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Arch Pediatr Adolesc Med. 2008 Jun;162(6):505-12. doi: 10.1001/archpedi.162.6.505.

Prevalence of vitamin D deficiency among healthy infants and toddlers.

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  • 1Divisions of Adolescent Medicine and Endocrinology, Children's Hospital Boston, 300 Longwood Ave, Boston, MA 02115, USA. catherine.gordon@childrens.harvard.edu

Abstract

OBJECTIVES:

To determine the prevalence of vitamin D deficiency and to examine whether 25-hydroxyvitamin D (25OHD) concentration varies as a function of skin pigmentation, season, sun exposure, breastfeeding, and vitamin D supplementation.

DESIGN:

Cross-sectional sample.

SETTING:

Urban primary care clinic.

PARTICIPANTS:

Healthy infants and toddlers (N = 380) who were seen for a routine health visit.

OUTCOME MEASURES:

Primary outcomes were serum 25OHD and parathyroid hormone levels; secondary measures included data on sun exposure, nutrition, skin pigmentation, and parental health habits. Wrist and knee radiographs were obtained for vitamin D-deficient participants.

RESULTS:

The prevalence of vitamin D deficiency (< or =20 ng/mL) was 12.1% (44 of 365 participants), and 146 participants (40.0%) had levels below an accepted optimal threshold (< or =30 ng/mL). The prevalence did not vary between infants and toddlers or by skin pigmentation. There was an inverse correlation between serum 25OHD and parathyroid hormone levels (infants: r = -0.27, P < .001; toddlers: r = -0.20, P = .02). In multivariable models, breastfeeding without supplementation among infants and lower milk intake among toddlers were significant predictors of vitamin D deficiency. In vitamin D-deficient participants, 3 participants (7.5%) exhibited rachitic changes on radiographs, whereas 13 (32.5%) had evidence of demineralization.

CONCLUSIONS:

Suboptimal vitamin D status is common among otherwise healthy young children. Predictors of vitamin D status vary in infants vs toddlers, information that is important to consider in the care of these young patients. One-third of vitamin D-deficient participants exhibited demineralization, highlighting the deleterious skeletal effects of this condition.

Comment in

PMID:
18524739
[PubMed - indexed for MEDLINE]
PMCID:
PMC3206624
Free PMC Article
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