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Published in: BMC Pediatrics 1/2022

Open Access 01-12-2022 | Vitamin D Deficiency | Research

Prevalence and risk factors for vitamin D insufficiency in 6-12-month-old infants: a cross-sectional study in Southern Thailand

Authors: Staporn Kasemsripitak, Somchit Jaruratanasirikul, Sasivara Boonrusmee, Tansit Saengkaew, Hutcha Sriplung

Published in: BMC Pediatrics | Issue 1/2022

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Abstract

Background

Vitamin D is an essential micronutrient for bone mineralization and bone growth in children. There have been few studies to date of vitamin D status in infants aged 6–12 months in Southeast Asian countries.

Aim

To examine the prevalence of vitamin D insufficiency (VDI, including vitamin D deficiency) in healthy infants and the risk factors for VDI in southern Thailand.

Methods

A cross-sectional study was carried out in 120 healthy infants aged 6–12 months and their mothers. Blood samples were obtained for measurement of serum calcium, phosphate, alkaline phosphatase, albumin, parathyroid hormone and 25-hydroxyvitamin D (25OHD) levels. The mothers were interviewed for their infants feeding intake, sunlight exposure, type of dress, and sunscreen use. Chi-square and t-test were used to compare between groups for categorical and continuous variables, respectively. Pearson correlation was used to identify the relationship between serum levels of 25OHD of the infants and other biochemical variables of the infants and serum levels of maternal 25OHD. Logistic regression analysis was used to identify the factors associated with vitamin D status.

Results

The prevalence of VDI in our study infants was high at 28.3%, all of whom were mainly breastfed infants. Subgroup analysis of the mainly breastfed infants found that the risk factors for VDI were maternal VDI and a short duration of sunlight exposure. The serum 25OHD levels of the mainly breastfed infants were significantly positively correlated with the maternal serum 25OHD levels (r = 0.49, p-value < 0.01) and with sunlight exposure duration (r = 0.40, p-value < 0.01).

