Dilek KONUKSEVER, Sevinç Püren YÜCEL KARAKAYA

Üçüncü Basamak Bir Hastaneye Başvuran Çocuklarda D Vitamini Eksikliği

Giriş: Bu çalışmanın amacı hastanemize başvuran çocuklarda cinsiyet ve yaş gruplarına göre D vitamini eksikliği sıklığını belirlemektir. Metod: Ocak 2015-Ocak 2020 yılları arasında üçüncü basamak bir hastanenin çocuk kliniğinde, herhangi bir nedenle 25-hidroksivitamin D düzeyi ölçülen sağlıklı çocukların D vitamini düzeylerinin yaş, cinsiyet ve mevsim özellikleri ile ilişkisinin analiz edildiği kesitsel bir çalışmadır. Çocuklar yaşlarına göre infant (0-1 yaş), okul öncesi (2-5 yaş), okul dönemi(6-11 yaş) ve adölesan (12-18 yaş) olmak üzere 4 alt gruba ayrılmıştır. D vitamini eksikliği serum 25-hidroksivitamin D ≤20 ng/ml olarak kabul edilmiştir. Bulgular: Çalışmaya toplam 16321 çocuk dahil edildi. Katılımcıların 10777'sinde (%66) D vitamini eksikliği tespit edildi. Eksiklik en sık ergenlik döneminde saptandı (n: 6718, %51). Bunu sırasıyla okul dönemi (%31.3), okul öncesi dönem (%15.1) ve infant dönemi (%2.7) izledi. Eksiklik çoğunlukla kış aylarında tespit edildi. D vitamini eksikliği altı yaş üstünde kızlarda sık görülürken, altı yaş altında cinsiyetler arasında fark yoktu. Sonuç: : Bu çalışmada çocuklarda D vitamini eksikliği görülme sıklığı yüksek bulunmuştur. Birçok fizyolojik olaydaki rolü nedeniyle çocuklarda D vitamini eksikliğinin önlenmesi, tanınması ve tedavisi için acil önlemler alınmalıdır.

Anahtar Kelimeler:

D vitamini eksikliği, çocuk, yaş, cinsiyet

Vitamin D Deficiency in Children Admitted to a Tertiary Care Hospital

Introduction: This study aims to determine the frequency of vitamin D deficiency according to gender and age groups in children admitted to our hospital. Methods: A cross-sectional study was conducted in the pediatric clinic of a tertiary care hospital in Ankara. Healthy children whose 25-hydroxyvitamin D levels were measured for any reason from January 2015 to January 2020 were included in the study. The vitamin D levels of the participants were analyzed according to age, gender, and measuring season. Children were divided into 4 subgroups according to their age: infancy (0-1 years), preschool (2-5 years), school (6-11 years), and adolescence (12-18 years). Vitamin D deficiency was defined as serum 25-hydroxyvitamin D concentrations ≤20 ng/ml. Results: A total of 16321 children were included in the study. The participants detected Vitamin D deficiency in 10777 (66%). The deficiency was mostly detected during adolescence (n: 6718, 51%). This was followed by the school period (31.3%), preschool period (15.1%), and infancy (2.7%), respectively. The deficiency was mostly detected during the winter months. While vitamin D deficiency was more common in women over the age of six, no difference was found between the sexes under the age of six. Conclusions: In this study, the prevalence of vitamin D deficiency in children was found to be high. Due to its role in many physiological events, urgent measures should be taken for the prevention, recognition, and treatment of vitamin D deficiency in children.

Keywords:

