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Vitamin D status in hospitalized black children under 2 years of age
Insights
Despite a perceived decline in rickets, many South African infants show suboptimal vitamin D levels. This suggests a continued risk for vitamin D deficiency rickets in this vulnerable population.
Area of Science:
- Pediatrics
- Nutritional Science
- Public Health
Background:
- Vitamin D deficiency rickets historically impacted black infants in South Africa.
- Recent observations suggested an improvement in vitamin D status within this demographic.
Purpose of the Study:
- To determine the prevalence of vitamin D deficiency and associated risks in hospitalized black infants under two years old.
- To assess current vitamin D status and identify infants at risk.
Main Methods:
- Serum levels of 25-hydroxy-vitamin D, calcium, phosphorus, and alkaline phosphatase were measured.
- Radiographs of the left wrist were obtained for radiological assessment.
- Data were collected from 114 hospitalized black infants.
Main Results:
- Mean 25-hydroxy-vitamin D levels were in the low normal range, with no correlation to age or season.
- Vitamin D stores were depleted in 7% and relatively deficient in 20.7% of infants.
- Only two patients exhibited suggestive radiological features of rickets; biochemical assessment was hindered by malnutrition and infection.
Conclusions:
- Suboptimal vitamin D levels were prevalent in the studied infant population.
- Despite low rickets prevalence, infants remain at increased risk for vitamin D deficiency rickets.
- Further monitoring and intervention strategies may be necessary to address vitamin D insufficiency.
Abstract:
The apparent decline over the last decade of vitamin D deficiency rickets among black infants in South Africa has suggested a significant improvement in their vitamin D status. Levels of serum 25-hydroxy-vitamin D, calcium, phosphorus and alkaline phosphatase, together with a radiograph of the left wrist, were obtained in 114 hospitalized black infants under the age of 2 years in order to establish the frequency of infants with or at risk of vitamin D deficiency. Mean 25-hydroxyvitamin D levels were found to be in the low normal range and showed no correlation with either age or season. Vitamin D stores were depleted in 7% and relatively deficient in 20,7% with suggestive radiological features of rickets in only 2 patients. The high prevalence of malnutrition and infection made a biochemical assessment of rickets impossible. The significance of these suboptimal vitamin D levels is uncertain, but the available literature would suggest that these infants are at increased risk of developing vitamin D deficiency rickets.