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Vitamin D status in infancy: What is the solution?

Year 2019, Volume: 3 Issue: 8, 579 - 582, 01.08.2019
https://doi.org/10.28982/josam.555486

Abstract

Aim: Vitamin D deficiency and insufficiency are common public health problems throughout the world. Besides important multisystemic metabolic effects, vitamin D is necessary for a healthy skeletal system. Various reasons cause vitamin D deficiency in infancy, and supplementation is one of the treatment options. A nationwide supplementation program has been implemented in Turkey since 2005. In this study, we aimed to evaluate the efficacy of this program in our city.

Methods: All infants aged between one and twelve months who were referred to the pediatric outpatient clinics of the hospital and tested for serum 25-(OH)-D levels between January 1, 2015 and December 31, 2016 were enrolled in the study. Patients with chronic illnesses were excluded. Data was obtained retrospectively from the hospital registry. In accordance with the criteria of American Academy of Pediatrics, patients were divided into three groups based on serum 25-(OH)-D levels as follows: 25-(OH)-D<15 ng/ml were considered deficient, 15.1<25-(OH)-D<20 ng/ml were considered insufficient and sufficiency was defined as 25-(OH)-D>20 ng/ml.

Results: The study group consisted of 265 infants. The mean age of the group was 7.53 (2.75) months. Approximately 15% (n=39) of the study group had vitamin D deficiency, 10.5% (n=28) had insufficiency and Vitamin D levels of 74.4% (n=198) of the group were sufficient. Serum 25 (OH) D levels did not differ with gender, age or season (P=0.12, P=0.65 and P=0.09, respectively). Vitamin D levels were sufficient in 78.5% (n=150) of the urban area residents and 69.6% (n=32) of the rural area residents, between which there was no significant difference (P=0.32). 

Conclusion: Our results established that supplementation is one of the ways to avoid limitations affecting serum vitamin D levels. Supplementation with 400 IU/day Cholecalciferol is provided during the first year of life by the Turkish Ministry of Health, which we believe rendered gender, age, time of measurement and residential area insignificant in terms of 25(OH) D levels. This supplementation program may solve the problem of vitamin D insufficiency or deficiency among disadvantaged groups.

