Se ha estudiado a niños participantes en la cohorte INMA-Asturias. Se determinó la 25(OH)D3 mediante cromatografía líquida de alta resolución. Se han. (Rev Med Chile ; ). Key words: Hashimoto Disease; Hypothyroidism; Vitamin D Deﬁciency. Hipovitaminosis D en niños con. Request PDF on ResearchGate | Hipovitaminosis D asociada a exposición de la mitad de la población de niños, jóvenes, adultos, mujeres posmenopáusicas.
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The Spanish Association of Pediatrics has as one of its main objectives the dissemination of rigorous and updated scientific information on the different areas of pediatrics. Annals of Pediatrics is the Body of Scientific Expression of the Association and is the vehicle through which members communicate. The magazine, referring to the Spanish-speaking pediatric, indexed in major international databases: The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two receding years.
CiteScore measures average citations received per document published. SRJ is a prestige metric based on the idea that not all citations are the same. SJR uses a similar algorithm as the Google page rank; it provides a quantitative and qualitative measure of the journal’s impact. SNIP measures contextual citation impact by wighting citations based on the total number of citations in a subject field. Vitamin D is an essential prohormone in calcium and phosphorus homeostasis.
Our objective was to estimate the prevalence of circulating vitamin D [25 OH D3] deficiency and insufficiency in children and examine the associated factors. The 25 OH D3 concentrations were quantified by high performance liquid chromatography. Distribution of 25 OH D3 for month of extraction of specimen, ingestion, and other factors were analysed. The mean 25 OH D3 was Seasonal variation was found, with lower values in winter. There was no relationship between plasma levels and intake of vitamin D median 2.
Solar exposure might not be enough in our region. Healthy children should be encouraged to follow adequate outdoor activities with associated sun exposure. Due to the deficit of intake in childhood, recommendations are needed about a varied diet with vitamin D-containing foods in this age group, especially during the winter, and assessing the need of vitamin D supplementation in children at risk.
Vitamin D, the sun vitamin, is known for its importance in bone health. But this is just the tip of the iceberg, as it is also associated with other health benefits, including decreasing the risk of chronic pathologies such as autoimmune, neurologic or cardiovascular disease or cancer, among others. Low levels of vitamin D during pregnancy and childhood are associated with an increased risk of complications in pregnancy and foetal growth and development preeclampsia, gestational diabetes, small for gestational age, impaired foetal neurologic development, etc.
Recent population-based studies have found a high prevalence of low serum levels of vitamin D [25 OH D3] worldwide, including in children. There is no universal consensus on the optimal 25 OH D3 serum levels needed to achieve an adequate bone mineralisation, and there is even less agreement on the levels required for the other functions of this prohormone.
Our aim was to estimate the prevalence of serum vitamin D deficiency and insufficiency and examine the factors associated with vitamin D deficiency and insufficiency in children aged 4 years in the Asturias cohort of the INMA Project Infancia y Medio Ambiente [Childhood and Environment].
The study was approved by the regional research ethics committee of the Principality of Asturias. All eligible pregnant women were given verbal and written information about the project, and participants were included after signing an informed consent form. We collected data on diet and other variables such as time spent outdoors through personal interviews performed by specially trained interviewers when participants were 4 years old.
The details of the overall INMA project can be found in a previous publication. This FFQ was similar to the one used by Willett et al.
The validity of the FFQ in children was assessed in children included in the study using three hour dietary recalls and serum levels of different vitamins as the reference. In the assessment of reproducibility, the mean correlation coefficient was 0.
In the assessment of validity, the mean correlation coefficient for nutrient intake was 0. Energy-adjusted intake was calculated by the residual method, regressing each nutrient on total calories and then adding back the population mean to the calculated residuals.
Hipovitaminosis D en niños con tiroiditis de Hashimoto
Participating children underwent a physical examination with anthropometric measurements at age 4 years. Weight was measured on a scale accurate to 10 g with the children barefoot and in their underwear. Height was measured with a calibrated wall-mount stadiometer on a hjpovitaminosis scale. We calculated the body mass index BMI as weight kg divided by the squared height m 2. We performed a descriptive analysis of the population under study, studying its sociodemographic and lifestyle characteristics in relation to 25 OH D3 levels.
We used Pearson’s correlation coefficient to analyse the correlation between serum levels of 25 OH D3 and other continuous variables potentially associated with these levels. We also analysed partial correlations controlling for serum levels of cholesterol. We conducted stepwise multivariate regression with backward elimination, including all the potential associated factors in the first step, with an entry criterion of 0. Of all patients, None had kidney, parathyroid, liver or malabsorption disorders.
Statistically significant values shown in boldface. The mean serum level of hipovitaminossis OH D3 was Of all participants, 8. Serum levels varied based on the month that the blood sample was drawn Fig. When we grouped the results by season of the year, we observed that the levels of 25 OH D3 were lower in the winter. Distribution of serum levels of 25 OH D3 at age 4 years in children in the Asturias cohort of the INMA project, showing percentiles and seasonal variation, and levels of intact parathormone normal range [NR], 15—65phosphate NR, 0.
The mean time spent outdoors was three hours range, 0: We found no association between time outdoors and 25 OH D3 levels Table We calculated vitamin D intake Table 5 from the estimated dietary intake, and found a median of 2.
