Natural History of Infants with Vitamin D Deficiency in Hong Kong

Overview

Journal Asia Pac J Clin Nutr

Specialty Nutritional Sciences

Date 2023 Dec 22

PMID 38135475

Authors

Joanna Yuet-Ling Tung

Hung-Kwan So

Keith Tsz-Suen Tung

Rosa Sze-Man Wong

Hing-Wai Tsang

Bianca Chan

Winnie Wan-Yee Tso

Ian Chi-Kei Wong

Jason Cheuk-Sing Yam

Samantha Lai-Ka Lee

Gloria Pang

Wilfred Hing-Sang Wong

Ka-Wang Cheung

Wing-Cheong Leung

Patrick Ip

Affiliations

Soon will be listed here.

Abstract

Background And Objectives: The usual recommended intake of vitamin D for healthy infants is 400 international unit (IU) daily. However, a high dose of vitamin D at 2000-3000 IU daily is needed for those with vitamin D deficiency (VDD). This study aimed to assess the natural history of a group of healthy infants with VDD and the associated factors for persistent VDD.

Methods And Study Design: Healthy infants detected to have VDD (25OHD <25 nmol/L) in a population study were followed, and their demographics and clinical data were collected.

Results: One hundred and thirty-one subjects (boys = 66%) were included. Their first serum 25OHD was taken at a median age of 87.5 days. None were treated with high-dose vitamin D supplements, but some have been given vitamin D at 400 IU daily. They were assessed again at the median age of 252.5 days when 15 remained to have VDD and 26 were in the insufficient range (25 - 49.9nmol/L). All persistent VDD children were on exclusive breastfeeding. Exclusive breastfeeding and no vitamin D supplementation were significant risk factors for persistent vitamin D insufficiency (<50nmol/L).

Conclusions: Persistent VDD is common among infants exclusively breastfeeding and those who did not receive vitamin D supplementation.

References

Wagner C, Hollis B . Early-Life Effects of Vitamin D: A Focus on Pregnancy and Lactation. Ann Nutr Metab. 2020; 76 Suppl 2:16-28. DOI: 10.1159/000508422. View

Dawodu A, Tsang R . Maternal vitamin D status: effect on milk vitamin D content and vitamin D status of breastfeeding infants. Adv Nutr. 2012; 3(3):353-61. PMC: 3649470. DOI: 10.3945/an.111.000950. View

He L, Zhou P, Zhou X, Tian S, Han J, Zhai S . Evaluation of the clinical practice guidelines and consensuses on calcium and vitamin D supplementation in healthy children using the Appraisal of Guidelines for Research and Evaluation II instrument and Reporting Items for Practice Guidelines in.... Front Nutr. 2022; 9:984423. PMC: 9551644. DOI: 10.3389/fnut.2022.984423. View

Holick M, Binkley N, Bischoff-Ferrari H, Gordon C, Hanley D, Heaney R . Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011; 96(7):1911-30. DOI: 10.1210/jc.2011-0385. View

Revez J, Lin T, Qiao Z, Xue A, Holtz Y, Zhu Z . Genome-wide association study identifies 143 loci associated with 25 hydroxyvitamin D concentration. Nat Commun. 2020; 11(1):1647. PMC: 7118120. DOI: 10.1038/s41467-020-15421-7. View

Focker M, Antel J, Ring S, Hahn D, Kanal O, Ozturk D . Vitamin D and mental health in children and adolescents. Eur Child Adolesc Psychiatry. 2017; 26(9):1043-1066. DOI: 10.1007/s00787-017-0949-3. View

Dipasquale V, Lo Presti G, Milani G, Corsello A, Agostoni C, Romano C . Vitamin D in Prevention of Autoimmune Diseases. Front Biosci (Landmark Ed). 2022; 27(10):288. DOI: 10.31083/j.fbl2710288. View

Hattangdi-Haridas S, Lanham-New S, Wong W, Ho M, Darling A . Vitamin D Deficiency and Effects of Vitamin D Supplementation on Disease Severity in Patients with Atopic Dermatitis: A Systematic Review and Meta-Analysis in Adults and Children. Nutrients. 2019; 11(8). PMC: 6722944. DOI: 10.3390/nu11081854. View

Wang Q, Ying Q, Zhu W, Chen J . Vitamin D and asthma occurrence in children: A systematic review and meta-analysis. J Pediatr Nurs. 2021; 62:e60-e68. DOI: 10.1016/j.pedn.2021.07.005. View

10.

Rostami M, Ramezani Tehrani F, Simbar M, Yarandi R, Minooee S, Hollis B . Effectiveness of Prenatal Vitamin D Deficiency Screening and Treatment Program: A Stratified Randomized Field Trial. J Clin Endocrinol Metab. 2018; 103(8):2936-2948. DOI: 10.1210/jc.2018-00109. View

11.

Munns C, Shaw N, Kiely M, Specker B, Thacher T, Ozono K . Global Consensus Recommendations on Prevention and Management of Nutritional Rickets. J Clin Endocrinol Metab. 2016; 101(2):394-415. PMC: 4880117. DOI: 10.1210/jc.2015-2175. View

12.

Andrews L, Phlegar K, Baatz J, Ebeling M, Shary J, Gregoski M . Comparison of Infant Bone Mineral Content and Density After Infant Daily Oral Vit D 400 IU Supplementation Versus Nursing Mother Oral 6,400 IU Supplementation: A Randomized Controlled Lactation Study. Breastfeed Med. 2022; 17(6):493-500. PMC: 9234966. DOI: 10.1089/bfm.2021.0281. View

13.

Wong R, Tung K, Mak R, Leung W, Yam J, Chua G . Vitamin D concentrations during pregnancy and in cord blood: a systematic review and meta-analysis. Nutr Rev. 2022; 80(12):2225-2236. DOI: 10.1093/nutrit/nuac023. View

14.

Hollis B, Wagner C, Howard C, Ebeling M, Shary J, Smith P . Maternal Versus Infant Vitamin D Supplementation During Lactation: A Randomized Controlled Trial. Pediatrics. 2015; 136(4):625-34. PMC: 4586731. DOI: 10.1542/peds.2015-1669. View

15.

Chan K, Tam W, Chan M, Chan R, Li A . Vitamin D deficiency among healthy infants in Hong Kong: a pilot study. Hong Kong Med J. 2018; 24 Suppl 3(3):32-35. View

16.

Holick M, Chen T, Lu Z, Sauter E . Vitamin D and skin physiology: a D-lightful story. J Bone Miner Res. 2008; 22 Suppl 2:V28-33. DOI: 10.1359/jbmr.07s211. View

17.

Ariyawatkul K, Lersbuasin P . Prevalence of vitamin D deficiency in cord blood of newborns and the association with maternal vitamin D status. Eur J Pediatr. 2018; 177(10):1541-1545. DOI: 10.1007/s00431-018-3210-2. View

18.

Wagner C, Greer F . Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics. 2008; 122(5):1142-52. DOI: 10.1542/peds.2008-1862. View

19.

McDonnell S, Baggerly K, Baggerly C, Aliano J, French C, Baggerly L . Maternal 25(OH)D concentrations ≥40 ng/mL associated with 60% lower preterm birth risk among general obstetrical patients at an urban medical center. PLoS One. 2017; 12(7):e0180483. PMC: 5524288. DOI: 10.1371/journal.pone.0180483. View

20.

Palacios C, Kostiuk L, Pena-Rosas J . Vitamin D supplementation for women during pregnancy. Cochrane Database Syst Rev. 2019; 7:CD008873. PMC: 6659840. DOI: 10.1002/14651858.CD008873.pub4. View