References

  • 1. Sahin ON, Serdar M, Serteser M, Unsal I, Ozpinar A. Vitamin D levels and parathyroid hormone variations of children living in a subtropical climate: a data mining study. Ital J Pediatr. 2018 ;44(1):40.
  • 2. Lips P. Vitamin D status and nutrition in Europe and Asia. J Steroid Biochem Mol Biol. 2007;103(3-5):620-5.
  • 3. Ala-Houhala M, Koskinen T, Terho A, Koivulo T, Visakarpi J. Maternal compared with infant vitamin D supplementation. Arch Dis Child 1986;61(12):1159-63
  • 4. Reeve LE, Chesney RW, DeLuca HF. Vitamin D of human milk identification of biologically active form. Am J Clin Nutr. 1982;36(1):122-6.
  • 5. Antonucci R, Locci C, Clemente MG, Chicconi E, Antonucci L. Vitamin D deficiency in childhood: old lessons and current challenges. J Pediatr Endocrinol Metab. 2018;31(3):247–60.
  • 6. Hatun S, Ozkan B, Bereket A. Vitamin D deficiency and prevention: Turkish experience. Acta Pediatr. 2011;100(9): 1195-9.
  • 7. Ozkan B, Doneray H, Karacan M, Vançelik S, Yildirim ZK, Özkan A, et al. Prevalence of vitamin D deficiency rickets in the eastern part of Turkey. Eur J Pediatr. 2009;168(1):95-100.
  • 8. Holick MF. Vitamin D status:measurement, interpretation and clinical application. Ann Epidemiol. 2009; 19(2): 73–8.
  • 9. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an endocrine society clinical practice guideline, J. Clin. Endocrinol. Metab. 2011;96(7):1911–30.
  • 10. Misra M, Pacaud D, Petryk A, Collett-Solberg PF, Kappy M, Drug and Therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society. Vitamin D deficiency in children and its management: review of current knowledge and recommendations. Pediatrics. 2008;122(2):398–417.
  • 11. Munns CF, Shaw N, Kiely M, Specker BL, Thacher TD, Ozono K, et al. Global Consensus Recommendations on Prevention and Management of Nutritional Rickets. J Clin Endocrinol Metab. 2016;101(2):394–415.
  • 12. Amasya Valiliği: Amasya Genel Bilgiler: http://www.amasya.gov.tr/cografi-konum. accessed in January 2019
  • 13. Amasya Valiliği. Genel bigiler. https://www.mgm.gov.tr/veridegerlendirme/il-ve-ilceler-istatistik.aspx?m=AMASYA, accessed in January 2019
  • 14. Zittermann A, Gummert JF. Nonclassical vitamin D action. Nutrients. 2010;2(4):408–25.
  • 15. Nicolaidou P, Hatzistamatiou Z, Papadopoulou A, Kaleyias J. Low vitamin D status in mother–newborn pairs in Greece. Calcif Tissue Int. 2006;78(6):337-42.
  • 16. Mutlu GY, Kuşdal Y, Özsu E, Çizmecioğlu FM, Hatun S. Prevention of Vitamin D deficiency in infancy: daily 400 IU vitamin D is sufficient. Int J Pediatr Endocrinol. 2011;(1):4.
  • 17. Gülez P, Korkmaz HA, Özkök D, Can D, Özkan B. Factors Influencing Serum Vitamin D Concentration in Turkish Children Residing in İzmir: A Single-Center Experience. J Clin Res Pediatr Endocrinol. 2015;7:294-300.
  • 18. Chan KC, Tam WH, Chan MH, Chan RS, Li AM. Vitamin D deficiency among healthy infants in Hong Kong: a pilot study. Hong Kong Med J. 2018;24 Suppl 3(3):32-5.
  • 19. Güven A, Ecevit A, Tarcan A, Tarcan A, Özbek N. Yenidoğan bebeklerde kordon kanı vitamin D düzeyleri. Çocuk Sağlığı ve Hastalıkları Dergisi. 2011;54:55-61.
  • 20. Sachan A, Gupta R, Das V, Agarwal A, Awasthi PK, Bhatia V. High prevalence of vitamin D deficiency among pregnant women and their newborns in northern India. Am J Clin Nutr. 2005; 81(5):1060- 4.
  • 21. Karagüzel G, Dilber B, Çan G, Ökten A, Değer O, Holick MF. Seasonal vitamin D status of healthy schoolchildren and predictors of low vitamin D status. J Pediatr Gastroenterol Nutr. 2014;58(5):654-60.
  • 22. Akman A O, Tümer L, Hasanoğlu A, İlhan M, Çaycı B. Frequency of vitamin D insufficiency in healthy children between 1 and 16 years of age in Turkey. Pediatrics International. 2011;53(6):968–73.
  • 23. Yenilmez E, Çetinkaya RA. Evaluation of initial results of naïve HIV-infected patients regarding bone health. J Surg Med. 2019;3(5):384-9.

Bebeklikte D vitamini sorunu: Çözüm nedir?

Year 2019, Volume: 3 Issue: 8, 579 - 582, 01.08.2019
https://doi.org/10.28982/josam.555486

Abstract

Amaç: D vitamini eksikliği tüm dünyada yaygın bir halk sağlığı sorunudur. Vitamin D pek çok sistemi ilgilendiren etkilerinin yanında iskelet sistemi sağlığı için gereklidir. Bebeklik döneminde çeşitli nedenlere bağı olarak D vitamini eksikliği gelişebilir. Yeterlilik sağlamanın yollarından biri destek tedavisidir. Türkiye’de 2005 yılından beri tüm bebekleri kapsayan ulusal bir kampanya ile vitamin desteği ücretsiz olarak sağlanmaktadır. Bu çalışmada amaç kampanyanın ilimizdeki etkinliğini saptamaktır.

Yöntemler: Çalışmaya hastanenin Çocuk Sağlığı ve Hastalıkları polikliniklerine 1 Ocak 2015- 31 Aralık 2016 tarihleri arasında başvuran, 1-12 aylıkken 25- hidroksi- D düzeyi çalışılan tüm sağlıklı bebekler dahil edilmiştir. Altta yatan kronik hastalığı olanlar çalışma dışı bırakılmıştır. Veriler kayıt sisteminden geriye dönük olarak elde edilmiştir. Katılımcılar Amerikan Pediatri Akademisi’nin belirlemiş olduğu kriterlere dayanarak serum 25 (OH) D düzeylerine göre gruplara ayrılmıştır. Bu gruplar sırası ile “eksiklik: <15 ng/ml”, “yetmezlik: 15,1-20 ng/ml” ve “yeterlilik: >20 ng/ml” olarak belirlenmiştir.

