Çocuk ve adölosanlarda yaş, cinsiyet ve mevsimsel özelliklere göre vitamin D düzeylerinin değerlendirilmesi

Amaç: D vitamini, kas-iskelet sistemi sağlığı için gerekli bir hormondur ve bağışıklık sistemi, kardiyovasküler sistem ve metabolik homeostazda görev yapar. Bu çalışmanın amacı, Türkiye'nin orta bölgesinde yaşayan çocukların D vitamini durumunu belirlemektir. Ayrıca, çalışma yaş, cinsiyet ve mevsimsel değişiklikleri değerlendirdi. Gereç ve Yöntem: Bu çalışmaya Konya’da ikinci basamak bir Kadın Doğum ve Çocuk Hastanesi’ne başvuran 1-17 yaş arası çocuklar dahil edildi. Katılımcıların tıbbi kayıtları Temmuz 2016 ve Aralık 2021 tarihleri arasında geriye dönük olarak hastane bilgi sisteminden incelendi. Tüm hastalar yaş, cinsiyet ve kanlarının alındığı mevsime göre kategorize edildi. Bulgular: Toplam 3547 çocuk çalışmaya dahil edildi. Çalışma popülasyonundaki ortalama serum 25-hidroksivitamin D düzeyi 16.45±9.39 ng/ml idi. Kış aylarında elde edilen örnek sayısı sırasıyla 1063 (%30) ve yaz aylarında 756 (%21,3) olmuştur. Katılımcıların sadece %7.4'ü (n=262) çalışma popülasyonunda yeterli D vitamini düzeyine (>30 ng/ml) sahipti. Ayrıca şiddetli serum 25-hidroksivitamin D düzeyi eksikliği en çok kış mevsiminde ölçüldü (378 hasta, %45). Şiddetli eksiklik (352 hasta, %41.9) en yaygın olarak 12-17 yaş arası çocuklarda görüldü. Tüm hastalar arasında sadece %7.4'ünde yeterli serum 25-hidroksivitamin D seviyeleri vardı. Ayrıca, kızların %5,2'si (103 hasta) ve erkeklerin %3,7'si (59 hasta) yeterli 25-hidroksivitamin D düzeyine sahipti. Diğer taraftan, serum 25-hidroksivitamin D düzeylerinin ciddi eksikliği, kızlardan (137 hasta, %6.9) daha çok erkek çocuklarda (521 hasta, %33.1) yaygındı. Sonuç: D vitamini eksikliği/yetersizliği dünyada ve Türkiye'de çocuklar arasında yaygın olarak görülmektedir. Çalışmamız mevsimsel farklılıklar, yaş ve cinsiyetin çocuklarda 25-hidroksivitamin D serum düzeylerini etkilediğini ortaya koydu. Bu bağlamda D vitamini yönünden zengin besinlerin veya D vitamini takviyesinin önemi giderek artmaktadır.

Anahtar Kelimeler:

Vitamin D, çocuk, adölosan, yaş, mevsimsel farklılık, tedavi

Evaluation of Vitamin D Levels According to Age, Gender and Seasonal Characteristics in Children and Adolescents

Objective: Vitamin D is an essential hormone for the health of the musculoskeletal system and acts in immune system, cardiovascular system and metabolic homeostasis. The aim of this study was to determine the vitamin D status of children in middle region of Turkey. Also, the study evaluated the age, gender and seasonal variations in the study population. Materials and Methods: Children aged 1-17 years who were admitted to a Secondary Maternity and Children Hospital in Konya were included in this study. The medical records of the participants were retrospectively evaluated from the hospital information system between July 2016 and December 2021. All patients were categorized according to age, gender, and season in which their blood had been sampled. Results: A total of 3547 children were included in the study. The mean serum level of 25-hydroxyvitamin D in the study population was 16.45±9.39 ng/ml. The number of samples obtained in winter was 1063 (30%) and in summer 756 (21.3%), respectively. Only 7.4% (n=262) of the participants had sufficient vitamin D levels (>30 ng/ml) in the study population. Additionally, severely deficiency of serum 25-hydroxyvitamin D level was mostly measured in winter season (378 patients, 45%). Severely deficiency (352 patients, 41.9%) was most common in children aged 12-17 years. Among all patients, only 7.4% had sufficient serum 25-hydroxyvitamin D levels. Also, 5.2% (103 patients) of the girls and 3.7% (59 patients) of the boys had sufficient 25-hydroxyvitamin D levels. On the other hand, severely deficiency of serum 25-hydroxyvitamin D levels was most common in boys (521 patients, 33.1%) than in girls (137 patients, 6.9%). Conclusion: Vitamin D deficiency/insufficiency is wide spread among children in the world and in Turkey. Our study revealed that seasonal variations, age and gender affect the serum levels of 25-hydroxyvitamin D in children. In this context, the importance of vitamin D rich foods or vitamin D supplementation is increasing.

