Association of serum 25-hydroxyvitamin D status with bone mineral density in 0-7 year old children

Serum phospholipid fatty acids are associated with bone mass in healthy 4-years-old children

BACKGROUND

Fatty acids are involved in bone development but knowledge in children is limited. The aim of this study was to investigate bone mass and mineral density in healthy preschool children in relation to fatty acids.

MATERIAL AND METHODS

In 111 healthy 4-yrs-old children (20 % overweight) bone was analysed by dual X-ray absorptiometry and serum phospholipid fatty acid by gas chromatography. Fat intake was calculated from 7 days self-reported dietary records and food frequency questionnaire.

RESULTS

Total bone mass content (BMC) and mineral density (BMD) differed by sex in normal weight, but not in overweight children showing generally higher bone mass density than children with normal weight. Linoleic acid intake was strongly correlated to BMC and femoral BMD in normal weight children. Serum concentration of docosahexaenoic acid correlated positively to BMD in all children (p = 0.01), but linoleic and arachidonic acids, and monounsaturated fatty acids showed diverging associations with bone in normal weight and overweight children.

CONCLUSION

Serum phospholipid DHA was associated with bone density. Other fatty acids associations to bone sites differed in overweight children, analogue to the pattern in healthy 8-yrs-old.The finding need to be confirmed longitudinally and in a larger group of overweight individuals.

Systematic Literature Review of the Nutrient Status, Intake, and Diet Quality of Chinese Children across Different Age Groups

There is a lack of comprehensive reports on nutrient deficiencies and dietary intake among various age groups of children in China. The objective of this review is to provide an overview of the nutrient status, intake, and diet adequacy of Chinese children (0-18 years old). PubMed and Scopus were searched for literature published between January 2010 and July 2022. A systematic review approach with a quality assessment was performed to analyze 2986 identified articles in English and Chinese. Eighty-three articles were included in the analysis. In younger children, anemia and iron and Vitamin A deficiencies remain severe public health problems, despite high Vitamin A and adequate iron intake. In older children, a high prevalence of selenium; Vitamin A and D deficiencies; and inadequate intakes of Vitamins A, D, B, C, selenium, and calcium were reported. Intakes of dairy, soybeans, fruits, and vegetables were below recommended levels. High intakes of iodine, total and saturated fat, and sodium and low dietary diversity scores were also reported. As nutritional concerns vary with age and region, future nutrition interventions should be tailored accordingly.

Is vitamin D deficiency influenced by obesity during the first 5 years of life? A cross-sectional multicenter study

Evidence on the association of 25-hydroxyvitamin D (25[OH]D) and obesity during the first 5 years of life is limited in China. The objective of this study was to examine the associations between weight, weight for age z score (ZWAZ), weight for length/height z score (ZWHZ), and body mass index for age z score (ZBMI) and 25(OH)D. This was a large population-based cross-sectional multicenter study in which the children aged 0-5 years were recruited from 12 children's healthcare centers by a stratified cluster random-sampling method in 10 cities of the Jiangsu province, China. The 25(OH)D concentration was determined by ELISA. A total of 5289 children were investigated. For 0-71 months children with obesity and nonobesity, the prevalence of vitamin D deficiency was 36.0% and 29.8%, and the 25(OH)D level was 59.8 and 64.0 nmol/L, respectively, and there were all significant difference. Compared with children with nonobesity, children with obesity had higher risk of vitamin D deficiency (OR [95% CI]: 1.33 [1.02, 1.72], p < .05), and had lower 25(OH)D level (β = -3.84, 95% CI = -7.58, -0.09, p < .05). The results for children aged 24-71 months were similar to those for children aged 0-71 months. However, no significant difference was observed in children aged 0-23 months. Vitamin D deficiency was observed in children with greater adiposity during the first 5 years of life. However, the results mainly came from those in the age group of 2 to 5 years instead of the first 2 years in their lives.