Conclusions

The prevalence of VDI was high in 6–12-month-old infants, particularly those who were mainly breastfed from VDI mothers, and who had short durations of sunlight exposure. As breast milk contains adequate amounts of most important vitamins and growth factors, breastfeeding is still encouraged for infants with 400 IU vitamin D daily supplementation to prevent VDI.
Literature
1.
go back to reference Chang SW, Lee HC. Vitamin D and health - The missing vitamin in humans. Pediatr Neonatol. 2019;60:237–44.CrossRef Chang SW, Lee HC. Vitamin D and health - The missing vitamin in humans. Pediatr Neonatol. 2019;60:237–44.CrossRef
2.
go back to reference Stoffman N, Gordon CM. Vitamin D and adolescents: what do we know? Curr Opin Pediatr. 2009;21:465–71.CrossRef Stoffman N, Gordon CM. Vitamin D and adolescents: what do we know? Curr Opin Pediatr. 2009;21:465–71.CrossRef
3.
go back to reference Lessen R, Kavanagh K. Position of the academy of nutrition and dietetics: promoting and supporting breastfeeding. J Acad Nutr Diet. 2015;115:444–9.CrossRef Lessen R, Kavanagh K. Position of the academy of nutrition and dietetics: promoting and supporting breastfeeding. J Acad Nutr Diet. 2015;115:444–9.CrossRef
4.
go back to reference World Health Organization. Nutrient adequacy of exclusive breastfeeding for the term infant during the first six months of life. Geneva (Switzerland): WHO; 2002. World Health Organization. Nutrient adequacy of exclusive breastfeeding for the term infant during the first six months of life. Geneva (Switzerland): WHO; 2002.
6.
go back to reference Erick M. Breast milk is conditionally perfect. Med Hypotheses. 2018;111:82–9.CrossRef Erick M. Breast milk is conditionally perfect. Med Hypotheses. 2018;111:82–9.CrossRef
7.
go back to reference Keikha M, Bahreynian M, Saleki M, Kelishadi R. Macro- and micronutrients of human milk composition: Are they related to maternal diet? A comprehensive systematic review. Breastfeed Med. 2017;12:517–27.CrossRef Keikha M, Bahreynian M, Saleki M, Kelishadi R. Macro- and micronutrients of human milk composition: Are they related to maternal diet? A comprehensive systematic review. Breastfeed Med. 2017;12:517–27.CrossRef
8.
go back to reference Poh BK, Rojroongwasinkul N, Nguyen BK, Sandjaja, Ruzita AT, Yamborisut U, et al; SEANUTS Study Group. 25-hydroxy-vitamin D demography and the risk of vitamin D insufficiency in the South East Asian Nutrition Surveys (SEANUTS). Asia Pac J Clin Nutr. 2016;25:538–48. Poh BK, Rojroongwasinkul N, Nguyen BK, Sandjaja, Ruzita AT, Yamborisut U, et al; SEANUTS Study Group. 25-hydroxy-vitamin D demography and the risk of vitamin D insufficiency in the South East Asian Nutrition Surveys (SEANUTS). Asia Pac J Clin Nutr. 2016;25:538–48.
9.
go back to reference Rojroongwasinkul N, Kijboonchoo K, Wimonpeerapattana W, Purttiponthanee S, Yamborisut U, Boonpraderm A, et al. SEANUTS: the nutritional status and dietary intakes of 0.5–12-year-old Thai children. Br J Nutr. 2013;110(Suppl 3):S36-44.CrossRef Rojroongwasinkul N, Kijboonchoo K, Wimonpeerapattana W, Purttiponthanee S, Yamborisut U, Boonpraderm A, et al. SEANUTS: the nutritional status and dietary intakes of 0.5–12-year-old Thai children. Br J Nutr. 2013;110(Suppl 3):S36-44.CrossRef
12.
go back to reference Munns CF, Shaw N, Kiely M, Specker BL, Thacher TD, Ozono K, et al. Global consensus recommendations on prevention and management of nutritional rickets. J Clin Endocrinol Metab. 2016;101:394–415.CrossRef Munns CF, Shaw N, Kiely M, Specker BL, Thacher TD, Ozono K, et al. Global consensus recommendations on prevention and management of nutritional rickets. J Clin Endocrinol Metab. 2016;101:394–415.CrossRef
13.
go back to reference van Schoor N, Lips P. Global overview of vitamin D status. Endocrinol Metab Clin North Am. 2017;46:845–70.CrossRef van Schoor N, Lips P. Global overview of vitamin D status. Endocrinol Metab Clin North Am. 2017;46:845–70.CrossRef
14.
go back to reference van der Pligt P, Willcox J, Szymlek-Gay EA, Murray E, Worsley A, Daly RM. Associations of maternal vitamin D deficiency with pregnancy and neonatal complications in developing countries: A systematic review. Nutrients. 2018;10:640.CrossRef van der Pligt P, Willcox J, Szymlek-Gay EA, Murray E, Worsley A, Daly RM. Associations of maternal vitamin D deficiency with pregnancy and neonatal complications in developing countries: A systematic review. Nutrients. 2018;10:640.CrossRef
15.