Vitamin D Deficiency, children, age, gender,

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1. Sirajudeen S, Shah I, Al Menhali A. A narrative role of vitamin D and its receptor: with current evidence on the gastric tissues. International journal of molecular sciences. 2019;20(15):3832.
2. Cediel G, Pacheco Acosta J, Castillo Durán C. Vitamin D deficiency in pediatric clinical practice. 2018.
3. Alonso M, Mantecón L, Santos F. Vitamin D deficiency in children: a challenging diagnosis! Pediatric research. 2019;85(5):596-601.
4. Cashman K. Vitamin D Deficiency: Defining, Prevalence, Causes, and Strategies of Addressing. Calcified Tissue International. 2020;106.
5. LeFevre M, LeFevre NM. Vitamin D screening and supplementation in community-dwelling adults: common questions and answers. American family physician. 2018;97(4):254-60.
6. Grossman Z, Hadjipanayis A, Stiris T, Del Torso S, Mercier J-C, Valiulis A, et al. Vitamin D in European children—statement from the European Academy of Paediatrics (EAP). European journal of pediatrics. 2017;176(6):829-31.
7. Rahman A, Elmi A. Air pollutants are negatively associated with vitamin D-synthesizing UVB radiation intensity on the ground. Scientific Reports. 2021;11(1):1-10.
8. Hansen L, Tjønneland A, Køster B, Brot C, Andersen R, Cohen AS, et al. Vitamin D status and seasonal variation among Danish children and adults: a descriptive study. Nutrients. 2018;10(11):1801.
9. Wang Q, Ying Q, Zhu W, Chen J. Vitamin D and asthma occurrence in children: A systematic review and meta-analysis. Journal of Pediatric Nursing. 2021.
10. Gavrilov A. Relationship of the vitamin D deficiency and the prevalence of type 1 diabetes mellitus. 2020.
11. Fletcher J, Cooper SC, Ghosh S, Hewison M. The role of vitamin D in inflammatory bowel disease: mechanism to management. Nutrients. 2019;11(5):1019.
12. Gubatan J, Chou ND, Nielsen OH, Moss AC. Systematic review with meta‐analysis: association of vitamin D status with clinical outcomes in adult patients with inflammatory bowel disease. Alimentary pharmacology & therapeutics. 2019;50(11-12):1146-58.
13. Minisola S, Colangelo L, Pepe J, Occhiuto M, Piazzolla V, Renella M, et al. Vitamin D screening. Journal of endocrinological investigation. 2020:1-5.
14. Ozkan B, Doneray H, Karacan M, Vançelik S, Yıldırım ZK, Ozkan A, et al. Prevalence of vitamin D deficiency rickets in the eastern part of Turkey. European journal of pediatrics. 2009;168(1):95-100.
15. Smyczyńska J, Smyczyńska U, Stawerska R, Domagalska-Nalewajek H, Lewiński A, Hilczer M. Seasonality of vitamin D concentrations and the incidence of vitamin D deficiency in children and adolescents from central Poland. Pediatric Endocrinology Diabetes and Metabolism. 2019;25(2):54-9.
16. Beer RJ, Herrán OF, Villamor E. Prevalence and correlates of vitamin D deficiency in a tropical setting: results from a nationally representative survey. The American Journal of Clinical Nutrition. 2020;112(4):1088-98.
17. Guo Y, Ke H-J, Liu Y, Fu M, Ning J, Yu L, et al. Prevalence of vitamin D insufficiency among children in southern china: A cross-sectional survey. Medicine. 2018;97(25).
18. Al-Taiar A, Rahman A, Al-Sabah R, Shaban L, Al-Harbi A. Vitamin D status among adolescents in Kuwait: a cross-sectional study. BMJ open. 2018;8(7):e021401.
19. Alpdemir M, Alpdemir MF. Meta Analysis Vitamin D deficiency status in Turkey: A meta-analysis. Int J Med Biochem. 2019;2(3):118-31.
20. Babaniamansour S, Hematyar M, Babaniamansour P, Babaniamansour A, Aliniagerdroudbari E. The prevalence of vitamin D deficiency among one to six year old children of Tehran, Iran. Journal of Kermanshah University of Medical Sciences. 2019;23(4).
21. Yang C, Mao M, Ping L, Yu D. Prevalence of vitamin D deficiency and insufficiency among 460,537 children in 825 hospitals from 18 provinces in mainland China. Medicine. 2020;99(44).
22. Ando E, Morisaki N, Asakura K, Sasaki S, Fujiwara T, Horikawa R. Serum 25-hydroxyvitamin D levels showed strong seasonality but lacked association with vitamin D intake in 3-year-old Japanese children. British Journal of Nutrition. 2018;120(9):1034-44.
23. Beyitler İ, Uncu M, Bahceciler N, Şanlıdağ B, Dalkan C, Kavukcu S. Impact of Mediterranean climate and seasonal variation on vitamin D levels in children. Cyprus J Med Sci. 2018;1:15-8.