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Advances in Pediatrics

Vitamin D Update in the Pediatric Population

  • Lindsey A. Warner
    Affiliations
    Children’s Hospital Colorado, University of Colorado School of Medicine, 13123 East 16th Avenue, B158, Aurora, CO 80045, USA

    Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
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  • Rachel L. Sewell
    Affiliations
    Children’s Hospital Colorado, University of Colorado School of Medicine, 13123 East 16th Avenue, B158, Aurora, CO 80045, USA

    Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
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  • Nina S. Ma
    Correspondence
    Corresponding author. University of Colorado School of Medicine, 13123 East 16th Avenue, B265, Aurora, CO 80045.
    Affiliations
    Bone and Mineral Metabolism Program, Section of Endocrinology, Children's Hospital Colorado, University of Colorado School of Medicine, 13123 East 16th Avenue, B265, Aurora, CO 80045, USA

    Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
    Search for articles by this author
      Risk factors for vitamin D deficiency include preterm and exclusively breastfed infants, darker skin, decreased sun exposure and sunscreen use, obesity, malabsorption disorders, and medications that increase vitamin D catabolism.

      Keywords

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      References

        • O'Neill C.M.
        • Kazantzidis A.
        • Ryan M.J.
        • et al.
        Seasonal changes in Vitamin D-effective UVB availability in Europe and Associations with population serum 25-hydroxyvitamin D.
        Nutrients. 2016; 8: 533
        • Kimlin M.G.
        Geographic location and vitamin D synthesis.
        Mol Aspects Med. 2008; 29: 453-461
        • Holick M.F.
        Vitamin D deficiency.
        N Engl J Med. 2007; 357: 266-281
        • Christakos S.
        • Dhawan P.
        • Porta A.
        • et al.
        Vitamin D and intestinal calcium absorption.
        Mol Cell Endocrinol. 2011; 347: 25-29
        • Harrison H.E.
        • Harrison H.C.
        Intestinal transport of phosphate: action of vitamin D, calcium, and potassium.
        Am J Physiol. 1961; 201: 1007-1012
        • Bouillon R.
        • Marcocci C.
        • Carmeliet G.
        • et al.
        Skeletal and extraskeletal actions of vitamin D: current evidence and outstanding questions.
        Endocr Rev. 2019; 40: 1109-1151
        • Thacher T.D.
        • Fischer P.R.
        • Strand M.A.
        • et al.
        Nutritional rickets around the world: causes and future directions.
        Ann Trop Paediatr. 2006; 26: 1-16
        • Thacher T.D.
        • Pludowski P.
        • Shaw N.J.
        • et al.
        Nutritional rickets in immigrant and refugee children.
        Public Health Rev. 2016; 37: 1-10
        • Ward L.M.
        • Gaboury I.
        • Ladhani M.
        • et al.
        Vitamin D–deficiency rickets among children in Canada.
        CMAJ. 2007; 177: 161-166
        • Callaghan A.L.
        • Moy R.
        • Booth I.W.
        • et al.
        Incidence of symptomatic vitamin D deficiency.
        Arch Dis Child. 2006; 91: 606-607
      1. Thacher TD, Fischer PR, Tebben PJ, et al. Increasing incidence of nutritional rickets: a population-based study in Olmsted County, Minnesota. Paper presented at: Mayo Clinic Proceedings 2013;88(2):176–83.

