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Study of the Determinants of Vitamin D Status in Pediatric Patients With Osteogenesis Imperfecta
Marina B Zambrano1, Evelise Brizola1, Bruna Pinheiro1
1a PostGraduate Program in Child and Adolescent Health, University of Rio Grande do Sul , Porto Alegre , BRAZIL.
Insights
Most pediatric osteogenesis imperfecta (OI) patients have insufficient vitamin D levels. Increasing sun exposure, milk intake, and reducing sedentary time can improve vitamin D status and bone health in children with OI.
Area of Science:
- Pediatric Endocrinology
- Metabolic Bone Disease
- Nutritional Biochemistry
Background:
- Vitamin D is crucial for skeletal development and maintenance, particularly in children with bone disorders like osteogenesis imperfecta (OI).
- Assessing vitamin D status is vital for managing OI patients and optimizing their bone health outcomes.
- Understanding the determinants of vitamin D status in this population can inform targeted interventions.
Purpose of the Study:
- To evaluate serum 25-hydroxyvitamin D (25-OHD) levels in pediatric patients with OI.
- To identify factors associated with vitamin D status in this cohort.
- To establish relationships between vitamin D levels and clinical parameters in OI.
Main Methods:
- A cross-sectional study involving 52 pediatric patients with OI.
- Analysis of serum 25-OHD, calcium, parathyroid hormone (PTH), phosphorus, and alkaline phosphatase (ALP).
- Evaluation of various potential determinants including demographics, lifestyle factors, supplementation, and bone mineral density (BMD).
Main Results:
- A high prevalence of vitamin D insufficiency or deficiency was observed, with 88.4% of patients having low serum 25-OHD levels.
- Serum 25-OHD showed an inverse correlation with sedentary activity time (r = -0.597, p < 0.001).
- Positive correlations were found between serum 25-OHD and height (r = 0.521, p = 0.046) and whole body BMD (r = 0.586, p = 0.022). A significant difference in milk consumption was also noted.
Conclusions:
- Pediatric patients with OI frequently exhibit insufficient or deficient vitamin D levels.
- Lifestyle modifications, including reduced inactivity, increased sun exposure, and higher milk consumption, are recommended to improve vitamin D status.
- Educating patients on these habits is essential for optimizing bone health in OI management.
Objective:
Vitamin D is essential to the development and maintenance of the skeleton, especially for children with bone disorders such as osteogenesis imperfecta (OI). We evaluated serum 25-hydroxyvitamin D (25-OHD) levels to assess the relationship between determinants of vitamin D status in pediatric patients with OI.
Methods:
This cross-sectional study evaluated sex, age, weight, height, body mass index, OI type, sunscreen use, season of assessment, sun exposure, vitamin D and calcium supplementation, bisphosphonate treatment, bone mineral density (BMD), milk and soda consumption, mobility, and time of sedentary activity. Levels of serum 25-OHD, calcium, parathyroid hormone (PTH), phosphorus, and alkaline phosphatase (ALP) were analyzed. Serum levels of 25-OHD were classified according to sufficient (>30 ng/ml or 75 nmol/L), insufficient (20-30 ng/ml or 50-75 nmol/L), moderately deficient (20-10 ng/ml or 50-25 nmol/L), and severely deficient (<10 ng/ml or 25 nmol/L).
Results:
Fifty-two patients were included and 46 (88.4%) were classified as having insufficient or deficient 25-OHD. An inverse correlation between serum 25-OHD and time of sedentary activity (r = -0.597, p < 0.001) and a positive correlation with height (r = 0.521, p = 0.046) and whole body BMD (r = 0.586, p = 0.022) were observed. A significant difference between the number of glasses of milk consumed (p = 0.010) was observed.
Conclusion:
To optimize bone health, patients with OI need to be educated regarding habits that can improve serum 25-OHD levels, such as a reduction in periods of inactivity, the importance of sun exposure, and increasing consumption of milk and fortified dairy products.
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