Keywords:

Vitamin D, children, adolescents, age, seasonal variations, treatment,

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Refererans 1 Taylor SN. Vitamin D in toddlers, preschool children, and adolescents. Ann Nutr Metab 2020;76:30-40.
Referans2 Jenkinson C. The vitamin D metabolome: An update on analysis and function. Cell Biochem Funct 2019;37:408-423.
Referans3 Marino R, Misra M. Extra-skeletal effects of vitamin D. Nutrients 2019;11:E1460.
Referans4 Huh YS, Gordon CM. Vitamin D deficiency in children and adolescents: epidemiology, impact and treatment. Rev Endocr Metab Disord 2008;9:161-170.
Referans5 DeLuca HF. Overview of general physiologic features and functions of vitamin D. Am J Clin Nutr 2004;80:1689S–1696S.
Referans6 Lips P. Which circulating level of 25-hydroxyvitamin D is appropriate? J Steroid Biochem Mol Biol 2004;89–90:611–4. Referans7 Braegger C, Campoy C, Colomb V et al. Vitamin D in the healthy European paediatric population. J Pediatr Gastroenterol Nutr 2013;56:692–701.
Referans8 Holick MF. Resurrection of vitamin D deficiency and rickets. J Clin Invest 2006;116:2062–2072.
Referans9 Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357:266–281.
Referans10 McGrath J. Does ‘imprinting’ with low prenatal vitamin D contribute to the risk of various adult disorders. Med Hypotheses 2001;56:367–371.
Referans11 Holick MF. High prevalence of vitamin D inadequacy and implications for health. Mayo Clin Proc 2006;81:353–373.
Referans12 Doğan N, Çolak A, Güden N, et al. Vitamin D deficiency in children in Aegean Region in Turkey. Cumhuriyet Medical Journal 2015;37:17-22.
Referans13 Kocaman H. Vitamin D levels in childhood gastrointestinal system diseases. Middle East Journal of Medicine 2019;11:542-547.
Referans14 Fettah A, Reis GP, Erten İ, et al. The effect of serum vitamin D levels on anemia and iron parameters in children and review of the literature. Medicine 2016;5:821-825.
Referans15 Topal İ, Mertoğlu C, Arslan YK, et al. Evaluation of Vitamin D levels of children in Erzincan region by age, gender and seasons. Fırat Medical Journal 2018;23:168-172.
Referans16 Durmaz ZH, Demir AD, Tiryaki M, et al. Vitamin D levels in patients admitted to the hospital in Amasya region. Bozok Medical Journal 2015;5:26-32.
Referans17 Güven B, Can M. Vitamin D status of children aged 5-15 years in Zonguldak, Turkey. Albanian Medical Journal 206;4:11-16.
Referans18 Karagüzel G, Dilber B, Çan G, et al. Seasonal vitamin D status of healthy schoolchildren and predictors of low vitamin D status. J Pediatr Gastroenterol Nutr 2014;58:654-660.
Referans19 Bucak İH, Almış H. The retrospective analysis of vitamin D levels of pediatric patients in a small city center in Turkey. Sakarya Medical Journal 2016;6:136-140.
Referans20 Matyar S, Dişel RN, Açıkalın A, et al. Vitamin D levels in Çukurova region. Çukurova Medical Journal 2017;42:320-328.
Referans21 Savaş HB, Ceyhan BM, Gültekin F. 25 OH vitamin D levels of patients living in Isparta, Turkey. J Ann Eu Med 2017;5:38-40.
Referans22 Solak İ, Cihan FG, Mercan S, et al. Evaluation of 25-hydroxyvitamin D levels in Central Anatolia, Turkey. BioMed Research International, 2018;2018:1-5.
Referans23 Öğüş E, Sürer H, Kılınç AŞ et al. Evaluation of vitamin D levels by months, sex and age. Ankara Med J 2015:15:1-5.
Referans24 Wagner CL, Greer FR. American Academy of Pediatrics Section on Breastfeeding; American Academy of Pediatrics Committee on Nutrition. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics 2008;122:1142–1152.