go back to reference Keikha M, Bahreynian M, Saleki M, Kelishadi R. Macro- and micronutrients of human milk composition: Are they related to maternal diet? A comprehensive systematic review Breastfeed Med. 2017;12:517–27.CrossRef Keikha M, Bahreynian M, Saleki M, Kelishadi R. Macro- and micronutrients of human milk composition: Are they related to maternal diet? A comprehensive systematic review Breastfeed Med. 2017;12:517–27.CrossRef
16.
go back to reference Hollis BW, Wagner CL, Howard CR, Ebeling M, Shary JR, Smith PG, et al. Maternal versus infant vitamin D supplementation during lactation: a randomized controlled trial. Pediatrics. 2015;136:625–34.CrossRef Hollis BW, Wagner CL, Howard CR, Ebeling M, Shary JR, Smith PG, et al. Maternal versus infant vitamin D supplementation during lactation: a randomized controlled trial. Pediatrics. 2015;136:625–34.CrossRef
17.
go back to reference Andrews L, Phlegar K, Baatz JE, Ebeling MD, Shary JR, Gregoski MJ, et al. Comparison of infant bone mineral content and density after infant daily oral vitamin D 400 IU supplementation versus nursing mother oral 6,400 IU supplementation: A randomized controlled lactation study. Breastfeed Med. 2022;17:493–500.CrossRef Andrews L, Phlegar K, Baatz JE, Ebeling MD, Shary JR, Gregoski MJ, et al. Comparison of infant bone mineral content and density after infant daily oral vitamin D 400 IU supplementation versus nursing mother oral 6,400 IU supplementation: A randomized controlled lactation study. Breastfeed Med. 2022;17:493–500.CrossRef
18.
go back to reference Nair R, Maseeh A. Vitamin D: The “sunshine” vitamin. J Pharmacol Pharmacother. 2012;3:118–26. Nair R, Maseeh A. Vitamin D: The “sunshine” vitamin. J Pharmacol Pharmacother. 2012;3:118–26.
19.
go back to reference Engelsen O. The relationship between ultraviolet radiation exposure and vitamin D status. Nutrients. 2010;2:482–95.CrossRef Engelsen O. The relationship between ultraviolet radiation exposure and vitamin D status. Nutrients. 2010;2:482–95.CrossRef
20.
go back to reference Misra M, Pacaud D, Petryk A, Collet-Solberg PF, Kappy M. Drug and Therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society Vitamin D deficiency in children and its management: review of current knowledge and recommendations. Pediatrics. 2008;122:398–417.CrossRef Misra M, Pacaud D, Petryk A, Collet-Solberg PF, Kappy M. Drug and Therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society Vitamin D deficiency in children and its management: review of current knowledge and recommendations. Pediatrics. 2008;122:398–417.CrossRef
21.
go back to reference Bogh MKB. Vitamin D production after UVB: Aspects of UV-radiated and personal factors. Scand J Clin Lab Invest. 2012;72(suppl 243):24–31. Bogh MKB. Vitamin D production after UVB: Aspects of UV-radiated and personal factors. Scand J Clin Lab Invest. 2012;72(suppl 243):24–31.
22.
go back to reference Nimitphong H, Holick MF. Vitamin D status and sun exposure in Southeast Asia. Dermatoendocrinol. 2013;5:34–7.CrossRef Nimitphong H, Holick MF. Vitamin D status and sun exposure in Southeast Asia. Dermatoendocrinol. 2013;5:34–7.CrossRef
23.
go back to reference Jablonski NG, Chaplin G. human skin pigmentation as an adaptation to UV radiation. Proc Natl Acad Sci U S A. 2010;107 Suppl 2(Suppl2):8962–8. Jablonski NG, Chaplin G. human skin pigmentation as an adaptation to UV radiation. Proc Natl Acad Sci U S A. 2010;107 Suppl 2(Suppl2):8962–8.
24.
go back to reference American Academy of Pediatrics, Committee on Environmental Health. Ultraviolet light: a hazard to children. Pediatrics. 1999;104(2 Pt 1):328–33. American Academy of Pediatrics, Committee on Environmental Health. Ultraviolet light: a hazard to children. Pediatrics. 1999;104(2 Pt 1):328–33.
25.
go back to reference Binkley N, Carter GD. Toward clarity in clinical vitamin D status assessment: 25OHD assay standardization. Endocrino Metab Clin North Am. 2017;46:885–99.CrossRef Binkley N, Carter GD. Toward clarity in clinical vitamin D status assessment: 25OHD assay standardization. Endocrino Metab Clin North Am. 2017;46:885–99.CrossRef
26.
go back to reference Farrell CJ, Herrmann M. Determination of vitamin D and its metabolites. Best Prac Res Clin Endocrinol Metab. 2013;27:675–88.CrossRef Farrell CJ, Herrmann M. Determination of vitamin D and its metabolites. Best Prac Res Clin Endocrinol Metab. 2013;27:675–88.CrossRef
Metadata
Title
Prevalence and risk factors for vitamin D insufficiency in 6-12-month-old infants: a cross-sectional study in Southern Thailand
Authors
Staporn Kasemsripitak
Somchit Jaruratanasirikul
Sasivara Boonrusmee
Tansit Saengkaew
Hutcha Sriplung
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2022
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-022-03797-y

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