Vitamin d deficiency in children
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Vitamin D Deficiency in Children: An Overview
Prevalence and Diagnosis of Vitamin D Deficiency in Children
Vitamin D deficiency is a significant health issue affecting children globally, with prevalence rates ranging from 10% to 50% in various pediatric populations1. In South-East Asia, the prevalence of vitamin D deficiency among healthy children can be as high as 96.4%, with severe deficiency observed in up to 55.8% of cases7. Diagnosis is primarily based on serum 25-hydroxyvitamin D levels, with clinical features such as bone deformities and elevated alkaline phosphatase indicating rickets1.
Clinical Manifestations and Associated Conditions
Vitamin D deficiency in children can lead to severe health issues, including life-threatening hypocalcemia in infants, rickets, and increased risk of metabolic and neurological problems in adulthood1. In critically ill children, vitamin D deficiency is linked to poor outcomes, such as prolonged PICU stays, increased mechanical ventilation duration, higher rates of ventilator-associated pneumonia, sepsis, and end-organ dysfunction2 9. Additionally, vitamin D deficiency has been associated with moderate anemia in young children, independent of iron deficiency3.
Risk Factors and Prevention
Several risk factors contribute to vitamin D deficiency in children, including limited sun exposure, inadequate dietary intake, and certain medical conditions. Female sex and urban living are common determinants of deficiency in South-East Asia7. In Russia, risk factors include short breastfeeding duration, maternal complications during pregnancy, and lack of specific antenatal and postnatal prophylaxis8. Prevention strategies include ensuring adequate sun exposure, food and beverage fortification, and dietary supplementation1 10.
Treatment and Supplementation
Effective treatment of vitamin D deficiency involves oral or injectable administration of vitamin D. Dosing and duration vary based on the child's health status and underlying conditions1. In critically ill children, high-dose vitamin D supplementation has been studied to assess short-term outcomes, with ongoing research needed to determine optimal dosing and long-term effects2. For healthy children, a minimum daily intake of 400 IU of vitamin D is recommended, starting soon after birth and continuing through adolescence10.
Impact on Growth and Development
Despite the high prevalence of vitamin D deficiency, its impact on growth, body composition, and pubertal development remains unclear. A study in Mongolia found that long-term vitamin D supplementation did not significantly influence these parameters in school-aged children4. However, vitamin D plays a crucial role in brain development, with some studies suggesting an association between low vitamin D levels and impaired neurobehavioral outcomes, though findings are inconsistent5.
Conclusion
Vitamin D deficiency is a prevalent and underdiagnosed condition in children, with significant implications for their health and development. Early diagnosis, effective treatment, and preventive measures are essential to mitigate the adverse effects of this deficiency. Further research is needed to fully understand the long-term impacts and optimize treatment protocols for affected children.
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Most relevant research papers on this topic
Treatment of vitamin D deficiency in children
Vitamin D deficiency in children can be effectively treated with oral or injectable administration, promoting prevention and reducing rickets.
Systematic ReviewStudy protocol for supplementation of single high dose Vitamin D in deficient critically ill children and assessment of their short-term outcome: An open label randomized control trial
A single high dose oral Vitamin D supplementation may improve short-term outcomes in critically ill children with Vitamin D deficiency.
RCTVitamin D deficiency and mild to moderate anemia in young North Indian children: A secondary data analysis.
Vitamin D deficiency is associated with moderate anemia in young children, independent of iron deficiency, but the causal association between vitamin D deficiency and anemia risk remains debatable.
RCT
Large Human TrialInfluence of Vitamin D Supplementation on Growth, Body Composition, and Pubertal Development Among School-aged Children in an Area With a High Prevalence of Vitamin D Deficiency: A Randomized Clinical Trial.
Vitamin D supplementation does not significantly influence growth, body composition, or pubertal development in school-aged children with vitamin D deficiency.
RCTLarge Human Trial
Very Rigorous JournalEffects of vitamin D deficiency on neurobehavioural outcomes in children: a systematic review
Vitamin D deficiency may impact neurobehavioral outcomes in children, but current studies are inconclusive and require further well-conducted, adequately powered research to confirm these findings.
Systematic Review
Rigorous JournalClinical features of vitamin D deficiency in children: A retrospective analysis
Vitamin D deficiency in children and adolescents can present diverse clinical features, highlighting the need for pediatricians to pay more attention to diverse signs and symptoms.
Observational StudyVitamin D deficiency in South-East Asian children: a systematic review
Vitamin D deficiency is common among healthy children in South-East Asia, with female sex and urban living being the most common determinants.
Systematic ReviewStudy of risk factors of vitamin d deficiency in young children
Vitamin D deficiency in young children is often under-reported, and addressing risk factors like short breastfeeding and maternal complications during pregnancy is crucial for optimal health outcomes.
Vitamin D Deficiency in Critically Ill Children
A high rate of vitamin D deficiency is found in critically ill children, with lower levels associated with higher illness severity and serious infections.
Observational Study
Highly CitedPrevention of Rickets and Vitamin D Deficiency in Infants, Children, and Adolescents
All infants, children, and adolescents should have a minimum daily intake of 400 IU of vitamin D beginning soon after birth, to prevent rickets and deficiency.
Highly Cited