Vitamin D Deficiency in Children and Its Management: Review of Current Knowledge and Recommendations

Pediatric Endocrine and Neuroendocrine Units, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
PEDIATRICS (Impact Factor: 5.47). 09/2008; 122(2):398-417. DOI: 10.1542/peds.2007-1894
Source: PubMed


Given the recent spate of reports of vitamin D deficiency, there is a need to reexamine our understanding of natural and other sources of vitamin D, as well as mechanisms whereby vitamin D synthesis and intake can be optimized. This state-of-the-art report from the Drug and Therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society was aimed to perform this task and also reviews recommendations for sun exposure and vitamin D intake and possible caveats associated with these recommendations.

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    • "Two independent pathways lead to vitamin D synthesis: the photochemical action of solar ultraviolet B (UVB) light in the skin and specific dietary sources. Vitamin D from supplements can be ingested as vitamin D2 from plant sources or vitamin D3 from animal sources [8]. Vitamin D3 is transported to the liver and is converted to 25-hydroxyvitamin D (25(OH)D). "
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    ABSTRACT: Vitamin D features immunomodulatory effects on both the innate and adaptive immune systems, which may explain the growing evidence connecting vitamin D to allergic diseases. A wealth of studies describing a beneficial effect of vitamin D on atopic dermatitis (AD) prevalence and severity are known. However, observations linking high vitamin D levels to an increased risk of developing AD have also been published, effectively creating a controversy. In this paper, we review the existing literature on the association between AD and vitamin D levels, focusing on childhood. As of today, the role of vitamin D in AD is far from clear; additional studies are particularly needed in order to confirm the promising therapeutic role of vitamin D supplementation in childhood AD.
    Journal of Immunology Research 05/2015; 2015:1-7. DOI:10.1155/2015/257879 · 2.93 Impact Factor
    • "We could not determine the exact role of vitamin D because the sample size of subjects who had serum 25OHD measurements precluded us from any meaningful analysis. Nonetheless, using the pediatric definitions for vitamin D sufficiency [30], children taking SSRIs had normal mean 25OHD concentrations at 28.7 ng/mL, with the lowest reported value at 13 ng/mL. In contrast, many subjects who were not receiving SSRIs had severe vitamin D deficiency and the mean serum 25OHD level among SSRI non-users was lower at 19.6 ng/mL. "
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    ABSTRACT: Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed medications to treat depression and anxiety. SSRIs exert their effects by inhibiting the serotonin transporter and modulating extracellular serotonin levels, a neurotransmitter that has been shown to affect bone metabolism in animals. Studies in adults suggest a negative association between SSRI use and bone mineral density (BMD), greater rates of bone loss with SSRI use and increased risk of fractures. However, the results on bone mass have been inconsistent. Furthermore, there is a dearth of studies examining an association between SSRI use and bone mass in the pediatric and adolescent age group.
    Bone 05/2015; 78. DOI:10.1016/j.bone.2015.04.042 · 3.97 Impact Factor
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    • "Regarding ethnicity, it is known that non-Caucasians usually have lower vitamin D concentrations due to limitations in vitamin D production from solar exposure in those individuals; however, we did not find a statistical difference between the two races (1). This finding is controversial, since our study population had a high mixture of ethnicities, which hampered a precise classification. "
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    ABSTRACT: We evaluated the concentrations of 25-hydroxyvitamin D [25(OH)D] in children and adolescents with juvenile systemic lupus erythematosus (JSLE) and associated them with disease duration and activity, use of medication (chloroquine and glucocorticoids), vitamin D intake, calcium and alkaline phosphatase levels, and bone mineral density. Thirty patients with JSLE were evaluated and compared to 30 healthy individuals, who were age and gender matched. Assessment was performed of clinical status, disease activity, anthropometry, laboratory markers, and bone mineral density. The 30 patients included 25 (83.3%) females and 16 (53.3%) Caucasians, with a mean age of 13.7 years. The mean age at diagnosis was 10.5 years and mean disease duration was 3.4 years. Mean levels of calcium, albumin, and alkaline phosphatase were significantly lower in patients with JSLE compared with controls (P<0.001, P=0.006, and P<0.001, respectively). Twenty-nine patients (97%) and 23 controls (77%) had 25(OH)D concentrations lower than 32 ng/mL, with significant differences between them (P<0.001). Fifteen patients (50%) had vitamin D levels <20 ng/mL and 14 had vitamin D levels between 20 and 32 ng/mL. However, these values were not associated with greater disease activity, higher levels of parathormone, medication intake, or bone mineral density. Vitamin D concentrations were similar with regard to ethnic group, body mass index, height for age, and pubertal stage. Significantly more frequently than in controls, we observed insufficient serum concentrations of 25(OH)D in patients with JSLE; however, we did not observe any association with disease activity, higher levels of parathormone, lower levels of alkaline phosphatase, use of medications, or bone mineral density alterations.
    Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas / Sociedade Brasileira de Biofisica ... [et al.] 07/2014; DOI:10.1590/1414-431X20143948 · 1.01 Impact Factor
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