukların kayıtları retrospektif olarak incelendi. Çocuklar yaşa göre dört gruba (0-1, 2-5, 6-11 ve 12-17 yaş); serum 25 (OH) D vitamini düzeylerine göre üç gruba (D vitamini eksikliği (12 ng/mL altı), D vitamini yetersizliği (12-20 ng/mL arası) ve D vitamini yeterliliği (20 ng/mL üstü)); ve mevsimlere göre dört gruba ayrıldı.
Sonuçlar: 41 899 çocuğun (19738 (%47,1) erkek ve 22161 (%52,9) kız) 25 (OH) D düzeyi 18,6 ng/mL (3-145) idi; ve kızlarda erkeklerden daha düşüktü (kızlarda 16,8 ng/mL (3-136) ve erkeklerde 20,3 ng/mL (3-145) p<0,001). D vitamini eksikliği %22,8 (erkeklerde %15,5 ve kızlarda %29,2, p<0.001) ve D vitamini yetersizliği %32,9 (erkeklerde %32,9 ve kızlarda %32,9, p=0.970) idi. Hastalarımızın %55,6'sında 25 (OH) D düzeyi 20 ng/mL'nin altındaydı (erkeklerin %48,4'ü ve kadınların %62,1'i, p<0,001). 25 (OH) D düzeyleri yaş arttıkça azalıyordu ve mevsimlere göre kış Sonuç: En düşük 25 (OH) D düzeyi adolesanlarda, özellikle de kız adolesanlarda kış ve ilkbahar mevsiminde bulunmuştur. Bu nedenle, bu grup için D vitamini eksikliğini önlemek için halk sağlığı stratejilerinin geliştirilmesi gerektiğini düşünüyoruz.