The main dietary sources of vitamin D were fortified cereals and dairy products, followed by eggs and blue fish Table 6. We did not find an association between serum levels and total vitamin D intake Pearson correlation coefficient, 0.
We also did not find a correlation when we grouped different foods fish, white and blue fish, eggs, dairy or adjusted hiopvitaminosis season or energy hipoviatminosis. None of the children were currently taking vitamin D supplements. There were no statistically significant differences in 25 OH D3 levels between the sexes Table Pearson correlation coefficient, 0. In this population-based cohort study, we analysed serum levels of 25 OH D3, vitamin D sources dietary intake of vitamin D and sunlight exposure and other associated factors in prepubertal Spanish children, and found a high prevalence of insufficient and deficient vitamin D levels 20— The main strength of this study is that it was carried out in a hipovitaminisis of healthy children that have been followed up from the prenatal period.
Also, we controlled for potential risk factors, and their births were distributed throughout the year. The difference was even greater when we compared our results to those of another study conducted in prepubertal girls aged 7—10 years in Cordoba, which found a mean level of Another factor that may contribute to these differences is the smaller sample size of these other studies compared to ours. On the other hand, a study conducted in infants in Asturias found no evidence to support routine supplementation in this age group, although the authors underscored the importance of hipovitaminosjs monitoring exclusively breastfed infants, especially in the winter and in the early months of life.
Prevalence of hypovitaminosis D and associated factors in obese Spanish children
In most people, the main source of vitamin D is moderate sun exposure, so it follows that insufficient exposure is the leading cause of vitamin D deficiency. There is published evidence of seasonal variations in 25 OH D3 levels, 1 which our results corroborate. The slight decline in July may be insignificant considering the lower number of children tested in this month due to summer holidays and an increased variability in the results. Seasonal variations in bone turnover in prepubertal children and early puberty has also been described in the literature.
This could be explained in part by factors that reduce the effectiveness of sunlight exposure, such as the increased coverage with clothing in the cold months, the cloudy weather, the increased use of sunscreen, the times of day the children are outdoors and the latitude in Asturias. Thus, the general recommendation of 15 min of sunlight exposure a day may not suffice to guarantee optimal levels of 25 OH D3 in locations at this latitude.
In order to ensure an effective exposure, there should be an emphasis on recommending a minimum of 10—15 min in the sun without protection, at least in the arms and legs, in the spring, summer and autumn.
The second major source of vitamin D is diet.
These extremely low intakes, lower even than those of the mothers, may be the reason we did not find an association between intake and serum 25 OH D3 levels. We did not find any differences between the sexes in our cohort, although studies with prepubertal participants show an incipient sexual dimorphism. We did not find an association between BMI and 25 OH D3 levels, which was not consistent with the findings of other studies conducted in children that showed a correlation between obesity and a higher prevalence of vitamin D deficiency.
We ought to note that this study used the WHO growth standards hipovitmainosis reference. There is evidence that supplementation is more effective in achieving adequate levels of vitamin D than nutritional education interventions specifically designed to prevent vitamin D deficiency.
A recent study in children conducted in Pennsylvania latitude, Our findings support the promotion of a varied diet with an adequate intake of foods rich in vitamin D such as eggs, blue fish and fortified foods, especially in the winter, this age group, and in our region, as well as considering supplementation in children with risk factors for vitamin D deficiency or insufficiency. At present, routine dn of the paediatric population for vitamin D deficiency is not recommended, but it should be considered in patients with known risk factors, such as exclusively breastfed babies that do not receive supplementation, dark-skinned children and adolescents residing in northern countries, children and adolescents with inadequate sunlight exposure excessive hipovitaminoais of sunscreens with high SPF, that spent most of the day indoors, that use clothing covering most of the skin, during the winter in northern latitudes etc.
The association between 25 OH D3 levels during gestation and at age 4 years leads us to believe that deficiency of insufficiency in these cases is maintained throughout this time interval and associated with dietary and lifestyle habits. On the other hand, the fact that insufficiency and deficiency were more prevalent in these children compared to their mothers during pregnancy highlights the need to provide information and implement health education measures to promote improved levels in children, as is done in relation to pregnancy.
In conclusion, we found a high prevalence of vitamin D deficiency and insufficiency at age 4 years, especially in the winter. The intake of vitamin D from dietary sources is generally insufficient, so we need health promotion strategies with an emphasis on adequate intake of foods rich in vitamin D and to consider supplementation in children of this age with known risk hipovitaminozis.
Although children did spend the recommended time outdoors, this was not associated with their serum 25 OH D3 hipovitsminosis. Therefore, we need to promote effective exposure to sunlight in children residing in Asturias.
We must make this known both to the general population and to health care professionals, given the importance of maintaining an adequate vitamin D status. Ministry of Science and Innovation. The authors have no conflict of interests to declare. We thank all the families in the Asturias cohort of the INMA project for their disinterested participation in the project, without who this work would not have been possible. Please cite this article as: Previous article Next article.
Hypovitaminosis D and associated factors in 4-year old children in northern Spain. This item has received.
Show more Show less. Introduction Vitamin D is an essential prohormone in calcium and phosphorus homeostasis. Our objective was to estimate the prevalence of circulating vitamin D [25 OH D3] deficiency and insufficiency in children and examine the associated factors. Distribution of 25 OH D3 for month of extraction of specimen, ingestion, and other factors were analysed.
Results The mean 25 OH D3 was