Prevalence of hypovitaminosis D and predictors of vitamin D status in Italian healthy adolescents

Italian Journal of Pediatrics

Giuseppe Saggese¹  Paola Erba²  Margherita Fanos¹  Marta Del Pistoia¹  Francesco Vierucci³ 

[1] Pediatric Clinic, University-Hospital Pisa, Pisa, Italy;Nuclear Medicine Unit, University-Hospital Pisa, Pisa, Italy;Pediatric Unit, Campo di Marte Hospital, Via Ospedale 1, 55100 Lucca, Italy

关键词: Parathyroid hormone;    Vitamin D insufficiency;    Vitamin D deficiency;    Hypovitaminosis D;    Adolescents;   

Others  :  802210
DOI  :  10.1186/1824-7288-40-54

 received in 2014-03-25, accepted in 2014-05-21,  发布年份 2014

【 摘 要 】

Background

Vitamin D plays an important role in health promotion during adolescence. Vitamin D deficiency and insufficiency are common in adolescents worldwide. Few data on vitamin D status and risk factors for hypovitaminosis D in Italian adolescents are currently available.

Methods

25-hydroxyvitamin D (25-OH-D) and parathyroid hormone (PTH) levels were evaluated in 427 Italian healthy adolescents (10.0-21.0 years). We used the following cut-off of 25-OH-D to define vitamin D status: deficiency < 50 nmol/L; insufficiency 50-75 nmol/L; sufficiency ≥ 75 nmol/L. Hypovitaminosis D was defined as 25-OH-D levels < 75.0 nmol/L and severe vitamin D deficiency as 25-OH-D levels < 25.0 nmol/L. We evaluated gender, residence, season of blood withdrawal, ethnicity, weight status, sun exposure, use of sunscreens, outdoor physical activity, and history of fractures as predictors of vitamin D status.

Results

Enrolled adolescents had a median serum 25-OH-D level of 50.0 nmol/L, range 8.1-174.7, with 82.2% having hypovitaminosis D. Vitamin D deficiency and insufficiency were detected in 49.9% and 32.3% of adolescents, respectively. Among those with deficiency, 38 subjects were severely deficient (38/427, 8.9% of the entire sample). Non-white adolescents had a higher prevalence of severe vitamin D deficiency than white subjects (6/17-35.3% vs 32/410-7.8% respectively, p = 0.002). Logistic regression showed increased risk of hypovitaminosis D as follows: blood withdrawal taken in winter-spring (Odds ratio (OR) 5.64) compared to summer-fall period; overweight-obese adolescents (OR 3.89) compared to subjects with normal body mass index (BMI); low sun exposure (OR 5.94) compared to moderate-good exposure and regular use of sunscreens (OR 5.89) compared to non regular use. Adolescents who performed < 3 hours/week of outdoor exercise had higher prevalence of hypovitaminosis D. Gender, residence, and history of fractures were not associated with vitamin D status. Serum 25-OH-D levels were inversely related to PTH (r = -0.387, p < 0.0001) and BMI-SDS (r = -0.141, p = 0.007). 44/427 (10.3%) adolescents showed secondary hyperparathyroidism.

Conclusions

Italian adolescents have high prevalence of vitamin D deficiency and insufficiency. Pediatricians should tackle predictors of vitamin D status, favoring a healthier lifestyle and promoting supplementation in the groups at higher risk of hypovitaminosis D.

【 授权许可】

   
2014 Vierucci et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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