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Published on: May 4, 2018
Risk factors for vitamin D deficiency in children with osteogenesis imperfecta
Lisa D Wilsford1, Elroy Sullivan, Lynnette J Mazur
1Shriners Hospitals for Children Houston, Houston, TX 77030, USA.
Insights
Most children with osteogenesis imperfecta (OI) have low vitamin D levels. Risk factors include older age, African American descent, obesity, and soda consumption, highlighting the need for targeted supplementation and lifestyle education.
Area of Science:
- Pediatrics
- Endocrinology
- Genetics
Background:
- Osteogenesis imperfecta (OI) is a genetic disorder characterized by fragile bones.
- Vitamin D deficiency is a common concern in pediatric populations, particularly those with chronic conditions.
- Assessing vitamin D status and associated risk factors in OI patients is crucial for bone health management.
Purpose of the Study:
- To determine the prevalence of vitamin D deficiency in children with osteogenesis imperfecta (OI).
- To identify potential risk factors associated with low serum vitamin D levels in this patient group.
Main Methods:
- Retrospective chart review of 44 children with OI treated at Shriners Hospitals for Children.
- Data collected included dietary habits (milk, soda), supplementation, outdoor time, screen time, BMI, and bisphosphonate treatment history.
- Serum 25-hydroxyvitamin D (25OHD) and parathyroid hormone levels were analyzed.
Main Results:
- A high prevalence of vitamin D deficiency was observed, with 79.5% of patients having insufficient or deficient levels (mean 25OHD: 23 ng/mL).
- Significant correlations with lower vitamin D levels included older age, African American descent, higher BMI, soda consumption, and pamidronate therapy.
- The studied variables collectively explained a significant portion of the variability in 25OHD levels.
Conclusions:
- Healthcare providers should recognize risk factors for vitamin D deficiency in OI patients.
- Education on modifiable factors like diet (soda, milk), obesity, and supplementation is essential for families.
- Further research is warranted on the interplay between fractures, vitamin D, and bisphosphonate therapy in OI.
Background:
The purpose of this study was to evaluate the prevalence of vitamin D deficiency and possible risk factors influencing the vitamin D serum levels in patients with osteogenesis imperfecta (OI).
Methods:
Charts of all children with OI seen at Shriners Hospitals for Children in Houston, TX, between November 2008 and June 2011 were reviewed for daily milk and soda consumption, multivitamin and vitamin D supplementation, time spent outside, use of sunscreen, amount of screen time, ambulatory status, height, weight, body mass index (BMI), serum 25 hydroxyvitamin D (25OHD), parathyroid hormone levels, and history of bisphosphonate treatment.
Results:
Of the 80 children with OI, charts of 44 children (26 female) had documentation of the variables of interest. Mean level of 25OHD was 23 ng/mL (±11) (range, 7 to 58) and 35 (79.5%) patients had insufficient or deficient levels. Significant correlations with low vitamin D levels were found for older age (P<0.001), African American descent (P=0.01), BMI (P<0.001), BMI percentile (P=0.30), consumption of soda (P=0.009), and pamidronate therapy (P=0.004). Evaluated together, the studied variables accounted for a large proportion of the variability of 25OHD levels in patients with OI (P=0.004).
Conclusions:
To optimize bone health in children with OI, health care providers need to be aware of patients' risk factors for low vitamin D levels and educate families on the modifiable risk factors of milk and soda consumption, obesity, and vitamin D supplementation. Future research is needed to address the relationship between fractures and vitamin D levels in patients with OI and on the cause and effect relationship between bisphosphonate therapy and vitamin D.
Level Of Evidence:
Level II.
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