The Crosstalk between Vitamin D and Pediatric Digestive Disorders

Vitamin D is a cyclopentane polyhydrophenanthrene compound involved mainly in bone health and calcium metabolism but also autophagy, modulation of the gut microbiota, cell proliferation, immune functions and intestinal barrier integrity. The sources of vitamin D include sunlight, diet and vitamin D supplements. Vitamin D3, the most effective vitamin D isoform is produced in the human epidermis as a result of sunlight exposure. Vitamin D undergoes two hydroxylation reactions in the liver and kidney to reach its active form, 1,25-dihydroxyvitamin D. Recent studies highlighted a complex spectrum of roles regarding the wellbeing of the gastrointestinal tract. Based on its antimicrobial effect, it was recently indicated that vitamin D supplementation in addition to standard eradication therapy might enhance H. pylori eradication rates. Moreover, it was suggested that low levels of vitamin D might also be involved in the acquisition of H. pylori infection. In terms of celiac disease, the negative effects of vitamin D deficiency might begin even during intrauterine life in the setting of maternal deficiency. Moreover, vitamin D is strongly related to the integrity of the gut barrier, which represents the core of the pathophysiology of celiac disease onset, in addition to being correlated with the histological findings of disease severity. The relationship between vitamin D and cystic fibrosis is supported by the involvement of this micronutrient in preserving lung function by clearing airway inflammation and preventing pathogen airway colonization. Moreover, this micronutrient might exert anticatabolic effects in CF patients. Inflammatory bowel disease patients also experience major benefits if they have a sufficient level of circulating vitamin D, proving its involvement in both induction and remission in these patients. The findings regarding the relationship between vitamin D, food allergies, diarrhea and constipation remain controversial, but vitamin D levels should be monitored in these patients in order to avoid hypo- and hypervitaminosis. Further studies are required to fill the remaining gaps in term of the complex impact of vitamin D on gastrointestinal homeostasis.

Vitamin D and Calcium in Children 0-36 Months: A Scoping Review of Health Outcomes

METHODS

Updated literature searches were conducted across 5 electronic databases to identify all randomized controlled trials, cohort studies, nested case-control or case-cohort studies, and systematic reviews published after the 2009 U.S. Agency for Healthcare Research and Quality's (AHRQ) evidence report, Vitamin D and Calcium: a Systematic Review of Health Outcomes. In total, 65 studies were summarized and analyzed in the present review.

RESULTS

There was a steady increasing trend in the number of publications reporting outcomes related to skeletal health, growth, and infectious disease from 2008 to 2019, although the number of published vitamin D studies was much larger than calcium studies.

CONCLUSIONS

The data presented in this review can facilitate assessment of the variety of outcomes and the amount of potentially useful literature available for each outcome. The results of this scoping review can be used to guide the undertaking of the subsequent systematic reviews.

Dietary calcium or phosphorus deficiency impairs the bone development by regulating related calcium or phosphorus metabolic utilization parameters of broilers

An experiment was conducted to investigate the effect of dietary calcium (Ca) or phosphorus (P) deficiency on bone development and related Ca or P metabolic utilization parameters of broilers. A total of 504 one-day-old Arbor Acres male broilers were randomly assigned to 1 of 4 treatments with 7 replicates of 18 birds per replicate in a completely randomized design. A 2 (Ca levels: 1.00 and 0.35%) × 2 (nonphytate P [NPP] levels: 0.45 and 0.23%) factorial arrangement of treatments was adopted in the 21-day trial. The 4 treatments were the Ca- and P-adequate diet (1.00% Ca + 0.45% NPP), the Ca-deficient diet (0.35% Ca + 0.45% NPP), the P-deficient diet (1.00% Ca + 0.23% NPP), and the Ca- and P-deficient diet (0.35% Ca + 0.23% NPP). The greatest impact on tibia bone mineral density, bone breaking strength, and ash content was in the P-deficient diets, especially in broilers fed with the Ca-adequate diet, whereas adequate P and reduced Ca reduced (P < 0.05) these parameters compared with adequate Ca and P, but not to the same level as P deficiency. Furthermore, dietary Ca or P deficiency, especially adequate Ca and P deficiency decreased (P < 0.05) serum P, 25-hydroxyvitamin D₃ (25-OHD₃) contents, and tibia ash Ca and P contents but increased (P < 0.05) the serum Ca content and tibia alkaline phosphatase (ALP) activity compared with adequate Ca and P. The results from this study indicated that the bone development and Ca or P metabolic utilization parameters of broilers were the most sensitive ones to dietary P deficiency, followed by dietary Ca deficiency or Ca and P deficiencies. Dietary P deficiency impaired the bone development by increasing serum Ca content and tibia ALP activity but decreasing serum P, 25-OHD₃ contents, and tibia ash Ca and P contents of broilers. Dietary Ca deficiency impaired bone development by increasing serum Ca content, tibia ALP activity, and tibia ash P content but decreasing serum P, 25-OHD₃ contents, and tibia ash Ca content of broilers.

Effect of circulating 25-hydroxyvitamin D and antioxidant capacity level on cognitive function parameters of children with idiopathic short stature

Background

An optimal level of vitamin D is necessary for normal bone growth. Recently, vitamin D has been linked to many neurological disorders, changes in antioxidant capacity levels, and cognitive function decline in old age; thus, the aim was to evaluate the effect of vitamin D and antioxidant levels on the cognitive function parameters of children with idiopathic short stature (ISS).

