Prevalence of Vitamin D Deficiency in Children (6–18 years) Residing in Kullu and Kangra Districts of Himachal Pradesh, India: Correspondence

Excerpt

To the Editor: We read with interest the article on the prevalence of vitamin D deficiency in children residing at high altitudes in the recent issue of your esteemed journal and found it very useful [1]. Despite formal guidelines on vitamin D supplementation for Indian children, most of the children are deficient [2]. Authors rightly stated that we are facing an unrecognized and untreated pandemic of Vitamin D deficiency for which there are no well-defined diagnostic/therapeutic endpoints. The magnitude of this pandemic is defined by prevalence based upon certain cut-offs which themselves are in a gray zone. A recently published review of guidelines [3] suggests that all except the Endocrine Society Clinical Practice Guideline [4] agreed upon cut-off of 20 ng/ml as sufficient and same cut-off has been endorsed by Indian Academy of Pediatrics (IAP) [2]. The cut-off of 20 ng/mL is more appropriate as it coincides with the level that would cover the needs of 97.5% of the population [2]. Defining a standard cut-off is very necessary as increasing the cut-off will greatly affect the prevalence rate of insufficiency and will increase the treatment rate. So, to ensure uniformity it will be useful to have data from this study on vitamin D deficiency using 12 mg/ml as the cut-off. …