Warning over vitamin D deficiency in southern Australian youngsters

A high percentage of children and teens in southern Australia may be deficient in vitamin D, putting them at increased risk of bone fractures and higher long-term risk of osteoporosis, warn researchers.

The new data, published in Bone Reports, investigated the prevalence of vitamin D deficiency in children and teens aged between two and 17 who presented to hospital with acute fractures. 

Led by Dae Hwan Kwon from Goulburn Valley Health in Australia, the team noted that it is widely established that a good vitamin D status is important for maintaining bone health at all ages of life, but especially in childhood and early development.

“Optimizing bone health in childhood may be critical to improving peak bone mass and potentially reducing the future risk of osteoporosis,” said the team – noting that osteoporosis is a disease with its genesis in childhood and adolescence, “as peak bone mass is achieved several years after growth cessation, and lifestyle habits established in youth tend to persist throughout adult life.”

“To our knowledge this is the first study to examine the prevalence of vitamin D deficiency in otherwise healthy children and adolescents with fractures in an ethnically and culturally diverse population, with a high proportion of highly pigmented individuals,” added Kwon et al.

Deficiency risk

The team reported that the prospective observational study was undertaken using a convenience sample data – collected from children aged between two and 17 years of age presenting with an acute fracture at Sunshine Hospital.

Recruitment of a total of 163 fracture patients was undertaken over a three month period in 2014. After recruitment, participants were assessed for risk factors for vitamin D deficiency (skin pigmentation, hours spent outdoors, sunscreen use and obesity) before measurements of serum vitamin D (known as 25-hydroxyvitamin D, or 25-OHD) were taken.

The team found that one third of all participants, and the majority participants who had one or more risk factors for vitamin D deficiency were vitamin D deficient.

“Of the 163 patients recruited into this study, 134 (82%) had one or more risk factor(s) for vitamin D deficiency,” revealed Kwon and colleagues. “Of these, 109 (81%) consented to 25-OHD testing (...) A total of 57 (52% at risk, 35% of total participants) were found to be vitamin D deficient.”

Of these participants, 45 (80%) had mild deficiency (defined as 30–50 nmol/l 25-OHD) while 11 (20%) had moderate deficiency (12.5–29 nmol/l).

“Based on our findings we recommend that vitamin D status be assessed in all children with risk factor of vitamin D deficiency living in urban environments at higher latitudes presenting with fractures,” said the team – noting that the effect of vitamin D status and supplementation on fracture risk and healing in children and teenagers is yet to be determined.

“We consider that the high prevalence of vitamin D deficiency observed in this study warrants further prospective cohort studies in the paediatric population to determine effects of chronic vitamin D deficiency on fracture risk, fracture healing rates, the risk of future fracture, and how this may be modified by vitamin D supplementation,” they concluded.

Source: Bone Reports

Volume 5, Pages 153–157, doi: 10.1016/j.bonr.2016.05.007

“High prevalence of vitamin D deficiency in 2–17 year olds presenting with acute fractures in southern Australia”

Authors: Dae Hwan Kwon, et al