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Stable Rates of Low Vitamin D Status Among Children Despite Increased Testing: A Population-Based Study.

Alyssa A Kerber1, Mitchell M Pitlick2, Anna E Kellund1

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Pediatric vitamin D testing surged 42-fold from 2002-2017 in Olmsted County. While deficiency incidence rose, the proportion of tested children with vitamin D deficiency remained stable.

Keywords:
deficiencyincidencepopulationtrendsvitamin D

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Area of Science:

  • Pediatric Endocrinology
  • Public Health Surveillance
  • Nutritional Science

Background:

  • Vitamin D deficiency is a growing public health concern in pediatric populations.
  • Understanding testing trends and deficiency incidence is crucial for targeted interventions.
  • Olmsted County, Minnesota, provides a unique setting for epidemiological studies due to its established health data repository.

Purpose of the Study:

  • To analyze the temporal trends in vitamin D testing rates among children in Olmsted County over a 16-year period.
  • To determine the incidence of vitamin D deficiency/insufficiency in the same pediatric cohort.
  • To assess the relationship between testing frequency and the prevalence of vitamin D deficiency.

Main Methods:

  • Utilized the Rochester Epidemiology Project (REP) database to identify pediatric residents (<19 years) with 25-hydroxyvitamin D [25(OH)D] measurements from 2002 to 2017.
  • Categorized patients based on initial 25(OH)D levels: <20 ng/mL (deficiency/insufficiency), 20-50 ng/mL, and >50 ng/mL.
  • Calculated incidence rates per 10,000 persons and analyzed trends in testing proportions.

Main Results:

  • A significant 42-fold increase in annual pediatric vitamin D testing was observed, from 3.7 to 156.1 per 10,000 persons.
  • The incidence of vitamin D deficiency/insufficiency (25(OH)D <20 ng/mL) increased from 1.7 to 19.9 per 10,000 persons.
  • Despite increased testing, the proportion of tested children with vitamin D deficiency remained stable, around 18-22%.

Conclusions:

  • Pediatric vitamin D testing dramatically increased in Olmsted County between 2002 and 2017.
  • The incidence of vitamin D deficiency/insufficiency in children also rose during this period.
  • The stable proportion of deficient cases among tested children suggests increased identification rather than a worsening epidemic.