Bulgular: Çalışmada 265 bebek değerlendirilmiştir. Yaş ortalaması 7,53 (2,75) aydır. Bebeklerin %14,7’sinde (n=39) D vitamini eksikliği, %10,5’inde (n=28) yetersizliği saptanmıştır. Grubun %74,4’ünde (n=198) yeterli düzey sağlanmıştır. Cinsiyete, yaşa veya ölçüm yapılan mevsime göre gruplar arasında 25 (OH) düzeyleri açısından anlamlı fark saptanmamıştır (sırasıyla P=0,12; P=0,65 ve P=0,09). Kentsel bölge sakinlerinin %78,5’inde (n=150), kırsal kesimde yaşayanların %69,9’unda (n=32) 25 (OH) D düzeyleri yeterli olup, aralarında anlamlı fark saptanmamıştır (P=0,32).

Sonuç: Vitamin desteği D vitamini eksikliğini kolaylaştıracak etmenlerin yok edilmesini sağlayan etkin bir yoldur. Türkiye Cumhuriyeti Sağlık Bakanlığı tarafından sağlanan günlük 400 IU dozundaki Kolekalsiferol desteği ile cinsiyet, yaş, ölçüm zamanı, yaşanılan yer gibi olumsuz etki oluşturabilecek değişkenler bertaraf edilebilmektedir. Aynı uygulamanın hassas gruplar için de uygulanabileceği düşünülmektedir.

References

  • 1. Sahin ON, Serdar M, Serteser M, Unsal I, Ozpinar A. Vitamin D levels and parathyroid hormone variations of children living in a subtropical climate: a data mining study. Ital J Pediatr. 2018 ;44(1):40.
  • 2. Lips P. Vitamin D status and nutrition in Europe and Asia. J Steroid Biochem Mol Biol. 2007;103(3-5):620-5.
  • 3. Ala-Houhala M, Koskinen T, Terho A, Koivulo T, Visakarpi J. Maternal compared with infant vitamin D supplementation. Arch Dis Child 1986;61(12):1159-63
  • 4. Reeve LE, Chesney RW, DeLuca HF. Vitamin D of human milk identification of biologically active form. Am J Clin Nutr. 1982;36(1):122-6.
  • 5. Antonucci R, Locci C, Clemente MG, Chicconi E, Antonucci L. Vitamin D deficiency in childhood: old lessons and current challenges. J Pediatr Endocrinol Metab. 2018;31(3):247–60.
  • 6. Hatun S, Ozkan B, Bereket A. Vitamin D deficiency and prevention: Turkish experience. Acta Pediatr. 2011;100(9): 1195-9.
  • 7. Ozkan B, Doneray H, Karacan M, Vançelik S, Yildirim ZK, Özkan A, et al. Prevalence of vitamin D deficiency rickets in the eastern part of Turkey. Eur J Pediatr. 2009;168(1):95-100.
  • 8. Holick MF. Vitamin D status:measurement, interpretation and clinical application. Ann Epidemiol. 2009; 19(2): 73–8.
  • 9. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an endocrine society clinical practice guideline, J. Clin. Endocrinol. Metab. 2011;96(7):1911–30.
  • 10. Misra M, Pacaud D, Petryk A, Collett-Solberg PF, Kappy M, Drug and Therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society. Vitamin D deficiency in children and its management: review of current knowledge and recommendations. Pediatrics. 2008;122(2):398–417.
  • 11. Munns CF, Shaw N, Kiely M, Specker BL, Thacher TD, Ozono K, et al. Global Consensus Recommendations on Prevention and Management of Nutritional Rickets. J Clin Endocrinol Metab. 2016;101(2):394–415.
  • 12. Amasya Valiliği: Amasya Genel Bilgiler: http://www.amasya.gov.tr/cografi-konum. accessed in January 2019
  • 13. Amasya Valiliği. Genel bigiler. https://www.mgm.gov.tr/veridegerlendirme/il-ve-ilceler-istatistik.aspx?m=AMASYA, accessed in January 2019
  • 14. Zittermann A, Gummert JF. Nonclassical vitamin D action. Nutrients. 2010;2(4):408–25.
  • 15. Nicolaidou P, Hatzistamatiou Z, Papadopoulou A, Kaleyias J. Low vitamin D status in mother–newborn pairs in Greece. Calcif Tissue Int. 2006;78(6):337-42.
  • 16. Mutlu GY, Kuşdal Y, Özsu E, Çizmecioğlu FM, Hatun S. Prevention of Vitamin D deficiency in infancy: daily 400 IU vitamin D is sufficient. Int J Pediatr Endocrinol. 2011;(1):4.
  • 17. Gülez P, Korkmaz HA, Özkök D, Can D, Özkan B. Factors Influencing Serum Vitamin D Concentration in Turkish Children Residing in İzmir: A Single-Center Experience. J Clin Res Pediatr Endocrinol. 2015;7:294-300.
  • 18. Chan KC, Tam WH, Chan MH, Chan RS, Li AM. Vitamin D deficiency among healthy infants in Hong Kong: a pilot study. Hong Kong Med J. 2018;24 Suppl 3(3):32-5.
  • 19. Güven A, Ecevit A, Tarcan A, Tarcan A, Özbek N. Yenidoğan bebeklerde kordon kanı vitamin D düzeyleri. Çocuk Sağlığı ve Hastalıkları Dergisi. 2011;54:55-61.
  • 20. Sachan A, Gupta R, Das V, Agarwal A, Awasthi PK, Bhatia V. High prevalence of vitamin D deficiency among pregnant women and their newborns in northern India. Am J Clin Nutr. 2005; 81(5):1060- 4.
  • 21. Karagüzel G, Dilber B, Çan G, Ökten A, Değer O, Holick MF. Seasonal vitamin D status of healthy schoolchildren and predictors of low vitamin D status. J Pediatr Gastroenterol Nutr. 2014;58(5):654-60.
  • 22. Akman A O, Tümer L, Hasanoğlu A, İlhan M, Çaycı B. Frequency of vitamin D insufficiency in healthy children between 1 and 16 years of age in Turkey. Pediatrics International. 2011;53(6):968–73.
  • 23. Yenilmez E, Çetinkaya RA. Evaluation of initial results of naïve HIV-infected patients regarding bone health. J Surg Med. 2019;3(5):384-9.
There are 23 citations in total.