Keywords

D vitamini eksikliği, D vitamini yetersizliği, 25 (OH) D, çocuk

References

• 1- Silva ICJ, Lazaretti-Castro M. Vitamin D metabolism and extraskeletal outcomes: an update. Arch Endocrinol Metab 2022 Nov 11; 66(5): 748-55. doi: 10.20945/2359-3997000000565, indexed in PubMed: 36382764
• 2- Bouillon R, Manousaki D, Rosen C, Trajanoska K, Rivadeneira F, Richards JB. The health effects of vitamin D supplementation: evidence from human studies. Nat Rev Endocrinol. 2022 Feb;18(2):96-110. doi: 10.1038/s41574-021-00593-z. Epub 2021 Nov 23. PMID: 34815552; PMCID: PMC8609267.
• 3- Ellison DL, Moran HR. Vitamin D: Vitamin or Hormone? Nurs Clin North Am. 2021 Mar;56(1):47-57. doi: 10.1016/j.cnur.2020.10.004. Epub 2020 Dec 28. PMID: 33549285.
• 4- Janoušek J, Pilařová V, Macáková K, Nomura A, Veiga-Matos J, Silva DDD et al Vitamin D: sources, physiological role, biokinetics, deficiency, therapeutic use, toxicity, and overview of analytical methods for detection of vitamin D and its metabolites. Crit Rev Clin Lab Sci. 2022 Dec;59(8):517-554. doi: 10.1080/10408363.2022.2070595. Epub 2022 May 16. PMID: 35575431.
• 5- Makhsudov J, Yılmaz R. Vitamin D Deficiency in Children. Chron Precis Med Res 2020; 1(1):8-19. doi: 10.5281/zenodo.7854217.
• 6- Alfredsson L, Armstrong BK, Butterfield DA, Chowdhury R, de Gruijl FR, Feelisch M, Garland CF et al. Insufficient Sun Exposure Has Become a Real Public Health Problem. Int J Environ Res Public Health. 2020 Jul 13;17(14):5014. doi: 10.3390/ijerph17145014. PMID: 32668607; PMCID: PMC7400257.
• 7- Taylor SN. Vitamin D in Toddlers, Preschool Children, and Adolescents. Ann Nutr Metab. 2020;76 Suppl 2:30-41. doi: 10.1159/000505635. Epub 2020 Nov 24. PMID: 33232959.
• 8- Jullien S. Vitamin D prophylaxis in infancy. BMC Pediatr. 2021 Sep 8;21(Suppl 1):319. doi: 10.1186/s12887-021-02776-z. PMID: 34496802; PMCID: PMC8424795.
• 9- Munns CF, Shaw N, Kiely M, Specker BL, Thacher TD, Ozono K, et al. Global Consensus Recommendations on Prevention and Management of Nutritional Rickets. Horm Res Paediatr 2016; 85(2): 83-106, doi.org/10.1159/000443136, indexed in PubMed: 26741135.
• 10- Liu Z, Huang S, Yuan X, Wang Y, Liu Y, Zhou J. The role of vitamin D deficiency in the development of paediatric diseases. Ann Med. 2023 Dec;55(1):127-135. doi: 10.1080/07853890.2022.2154381. PMID: 36495273; PMCID: PMC974422
• 11- He M, Cao T, Wang J, Wang C, Wang Z, Abdelrahim MEA. Vitamin D deficiency relation to sepsis, paediatric risk of mortality III score, need for ventilation support, length of hospital stay, and duration of mechanical ventilation in critically ill children: A meta-analysis. Int J Clin Pract. 2021 Apr;75(4):e13908. doi: 10.1111/ijcp.13908. Epub 2020 Dec 20. PMID: 33280208.
• 12- Cui A, Zhang T, Xiao P, Fan Z, Wang H, Zhuang Y. Global and regional prevalence of vitamin D deficiency in population-based studies from 2000 to 2022: A pooled analysis of 7.9 million participants. Front Nutr. 2023 Mar 17;10:1070808. doi: 10.3389/fnut.2023.1070808. PMID: 37006940; PMCID: PMC10064807.
• 13- Cashman KD. Global differences in vitamin D status and dietary intake: a review of the data. Endocr Connect. 2022 Jan 11;11(1):e210282. doi: 10.1530/EC-21-0282. PMID: 34860171; PMCID: PMC8789021.
• 14- Mogire RM, Mutua A, Kimita W, Kamau A, Bejon P, Pettifor JM et al. Prevalence of vitamin D deficiency in Africa: a systematic review and meta-analysis. Lancet Glob Health. 2020 Jan;8(1):e134-e142. doi: 10.1016/S2214-109X(19)30457-7. Epub 2019 Nov 27. Erratum in: Lancet Glob Health. 2022 Apr;10(4):e481. PMID: 31786117; PMCID: PMC7024961.
• 15- Yeşiltepe-Mutlu G, Aksu ED, Bereket A, Hatun Ş. Vitamin D Status Across Age Groups in Turkey: Results of 108,742 Samples from a Single Laboratory. J Clin Res Pediatr Endocrinol. 2020 Sep 2;12(3):248-255. doi: 10.4274/jcrpe.galenos.2019.2019.0097. Epub 2020 Jan 2. PMID: 31893581; PMCID: PMC7499130.
• 16- Topal İ, Mertoğlu C, Arslan YK, Gümüş A ve ark. Erzincan Bölgesindeki Çocukların D Vitamini Seviyelerinin Yaş, Cinsiyet ve Mevsimlere Göre Değerlendirilmesi. Fırat Med. J 2018; 23 (4): 168-172.
• 17- Sarı E, Çoban G, ÖÇ Fatma Zehra, Açoğlu EA. The Status of Vitamin D Among Children Aged 0 to 18 Years. J Pediatr Res 2021;8(4):438-43.
• 18- Doğan N, Çolak AA, Güden N, Üstüner F. Vitamin D deficiency in children in Aegean Region in Turkey. Cumhuriyet Medical Journal 2015;27 (1): 17-22.
• 19- Çömlek FÖ, Toprak A, Birbilen AZ, Dilek SÖ, Coşkun F. Evaluation of vitamin D levels in children and adolescents after the first year of the COVID-19 pandemic: 1-year results of a secondary-level state hospital. Arch Pediatr. 2024 Apr;31(3):179-182. doi: 10.1016/j.arcped.2023.11.001.
• 20- Göktaş O, Ersoy C, Ercan I, Can FE. Vitamin D status in the adult population of Bursa-Turkey. Eur J Gen Pract. 2020 Dec;26(1):156-162. doi: 10.1080/13814788.2020.1846712. PMID: 33292015; PMCID: PMC7733979.
• 21- Hu Y, Chen J, Wang R, Li M, Yun C, Li W et al. Vitamin D Nutritional Status and its Related Factors for Chinese Children and Adolescents in 2010-2012. Nutrients. 2017 Sep 15;9(9):1024. doi: 10.3390/nu9091024. PMID: 28914773; PMCID: PMC5622784.
• 22- Shen M, Li Z, Lv D, Yang G, Wu R, Pan J et al. Seasonal variation and correlation analysis of vitamin D and parathyroid hormone in Hangzhou, Southeast China. J Cell Mol Med. 2020 Jul;24(13):7370-7377. doi: 10.1111/jcmm.15330. Epub 2020 May 16. PMID: 32415728; PMCID: PMC7339220.
• 23- Jazayeri M, Moradi Y, Rasti A, Nakhjavani M, Kamali M, Baradaran HR. Prevalence of vitamin D deficiency in healthy Iranian children: A systematic review and meta-analysis. Med J Islam Repub Iran. 2018 Sep 8;32:83. doi: 10.14196/mjiri.32.83. PMID: 30643758; PMCID: PMC6325293.
• 24- Mendes MM, Darling AL, Hart KH, Morse S, Murphy RJ, Lanham-New SA. Impact of high latitude, urban living and ethnicity on 25-hydroxyvitamin D status: A need for multidisciplinary action? J Steroid Biochem Mol Biol. 2019 Apr;188:95-102. doi: 10.1016/j.jsbmb.2018.12.012. Epub 2019 Jan 2. PMID: 30610914.
• 25- Kunz C, Hower J, Knoll A, Ritzenthaler KL, Lamberti T. 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. Eur J Nutr. 2019 Jun;58(4):1711-1722. doi: 10.1007/s00394-018-1717-y. Epub 2018 May 18. PMID: 29777304; PMCID: PMC6561984.
• 26- Galeazzi T, Quattrini S, Pjetraj D, Gatti S, Monachesi C, Franceschini E et al. Vitamin D status in healthy Italian school-age children: a single-center cross-sectional study. Ital J Pediatr. 2023 Feb 22;49(1):27. doi: 10.1186/s13052-023-01422-x. PMID: 36814347; PMCID: PMC9945672.