Results

A prospective case-control study was conducted with 60 primary school-aged children with ISS who were compared to 60 unrelated healthy age- and sex-matched children as a control group. A complete clinical evaluation; anthropometric measurements; neurocognitive function parameters using the Stanford-Binet test, fifth edition; vitamin D level; total antioxidant capacity (TAC); total oxidative stress (TOS); and oxidative stress index (OSI) were measured. A total of 83.3% of children with ISS had a vitamin D level < 30 ng/ml with significantly lower vitamin D levels than the control group. The TAC level was significantly lower in children with ISS than in healthy children. Children with ISS had an average level for all of the cognitive function parameters but a lower non-verbal IQ, full-scale IQ, fluid reasoning, knowledge, quantitative reasoning, and working memory than healthy controls. A positive correlation was found between vitamin D level and all anthropometric measurements, all IQ parameters, and TAC levels in the studied children. A positive correlation was found between TAC and all IQ parameters.

Conclusion

Vitamin D level and antioxidant capacity level have a major impact on cognitive function parameters in children with ISS.

The relationship between serum vitamin D and fracture risk in the elderly: a meta-analysis

BACKGROUND

The incidence of osteoporotic fractures has increased rapidly, and because of the poor prognosis and high mortality associated with osteoporotic fractures, they remain a prospective research area globally. One way to reduce their incidence is to investigate their intervention risk factors in the elderly. Hence, this study explores the correlation between serum 25-hydroxyvitamin D [25(OH)D] levels and osteoporotic fractures in elderly patients through a meta-analysis.

METHODS

We conducted our literature search mainly in PubMed and Embase for identifying studies that investigated the relationship between serum 25(OH)D levels and the risk for osteoporotic fractures. We performed categorical analysis, heterogeneity checks, publication bias analysis, and subgroup analyses.

RESULTS

In total, 20 studies were included, of which 4 were case-cohort studies and 16 were cohort studies. A total of 41,738 patients from 20 studies were included in the meta-analysis, of which 5916 had fractures, including 3237 hip fractures. By combining the lowest and highest categories of relative risks (RRs) and 95% confidence intervals (CIs), it was suggested that lower serum 25-hydroxyvitamin D levels may be a risk factor for fractures. RR (95% CI) for total and hip fractures were 1.11 (0.99, 1.24) and 0.89 (0.80, 0.98) after adjustments.

CONCLUSIONS

Our study showed that compared to low serum 25(OH)D levels, high serum 25(OH)D levels reduce the risk of hip fractures in the patients aged 60 years or older. In contrast, serum 25(OH)D has no significant relationship with total fracture risk.

The serum 25-hydroxyvitamin D levels and hip fracture risk: a meta-analysis of prospective cohort studies

Hip fracture has increasingly become a social and economic burden. The relationship between serum 25-hydroxyvitamin D levels and the risk of hip fracture reported by previous studies remains controversial. We searched Pubmed and Embase to identify studies reporting the relationship between serum 25-hydroxyvitamin D levels and risk of hip fracture. Fifteen prospective cohort studies with a total of 51239 participants and 3386 hip fracture cases were included. By pooling the Relative Risk of the lowest vs. the highest categories indicated that lower levels of serum 25-hydroxyvitamin D were more likely to be a risk factor for hip fracture with adjusted Relative Risk (95%Confidence Interval) of 1.58 (1.41, 1.77). Subgroup meta-analysis examining the stability of the primary results achieved the same results. A dose-response meta-analysis showed that the risk of hip fracture was a descending curve below the line of RR=1. The descending trend was obvious when serum 25-hydroxyvitamin D levels were less than 60 nmol/L and was flat when serum 25-hydroxyvitamin D levels were more than 60 nmol/L. We found that individuals with low levels of serum 25-hydroxyvitamin D have an increased risk of hip fracture, and this effect was evident when the serum 25-hydroxyvitamin D levels were less than 60 nmol/L.

Vitamin D in pediatric age: consensus of the Italian Pediatric Society and the Italian Society of Preventive and Social Pediatrics, jointly with the Italian Federation of Pediatricians

Vitamin D plays a pivotal role in the regulation of calcium-phosphorus metabolism, particularly during pediatric age when nutritional rickets and impaired bone mass acquisition may occur.Besides its historical skeletal functions, in the last years it has been demonstrated that vitamin D directly or indirectly regulates up to 1250 genes, playing so-called extraskeletal actions. Indeed, recent data suggest a possible role of vitamin D in the pathogenesis of several pathological conditions, including infectious, allergic and autoimmune diseases. Thus, vitamin D deficiency may affect not only musculoskeletal health but also a potentially wide range of acute and chronic conditions. At present, the prevalence of vitamin D deficiency is high in Italian children and adolescents, and national recommendations on vitamin D supplementation during pediatric age are lacking. An expert panel of the Italian Society of Preventive and Social Pediatrics reviewed available literature focusing on randomized controlled trials of vitamin D supplementation to provide a practical approach to vitamin D supplementation for infants, children and adolescents.