        • Ma N.
        • Gordon C.
        The truth about vitamin D and adolescent skeletal health.
        Adolesc Med State Art Rev. 2012; 23: 457
        • Ganji V.
        • Zhang X.
        • Tangpricha V.
        Serum 25-hydroxyvitamin D concentrations and prevalence estimates of hypovitaminosis D in the US population based on assay-adjusted data.
        J Nutr. 2012; 142: 498-507
        • Herrick K.A.
        • Storandt R.J.
        • Afful J.
        • et al.
        Vitamin D status in the United States, 2011–2014.
        Am J Clin Nutr. 2019; 110: 150-157
        • Institute of Medicine Committee to Review Dietary Reference Intakes for Vitamin D, Calcium
        The National Academies Collection: reports funded by National Institutes of Health.
        in: Ross A.C. Taylor C.L. Yaktine A.L. Dietary reference intakes for calcium and vitamin D. National Academies Press (US), Washington, DC2011 (Copyright © 2011, National Academy of Sciences)
        • Holick M.F.
        • Binkley N.C.
        • Bischoff-Ferrari H.A.
        • et al.
        Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline.
        J Clin Endocrinol Metab. 2011; 96: 1911-1930
        • Misra M.
        • Pacaud D.
        • Petryk A.
        • et al.
        Vitamin D deficiency in children and its management: review of current knowledge and recommendations.
        Pediatrics. 2008; 122: 398-417
        • Wagner C.L.
        • Greer F.R.
        Prevention of rickets and vitamin D deficiency in infants, children, and adolescents.
        Pediatrics. 2008; 122: 1142-1152
        • Clemens T.
        • Henderson S.
        • Adams J.
        • et al.
        Increased skin pigment reduces the capacity of skin to synthesise vitamin D3.
        Lancet. 1982; 319: 74-76
        • Walsh J.S.
        • Bowles S.
        • Evans A.L.
        Vitamin D in obesity.
        Curr Opin Endocrinol Diabetes Obes. 2017; 24: 389-394
        • Wortsman J.
        • Matsuoka L.Y.
        • Chen T.C.
        • et al.
        Decreased bioavailability of vitamin D in obesity.
        Am J Clin Nutr. 2000; 72: 690-693
        • Gröber U.
        • Kisters K.
        Influence of drugs on vitamin D and calcium metabolism.
        Dermatoendocrinol. 2012; 4: 158-166
        • Altieri B.
        • Cavalier E.
        • Bhattoa H.P.
        • et al.
        Vitamin D testing: advantages and limits of the current assays.
        Eur J Clin Nutr. 2020; 74: 231-247
        • Sempos C.T.
        • Vesper H.W.
        • Phinney K.W.
        • et al.
        Vitamin D status as an international issue: national surveys and the problem of standardization.
        Scand J Clin Lab Invest. 2012; 72: 32-40
        • Wise S.A.
        • Phinney K.W.
        • Tai S.S.
        • et al.
        Baseline assessment of 25-hydroxyvitamin D assay performance: a vitamin D standardization program (VDSP) interlaboratory comparison study.
        J AOAC Int. 2017; 100: 1244-1252
        • Fraser W.D.
        • Tang J.C.
        • Dutton J.J.
        • et al.
        Vitamin D measurement, the debates continue, new analytes have emerged, developments have variable outcomes.
        Calcif Tissue Int. 2020; 106: 3-13
        • Gallo S.
        • Comeau K.
        • Agellon S.
        • et al.
        Methodological issues in assessing plasma 25-hydroxyvitamin D concentration in newborn infants.
        Bone. 2014; 61: 186-190
        • Giustina A.
        • Adler R.
        • Binkley N.
        • et al.
        Consensus statement from 2nd International Conference on Controversies in Vitamin D.
        Rev Endocr Metab Disord. 2020; 21: 89-116
        • Rabenberg M.
        • Scheidt-Nave C.
        • Busch M.A.
        • et al.
        Implications of standardization of serum 25-hydroxyvitamin D data for the evaluation of vitamin D status in Germany, including a temporal analysis.
        BMC Public Health. 2018; 18: 845
        • Singh R.J.
        • Taylor R.L.
        • Reddy G.S.
        • et al.
        C-3 epimers can account for a significant proportion of total circulating 25-hydroxyvitamin D in infants, complicating accurate measurement and interpretation of vitamin D status.
        J Clin Endocrinol Metab. 2006; 91: 3055-3061
        • Al-Zohily B.
        • Al-Menhali A.
        • Gariballa S.
        • et al.
        Epimers of Vitamin D: a review.
        Int J Mol Sci. 2020; 21: 470
        • Liu T.
        • Wang E.
