High vitamin D levels in Romanian children – wonder why – May 2015

Vitamin D Status: A Different Story in the Very Young versus the Very Old Romanian Patients.

PLoS One. 2015 May 29;10(5):e0128010. doi: 10.1371/journal.pone.0128010. eCollection 2015.
Chirita-Emandi A1 adela.chirita@umft.ro, Socolov D2, Haivas C3, Calapiș A4, Gheorghiu C1, Puiu M5.
1Genetics Department, University of Medicine and Pharmacy "Victor Babeș", Timișoara, Romania.
2Ginecology Department, University of Medicine and Pharmacy "Gr. T. Popa", Iași, Romania.
3Anatomy Department, University of Medicine and Pharmacy "Victor Babeș", Timișoara, Romania.
4Bioclinica Laboratoarele, SA, Timișoara, Romania.
5Genetics Department, University of Medicine and Pharmacy "Victor Babeș", Timișoara, Romania; Genetics Department, Clinical Emergency Hospital for Children "Louis Țurcanu", Timișoara, Romania.
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BACKGROUND:
In Romania (latitude 48°15'N to 43°40'N), vitamin D supplementation is common practice mostly in infants 0-1 year old. No published information is available regarding epidemiological data on vitamin D status in the Romanian population for a wide age range and geographical territory. In this context, we aimed to evaluate the seasonal and age variation of vitamin D status in a large Romanian population.

METHODS:
6631 individuals from across Romania had performed 7544 vitamin D assessments (2012-2014) in a chain of private laboratories. Vitamin D (25-hydroxyvitamin D2 and 25-hydroxyvitamin D3) was measured using High Performance Liquid Chromatography. Vitamin D levels were classified as severe deficiency<10 ng/mL, deficiency 10-20 ng/mL, insufficiency 21-29 ng/mL, sufficiency ≥ 30 ng/mL and potentially harmful>100 ng/ml.

RESULTS:
Male to female ratio was 1:2.9. Age ranged from 0 to 85 years. Mean vitamin D levels increased from April (26.3n g/ml) to September (35.6 ng/ml) and decreased from October (33.5 ng/ml) to March (24.4 ng/ml). Overall 40% had sufficient vitamin D, while the rest were insufficient 33%, deficient 22%, severely deficient 4% and 1% potentially harmful (of them 81% under 1 year old). Males compared to females showed higher percentages of sufficiency (47% vs. 38%). Children 0- 2 years presented the highest percentage of vitamin D sufficiency (77%). Lowest percentages (21%) of sufficiency were in people 80-84 years.

CONCLUSION:
In Romania, suboptimal vitamin D levels are common (59%), especially in older age, wintertime and in women. Vitamin D supplementation would be most warranted from January to April in the Romanian population. 25-hydroxyvitamin D levels > 100 ng/ml were relatively prevalent in children 0-1 year old (17.3%). This was attributed to supplementation errors and the fact that high-risk individuals were more likely to visit for medical check-up. Nonetheless, it stresses the need to increase awareness of the importance of preventing Vitamin D supplementation administration errors in the young.

PMID: 26024516

 Download the PDF from VitaminDWiki

Answer may be in the PDF: half of the patients were under the care of Endocrinologists - who may have prescribed lots of vitamin D

  • "Children (0 to 18 years) were referred for vitamin D assessment by paediatric endocrinologists in 48% of cases, general paediatricians in 24%, orthopaedics, rheumatology and dental medicine in 3.5% and from other specialists in 24.5% of cases.
  • In adults, most (51%) cases were referred by the endocrinologists, 10.5% by the general practitioner, 5% by internal medicine specialists, 5% by nephrologists, 3.5% by rheumatologists and 25% by other specialists
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