Low Vitamin D Status of Northern Italian Children in Pediatric Primary Care Setting: What to Do.

ABSTRACT

Aims: To analyze vitamin D status in a group of children living in Northeastern Italy cared by a “family pediatrician”. Study Design: Cross-sectional study. Place and Duration of Study Pediatric primary care in a rural area near Padua (Italy, 45°N latitude), between November 2010 and September 2012. Methodology: The study was conducted with 113 children (41 girls and 72 boys), aged between 1 and 15 years old. The serum level of 25-hydroxyvitamin D [25(OH)D] was measured using a chemiluminescence immunoassay methodology. Serum 25(OH)D test was included in a panel of laboratory tests ordered for different reasons. A correlation was researched between 25(OH)D level and the following variables class of age, gender, ethnicity, skin colour, period of blood withdrawal, BMI category, results in other laboratory tests and presence of comorbidity. Results: Only 26.5% of children had a normal level of 25(OH)D (> 30 ng/ml); in 66.4% of all patients 25(OH)D level was 10-29 ng/ml while 7.1% of children had 25(OH)D < 10 ng/ml. About 40% of all children had 25(OH)D < 20 ng/ml. Non-Italian ethnicity, nonwhite skin and blood withdrawal in January-March and April-June were significantly associated with hypovitaminosis D [25(OH)D < 30 ng/ml] at univariate level. Both non- Italian ethnicity (P = 0.029) and period of blood withdrawal (P = 0.0062) were also significant at multivariate analysis. The combination of chronic disease or non-white skin could identify only 50% of children with 25(OH)D < 10 ng/ml and 29% of children with 25(OH) < 20 ng/ml. Conclusion: We noted a high incidence of hypovitaminosis D in asymptomatic children without risk factors. In our region cholecalciferol supplementation should be implemented for all children between October and April. Appropriate dose for children of Northern Italy is debated.