Hypovitaminosis D among healthy children in the United States: a review of the current evidence.
Arch Pediatr Adolesc Med. 2008 Jun;162(6):513-9. PMID: 18524740
Division of Epidemiology, Statistics and Prevention, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6100 Executive Blvd, Room 7B13A, MSC 7510, Rockville, MD 20852, USA. email@example.com
OBJECTIVE: To review the published literature on serum 25-hydroxyvitamin D concentrations in US children.
DATA SOURCES: Articles were identified by searching MEDLINE using 25-hydroxyvitamin D, vitamin D, hypovitaminosis D, vitamin D insufficiency, vitamin D deficiency, children, and adolescents as key words and by screening references from original studies.
STUDY SELECTION: Studies were included if they fulfilled the following a priori criteria: contained a well-defined sample of children, included only healthy children, presented data on serum 25-hydroxyvitamin D concentrations, were published in the past 10 years, and were conducted in the United States.
DATA EXTRACTION: Serum 25-hydroxyvitamin D concentrations and prevalence of low vitamin D status (hypovitaminosis D).
DATA SYNTHESIS: Fourteen articles fulfilled the criteria. There were no consistent definitions of hypovitaminosis D; values corresponding to vitamin D deficiency ranged from less than 5 ng/mL to less than 12 ng/mL, and those for vitamin D insufficiency ranged from less than 10 ng/mL to less than 32 ng/mL (to convert 25-hydroxyvitamin D concentrations to nanomoles per liter, multiply by 2.496). The following assays were used: radioimmunoassay (7 studies), competitive binding protein assay (3 studies), automated chemiluminescence protein-binding assay (3 studies), and enzyme-linked immunosorbent assay (1 study). Breastfed infants in winter who did not receive vitamin D supplementation were the most severely vitamin D deficient (78%). Estimates of the prevalence of hypovitaminosis D ranged from 1% to 78%. Older age, winter season, higher body mass index, black race/ethnicity, and elevated parathyroid hormone concentrations were associated with lower 25-hydroxyvitamin D concentrations.
CONCLUSION: Although overt vitamin D deficiency is no longer common in US children, lesser degrees of vitamin D insufficiency are widespread.