        • Li Q.
        • et al.
        High prevalence of vitamin D insufficiency in Chinese children with upper limb fractures.
        Genes Dis. 2020; 7: 408-413
        • Karpiński M.
        • Galicka A.
        • Milewski R.
        • et al.
        Association between Vitamin D receptor polymorphism and serum Vitamin D levels in children with low-energy fractures.
        J Am Coll Nutr. 2017; 36: 64-71
        • Hosseinzadeh P.
        • Mohseni M.
        • Minaie A.
        • et al.
        Vitamin D status in children with forearm fractures: incidence and risk factors.
        J Am Acad Orthop Surg Glob Res Rev. 2020; 4 (e20.00150-5)
        • Thompson R.M.
        • Dean D.M.
        • Goldberg S.
        • et al.
        Vitamin D insufficiency and fracture risk in urban children.
        J Pediatr Orthop. 2017; 37: 368-373
        • Minkowitz B.
        • Cerame B.
        • Poletick E.
        • et al.
        Low Vitamin D levels are associated with need for surgical correction of pediatric fractures.
        J Pediatr Orthop. 2017; 37: 23-29
        • Schilling S.
        • Wood J.N.
        • Levine M.A.
        • et al.
        Vitamin D status in abused and nonabused children younger than 2 years old with fractures.
        Pediatrics. 2011; 127: 835-841
        • Perez-Rossello J.M.
        • Feldman H.A.
        • Kleinman P.K.
        • et al.
        Rachitic changes, demineralization, and fracture risk in healthy infants and toddlers with vitamin D deficiency.
        Radiology. 2012; 262: 234-241
        • Ceroni D.
        • Anderson De La Llana R.
        • Martin X.
        • et al.
        Prevalence of vitamin D insufficiency in Swiss teenagers with appendicular fractures: a prospective study of 100 cases.
        J Child Orthop. 2012; 6: 497-503
        • Ramirez N.
        • Ortiz-Fullana J.L.
        • Arciniegas N.
        • et al.
        Vitamin D levels and fracture risk among Hispanic children.
        Eur J Orthop Surg Traumatol. 2019; 29: 531-536
        • Contreras J.J.
        • Hiestand B.
        • O'Neill J.C.
        • et al.
        Vitamin D deficiency in children with fractures.
        Pediatr Emerg Care. 2014; 30: 777-781
        • Anderson L.N.
        • Heong S.W.
        • Chen Y.
        • et al.
        Vitamin D and fracture risk in early childhood: a case-control study.
        Am J Epidemiol. 2017; 185: 1255-1262
        • Calvo M.S.
        • Whiting S.J.
        Survey of current vitamin D food fortification practices in the United States and Canada.
        J Steroid Biochem Mol Biol. 2013; 136: 211-213
        • Rusińska A.
        • Płudowski P.
        • Walczak M.
        • et al.
        Vitamin D Supplementation guidelines for general population and groups at risk of Vitamin D deficiency in Poland-Recommendations of the Polish Society of Pediatric Endocrinology and Diabetes and the expert panel with participation of national specialist consultants and representatives of scientific societies-2018 update.
        Front Endocrinol (Lausanne). 2018; 9: 246
        • Hanson C.
        • Armas L.
        • Lyden E.
        • et al.
        Vitamin D status and associations in newborn formula-fed infants during initial hospitalization.
        J Am Diet Assoc. 2011; 111: 1836-1843
        • Dawodu A.
        • Nath R.
        High prevalence of moderately severe vitamin D deficiency in preterm infants.
        Pediatr Int. 2011; 53: 207-210
        • Hanson C.
        • Lyden E.
        • Nelson A.
        • et al.
        Response of vitamin D binding protein and free vitamin D concentrations to vitamin D supplementation in hospitalized premature infants.
        J Pediatr Endocrinol Metab. 2015; 28: 1107-1114
        • Monangi N.
        • Slaughter J.L.
        • Dawodu A.
        • et al.
        Vitamin D status of early preterm infants and the effects of vitamin D intake during hospital stay.
        Arch Dis Child Fetal Neonatal Ed. 2014; 99: F166-F168
        • Burris H.H.
        • Van Marter L.J.
        • McElrath T.F.
        • et al.
        Vitamin D status among preterm and full-term infants at birth.
        Pediatr Res. 2014; 75: 75-80
        • Anderson-Berry A.
        • Thoene M.
        • Wagner J.
        • et al.
        Randomized trial of two doses of vitamin D3 in preterm infants <32 weeks: dose impact on achieving desired serum 25(OH)D3 in a NICU population.
        PLoS One. 2017; 12: e0185950
