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Hypovitaminosis D in migrant children in Switzerland: a retrospective study
Olivia Fahrni1, Alexandra Wilhelm-Bals2, Klara M Posfay-Barbe3
1Faculty of Medicine, University of Geneva, Geneva, Switzerland. Olivia.Fahrni@gmail.com.
Insights
Migrant children in Switzerland frequently have vitamin D deficiency, with three-quarters affected. Supplementation upon arrival and during winter is recommended to prevent complications like rickets.
Area of Science:
- Pediatrics
- Endocrinology
- Public Health
Background:
- Vitamin D (cholecalciferol) is crucial for phosphocalcic metabolism and preventing rickets.
- Migrant children face increased risk of vitamin D deficiency due to various factors.
- Hypovitaminosis D is prevalent in Swiss children, affecting 35-50%.
Purpose of the Study:
- To determine the prevalence of hypovitaminosis D in children arriving in Switzerland.
- To assess vitamin D status alongside parathyroid hormone, phosphate, and calcium levels.
- To identify risk factors and geographical origins associated with vitamin D deficiency.
Main Methods:
- Retrospective analysis of 528 children's data from 2015-2018.
- Measurement of vitamin D, parathyroid hormone, phosphate, and calcium via electrochemiluminescence and spectrophotometry.
- Definition of vitamin D insufficiency (<50 nmol/L) and severe deficiency (<25 nmol/L).
Main Results:
- 73% of children exhibited hypovitaminosis D; 28% had severe deficiency.
- Highest deficiency rates were observed in children from Eastern Mediterranean (80%) and African (75%) regions.
- Severe deficiency was more common in South East Asian (39%) and Eastern Mediterranean (33%) regions, and in females. Deficiency worsened with age and during winter.
Conclusions:
- A significant majority of migrant children present with hypovitaminosis D.
- Supplementation for migrant children upon arrival and during winter is advised.
- Proactive supplementation without routine testing may be a viable strategy to prevent deficiency complications.
Abstract:
Cholecalciferol (vitamin D3) is essentially known for its role in the phosphocalcic metabolism and its associated pathologies, such as rickets. In Switzerland, 35 to 50% of children are vitamin D deficient. Due to skin colour, poor nutrition, living conditions and cultural practices, migrant population is particularly at risk. Our aim is to attest the prevalence of hypovitaminosis D in children arriving in Switzerland. We retrospectively assessed 528 children's vitamin D status and parathyroid hormone, phosphate and calcium levels between 2015 and 2018 by electrochemiluminescence and spectrophotometry. Cholecalciferol was considered insufficient under 50 nmol/L and severely deficient below 25 nmol/L. Seventy-three percent of children showed hypovitaminosis D and 28% had a severe deficiency. Highest prevalence of deficiency was found in children from Eastern Mediterranean (80%) and African regions (75%). Severe deficiency was more prevalent in the South East Asian (39%) and Eastern Mediterranean regions (33%) and more frequent in females. Deficiency was more frequent and more severe in winter. Hypovitaminosis D increased with age. Two children presented with all three biological manifestations associated to severe hypovitaminosis D (hyperparathyroidism, hypocalcaemia and hypophosphatemia).Conclusion: A majority of migrant children presented with hypovitaminosis D. They should be supplemented to prevent complications. A strategy could be to supplement all children at arrival and during wintertime without regular vitamin D level checks. What is Known: Hypovitaminosis D is frequent in children and can lead to bone-related complications. Migrant children are particularly at risk of deficiency. What is New: Three-quarters of migrant children evaluated at our migrant clinic in Geneva's children hospital are deficient in vitamin D, one third severely. A strategy to correct the deficiency would be to supplement all migrant children at arrival and in winter.
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