Details

Primary Language English
Subjects Paediatrics
Journal Section Research article
Authors

Gökçe Celep 0000-0001-6250-5096

Zeynep Hülya Durmaz 0000-0002-3260-0030

Hatice Dörtok Demir This is me 0000-0002-2231-5914

Yalçıner Erdoğan This is me 0000-0002-3476-7395

Publication Date August 1, 2019
Published in Issue Year 2019 Volume: 3 Issue: 8

Cite

APA Celep, G., Durmaz, Z. H., Dörtok Demir, H., Erdoğan, Y. (2019). Vitamin D status in infancy: What is the solution?. Journal of Surgery and Medicine, 3(8), 579-582. https://doi.org/10.28982/josam.555486
AMA Celep G, Durmaz ZH, Dörtok Demir H, Erdoğan Y. Vitamin D status in infancy: What is the solution?. J Surg Med. August 2019;3(8):579-582. doi:10.28982/josam.555486
Chicago Celep, Gökçe, Zeynep Hülya Durmaz, Hatice Dörtok Demir, and Yalçıner Erdoğan. “Vitamin D Status in Infancy: What Is the Solution?”. Journal of Surgery and Medicine 3, no. 8 (August 2019): 579-82. https://doi.org/10.28982/josam.555486.
EndNote Celep G, Durmaz ZH, Dörtok Demir H, Erdoğan Y (August 1, 2019) Vitamin D status in infancy: What is the solution?. Journal of Surgery and Medicine 3 8 579–582.
IEEE G. Celep, Z. H. Durmaz, H. Dörtok Demir, and Y. Erdoğan, “Vitamin D status in infancy: What is the solution?”, J Surg Med, vol. 3, no. 8, pp. 579–582, 2019, doi: 10.28982/josam.555486.
ISNAD Celep, Gökçe et al. “Vitamin D Status in Infancy: What Is the Solution?”. Journal of Surgery and Medicine 3/8 (August 2019), 579-582. https://doi.org/10.28982/josam.555486.
JAMA Celep G, Durmaz ZH, Dörtok Demir H, Erdoğan Y. Vitamin D status in infancy: What is the solution?. J Surg Med. 2019;3:579–582.
MLA Celep, Gökçe et al. “Vitamin D Status in Infancy: What Is the Solution?”. Journal of Surgery and Medicine, vol. 3, no. 8, 2019, pp. 579-82, doi:10.28982/josam.555486.
Vancouver Celep G, Durmaz ZH, Dörtok Demir H, Erdoğan Y. Vitamin D status in infancy: What is the solution?. J Surg Med. 2019;3(8):579-82.