        • van de Lagemaat M.
        • Rotteveel J.
        • van Weissenbruch M.M.
        • et al.
        Increased gain in bone mineral content of preterm infants fed an isocaloric, protein-, and mineral-enriched postdischarge formula.
        Eur J Nutr. 2013; 52: 1781-1785
        • van de Lagemaat M.
        • Rotteveel J.
        • Schaafsma A.
        • et al.
        Higher vitamin D intake in preterm infants fed an isocaloric, protein- and mineral-enriched postdischarge formula is associated with increased bone accretion.
        J Nutr. 2013; 143: 1439-1444
        • Natarajan C.K.
        • Sankar M.J.
        • Agarwal R.
        • et al.
        Trial of daily vitamin D supplementation in preterm infants.
        Pediatrics. 2014; 133: e628-e634
        • Abrams S.A.
        • Hawthorne K.M.
        • Rogers S.P.
        • et al.
        Effects of ethnicity and vitamin D supplementation on vitamin D status and changes in bone mineral content in infants.
        BMC Pediatr. 2012; 12: 6
        • Gallo S.
        • Comeau K.
        • Vanstone C.
        • et al.
        Effect of different dosages of oral vitamin D supplementation on vitamin D status in healthy, breastfed infants: a randomized trial.
        JAMA. 2013; 309: 1785-1792
        • Gallo S.
        • Hazell T.
        • Vanstone C.A.
        • et al.
        Vitamin D supplementation in breastfed infants from Montréal, Canada: 25-hydroxyvitamin D and bone health effects from a follow-up study at 3 years of age.
        Osteoporos Int. 2016; 27: 2459-2466
        • Rosendahl J.
        • Valkama S.
        • Holmlund-Suila E.
        • et al.
        Effect of higher vs standard dosage of vitamin D3 supplementation on bone strength and infection in healthy infants: a randomized clinical trial.
        JAMA Pediatr. 2018; 172: 646-654
        • Ward K.A.
        • Das G.
        • Roberts S.A.
        • et al.
        A randomized, controlled trial of vitamin D supplementation upon musculoskeletal health in postmenarchal females.
        J Clin Endocrinol Metab. 2010; 95: 4643-4651
        • El-Hajj Fuleihan G.
        • Nabulsi M.
        • Tamim H.
        • et al.
        Effect of vitamin D replacement on musculoskeletal parameters in school children: a randomized controlled trial.
        J Clin Endocrinol Metab. 2006; 91: 405-412
        • Al-Shaar L.
        • Nabulsi M.
        • Maalouf J.
        • et al.
        Effect of vitamin D replacement on hip structural geometry in adolescents: a randomized controlled trial.
        Bone. 2013; 56: 296-303
        • Soliman A.T.
        • Adel A.
        • Wagdy M.
        • et al.
        Manifestations of severe vitamin D deficiency in adolescents: effects of intramuscular injection of a megadose of cholecalciferol.
        J Trop Pediatr. 2011; 57: 303-306
        • Karlsland Åkeson P.
        • Åkesson K.E.
        • Lind T.
        • et al.
        Vitamin D intervention and bone: a randomized clinical trial in fair- and dark-skinned children at Northern Latitudes.
        J Pediatr Gastroenterol Nutr. 2018; 67: 388-394
        • Winzenberg T.
        • Powell S.
        • Shaw K.A.
        • et al.
        Effects of vitamin D supplementation on bone density in healthy children: systematic review and meta-analysis.
        BMJ. 2011; 342: c7254
        • Laing E.M.
        • Lewis R.D.
        New concepts in Vitamin D requirements for children and adolescents: a controversy revisited.
        Front Horm Res. 2018; 50: 42-65
        • Hollis B.W.
        • Wagner C.L.
        Vitamin D requirements during lactation: high-dose maternal supplementation as therapy to prevent hypovitaminosis D for both the mother and the nursing infant.
        Am J Clin Nutr. 2004; 80: 1752S-1758S
        • Greer F.R.
        • Marshall S.
        Bone mineral content, serum vitamin D metabolite concentrations, and ultraviolet B light exposure in infants fed human milk with and without vitamin D2 supplements.
        J Pediatr. 1989; 114: 204-212
        • Hollis B.W.
        • Wagner C.L.
        • Howard C.R.
        • et al.
        Maternal versus infant vitamin D supplementation during lactation: a randomized controlled trial.
        Pediatrics. 2015; 136: 625-634
        • Manson J.E.
        • Cook N.R.
        • Lee I.-M.
        • et al.
        Vitamin D supplements and prevention of cancer and cardiovascular disease.
        N Engl J Med. 2019; 380: 33-44