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Prevalence and predictors of vitamin D deficiency in young African children
Reagan M Mogire1,2, Alireza Morovat3, John Muthii Muriuki4
1Kenya Medical Research Institute (KEMRI) Centre for Geographic Medicine Coast, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya. reaganmoseti@gmail.com.
Insights
Vitamin D deficiency is uncommon in young African children, affecting less than 8% of those studied. Factors like location, age, season, malaria, and inflammation influence vitamin D levels.
Area of Science:
- Nutritional science
- Pediatric health
- Genetics
Background:
- Sub-Saharan Africa faces high rates of rickets and infectious diseases, often linked to vitamin D deficiency.
- Limited data exists on vitamin D status and its predictors in young African children.
- This study addresses the knowledge gap regarding vitamin D status in this vulnerable population.
Purpose of the Study:
- To determine the prevalence of vitamin D deficiency in young children across several African countries.
- To identify environmental and genetic factors influencing vitamin D status in this demographic.
- To inform public health strategies for managing vitamin D deficiency in African children.
Main Methods:
- Measured 25-hydroxyvitamin D (25(OH)D) levels in 4509 children aged 0-8 years across Kenya, Uganda, Burkina Faso, The Gambia, and South Africa.
- Genotyped single nucleotide polymorphisms (rs4588, rs7041) in the vitamin D binding protein (DBP) gene (GC).
- Analyzed associations between 25(OH)D levels and country, age, sex, season, anthropometry, inflammation, malaria, and DBP haplotypes using regression models.
Main Results:
- Prevalence of vitamin D deficiency (<30 nmol/L and <50 nmol/L) was low at 0.6% and 7.8%, respectively.
- Lower 25(OH)D levels were associated with South Africa, older age, winter/rainy season, and malaria; higher levels with inflammation.
- The DBP Gc2 variant was linked to lower median 25(OH)D levels compared to Gc1f and Gc1s variants.
Conclusions:
- Vitamin D deficiency is not widespread in young African children, with low prevalence rates observed.
- Geographic location (latitude), age, season, malaria, and inflammation are key factors to consider for vitamin D assessment and management.
- DBP gene variants play a role in vitamin D status, highlighting the interplay of genetics and environment.
Background:
Children living in sub-Saharan Africa have a high burden of rickets and infectious diseases, conditions that are linked to vitamin D deficiency. However, data on the vitamin D status of young African children and its environmental and genetic predictors are limited. We aimed to examine the prevalence and predictors of vitamin D deficiency in young African children.
Methods:
We measured 25-hydroxyvitamin D (25(OH)D) and typed the single nucleotide polymorphisms, rs4588 and rs7041, in the GC gene encoding the vitamin D binding protein (DBP) in 4509 children aged 0-8 years living in Kenya, Uganda, Burkina Faso, The Gambia and South Africa. We evaluated associations between vitamin D status and country, age, sex, season, anthropometric indices, inflammation, malaria and DBP haplotypes in regression analyses.
Results:
Median age was 23.9 months (interquartile range [IQR] 12.3, 35.9). Prevalence of vitamin D deficiency using 25(OH)D cut-offs of < 30 nmol/L and < 50 nmol/L was 0.6% (95% CI 0.4, 0.9) and 7.8% (95% CI 7.0, 8.5), respectively. Overall median 25(OH)D level was 77.6 nmol/L (IQR 63.6, 94.2). 25(OH)D levels were lower in South Africa, in older children, during winter or the long rains, and in those with afebrile malaria, and higher in children with inflammation. 25(OH)D levels did not vary by stunting, wasting or underweight in adjusted regression models. The distribution of Gc variants was Gc1f 83.3%, Gc1s 8.5% and Gc2 8.2% overall and varied by country. Individuals carrying the Gc2 variant had lower median 25(OH)D levels (72.4 nmol/L (IQR 59.4, 86.5) than those carrying the Gc1f (77.3 nmol/L (IQR 63.5, 92.8)) or Gc1s (78.9 nmol/L (IQR 63.8, 95.5)) variants.
Conclusions:
Approximately 0.6% and 7.8% of young African children were vitamin D deficient as defined by 25(OH)D levels < 30 nmol/L and < 50 nmol/L, respectively. Latitude, age, season, and prevalence of inflammation and malaria should be considered in strategies to assess and manage vitamin D deficiency in young children living in Africa.
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