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. 2023 Feb 22;49(1):27.
doi: 10.1186/s13052-023-01422-x.

Vitamin D status in healthy Italian school-age children: a single-center cross-sectional study

Tiziana Galeazzi  1 , Sara Quattrini  2 , Dorina Pjetraj  2 , Simona Gatti  2 , Chiara Monachesi  2 , Elisa Franceschini  2 , Luisita Marinelli  3 , Giulia N Catassi  4 , Elena Lionetti  2 , Carlo Catassi  2   5
Affiliations

Vitamin D status in healthy Italian school-age children: a single-center cross-sectional study

Tiziana Galeazzi et al. Ital J Pediatr. .

Abstract

Background: Vitamin D is involved in calcium homeostasis and bone metabolism, although its extra-skeletal actions are also well-known. Low serum 25(OH)D levels are common both in adults and children worldwide.

Methods: The purpose of this cross-sectional study was to determine the distribution of 25(OH)D levels in a cohort of healthy Italian school-age children, aged 5-10 years, in relationship to determinants of vitamin D deficiency such as season, BMI, gender, age and ethnicity.

Results: The mean serum 25(OH) D level was 28.2 ng/mL; the prevalence of 25(OH)D sufficiency (> 30 ng/mL), insufficiency (20-30 ng/mL), deficiency (10-20 ng/mL) and severe deficiency (< 10 ng/mL) was 36%, 37%, 21% and 6% of the study-group population, respectively. The lower serum 25(OH)D values were observed during winter (21.6 ng/mL) and spring (22.9 ng/mL), as compared to summer (46.7 ng/mL) (p < 0.001). Higher BMI z-scores were associated with lower 25(OH)D level while no statistical difference was observed as related to gender and age groups.

Conclusions: Healthy Italian schoolchildren show low 25(OH)D levels, particularly during winter and spring time. Seasonality, ethnicity and overweight/obesity were confirmed to influence the vitamin D status, thus indicating the need for effective initiatives to support adequate vitamin D status in this population group.

Keywords: 25(OH) D; BMI; Deficiency; Prevalence; School-age children; Season; Vitamin D.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Serum 25-hydroxyvitamin D [25(OH)D] distribution according to ethnicity. The category “Non-Caucasian” comprises children of African, Hispanic, and Asian origins. Data are expressed as ng/mL. Median values are 11.5 ng/mL in the non-Caucasian subjects and 26.7 ng/mL in the Caucasian subjects. The Caucasian subjects show the highest levels of 25(OH)D (90.1 ng/mL vs 49.6 ng/mL), with the higher number of outliers. Significance p values (p < 0.005) are marked as (*)
Fig. 2
Fig. 2
Seasonal fluctuation in the median serum 25-hydroxyvitamin D [25(OH)D] distribution. Data are expressed as ng/mL. Median values are 21.7 ng/mL in winter, 22.9 ng/mL in spring, 25.7 ng/mL in autumn and 44.9 ng/mL in summer. The lowest levels of 25(OH)D were registered in winter and spring with 3.9 ng/mL each. Summertime is the period with the highest median serum 25(OH)D level and interquartile range (IQR of 17.35); none of the participants presented a state of deficiency (25(OH)D < 20 ng/mL) during summer. Significance p values (p < 0.005) are marked as (*)
Fig. 3
Fig. 3
Percentage of children by serum 25-hydroxyvitamin D [25(OH)D] level under and over 20 ng/mL for BMI percentile groups. The obese group (BMI > 95 percentile) presents a significant higher prevalence of 25(OH)D deficiency when compared with the normal weight group (5–85 percentile). Significance p values (p < 0.005) are marked as (*)
Fig. 4
Fig. 4
Serum 25-hydroxyvitamin D [25(OH)D] distribution according to gender. Median values are 25.5 ng/mL in males, 26.7 ng/mL in females. IQR is 13.4 ng/mL and 16.2 ng/mL in males and females respectively. Minimum and maximum 25(OH)D level are 3.9 ng/mL and 80.1 ng/mL in males and 6 ng/mL and 90.1 ng/mL in females
Fig. 5
Fig. 5
Percentage of children by serum 25-hydroxyvitamin D [25(OH)D] level for age groups. The labels above each column refer to the number of children in each age category. The age-range goes from 6 to 10 years. As expected for such a small age range, there are no significant differences on the distribution of 25(OH)D levels compared by age
Fig. 6
Fig. 6
Cumulative frequency distribution of serum 25-hydroxyvitamin D [25(OH)D] concentration in the study children. The labelled values refer to 25(OH)D value at the 10,50,90th percentile
See this image and copyright information in PMC

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