EFFECTIVENESS OF CORRECTION OF HYPOVITAMINOSIS D IN ADOLESCENTS LIVING IN MOSCOW CITY
https://doi.org/10.21518/2079-701X-2017-9-136-142
Abstract
Schoolchildren and their state of health, in particular, deficiencies, deserve no less attention than children of early age, while the recognition of the existence of inadequate vitamin D sufficiency in children of all age groups has not yet led to the introduction of mass prophylaxis for hypovitaminosis D. There are a number of factors determining the concentration of 25(OH)D-calcidiol in the blood. However, it is obvious that among many factors one should focus on several most significant and develop a scheme for correcting deficiency in each region.
Purpose: to assess vitamin D sufficiency in adolescents living in Moscow, to correct calcidiol status in adolescents on the basis of baseline concentration of the metabolite transported in the blood. Material and methods: 769 adolescents aged 11-18 years for whom 25(OH)D concentration in the blood was evaluated, then 218 patients were randomized into 2 groups: the study group received tableted dietary supplement Minisun® vitamin D3, the control
group received placebo. The dosage of cholecalciferol was defined based on the initial level of calcidiol in patients. The study continued for 6 months, then blood was re-sampled to determine the level of calcidiol.
Results: the study found low sufficiency with calcidiol among the schoolchildren: 25(OH)D median was 16.3 [11.4-20.8] ng/ml, only 5.2% of patients had normal concentration of calcidiol in the blood. At the second examination, positively significant differences in the status of vitamin D were observed in the study compared to the control group, while patients in the study group,
against a background of cholecalciferol donation, demonstrated 25(OH)D median increase from 16.2 [12.25-19.3] ng/ml to 24.2 [21.05-26.4] ng/ml (p <0.001) .
Conclusions: a large proportion of the child population (70.6%) have a concentration of 25(OH)D <20 ng/ml. The doses of cholecalciferol used in the study make it possible to eliminate the deficiency of calcidiol and to overcome the threshold of 20 ng/ml, but in order to normalize vitamin D status in the blood of adolescents living in Moscow, it is necessary to use higher dosages that need to be confirmed by further research.
About the Authors
I. N. ZAKHAROVARussian Federation
MD, Prof.
E. A. SOLOVYEVA
Russian Federation
L. Ya. KLIMOV
Russian Federation
PhD in Medicine
S. V. VASILYEVA
Russian Federation
T. M. TVOROGOVA
Russian Federation
PhD in Medicine
N. G. SUGYAN
Russian Federation
PhD in medicine
A. V. RAKHTEENKO
Russian Federation
V. A. KURYANINOVA
Russian Federation
PhD in Medicine
P. (PAWEL PLUDOVSKI) PLUDOVSKI
Russian Federation
References
1. Al-Shaar L, Mneimneh R, Nabulsi M, Maalouf J, Fuleihan Gel-H. Vitamin D3 dose requirement to raise 25-hydroxyvitamin D to desirable levels in adolescents: results from a randomized controlled trial. J. Bone Miner. Res., 2014, 29(4): 944–951.
2. Das G, Crocombe S, McGrath M, Berry JL, Mughal MZ. Hypovitaminosis D among healthy adolescent girls attending an inner city school. Arch. Dis. Child., 2006, 91(7): 569–572.
3. Dura-Trave T., Gallinas-Victoriano F., Chueca Guindulain M.J., Berrade-Zubiri S. Vitamin D Deficiency in Children and Adolescents in Bağcılar, İstanbul. J. Clin. Res. Pediatr. Endocrinol., 2015, 7(2): 134–139.
4. El-Hajj Fuleihan G, Nabulsi M, Choucair M, Salamoun M, Hajj Shahine C, Kizirian A, Tannous R. Hypovitaminosis D in healthy school children. Pediatrics, 2001, 107(4): E53.
5. Erol M, Yiğit Ö, Küçük SH, Bostan Gayret Ö.Vitamin D Deficiency in Children and Adolescents in Bağcılar, İstanbul. J. Clin. Res. Ped. End., 2015, 7(2): 134–139.
6. Gordon CM, DePeter KC, Feldman HA, Grace E,Emans SJ. Prevalence of vitamin D deficiency among healthy adolescents. Arch. Pediatr. Adolesc. Med., 2004, 158(6): 531–537.
7. Gordon CM, Williams AL, Feldman HA, May J, Sinclair L, Vasquez A, Cox JE. Treatment of hypovitaminosis D in infants and toddlers. J.Clin. Endocrinol. Metab., 2008, 93(7): 2716–2721.
8. Harkness LS, Cromer BA. Vitamin D deficiency in adolescent females. J. Adolesc. Health., 2005, 37(1): 75.
9. Heaney R.P. Functional indices of vitamin D status and ramifications of vitamin D deficiency. Am J Clin Nutr., 2004, 80(6 Suppl): 1706S–11709.
10. Holick MF. High prevalence of vitamin D inadequacy and implications for health. Mayo Clin Proc, 2006 Mar, 81(3): 353-73.
11. Holick MF. Vitamin D deficiency. N. Engl. J.Med., 2007, 357(3): 266-281.
12. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Hassan Murad M, Weaver CM. Endocrine Society: Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J. Clin. Endocrinol. Metab., 2011, 96: 1911–1930.
13. Holick MF, Chen TC. Vitamin D deficiency: a worldwide problem with health consequences. Am. J. Clin. Nutr., 2008, 87(4): 1080S-6S.
14. King RJ, Chandrajay D, Fbbas A, Orme SM, Barth JH. High-dose oral colecalciferol loading in obesity: impact of body mass index and its utility prior to bariatric surgery to treat vitamin D deficiency. Clin. Obes., 2017, 7(2): 92–97.
15. Munns CF, Shaw N, Kiely M, Specker BL, Thacher TD, Ozono K, Michigami T, Tiosano D, Mughal MZ, Mäkitie O, Ramos-Abad L, Ward L, DiMeglio LA, Atapattu N, Cassinelli H, Braegger C, Pettifor JM, Seth A, Idris HW, Bhatia V, Fu J, Goldberg G, Sävendahl L, Khadgawat R, Pludowski P, Maddock J, Hyppönen E, Oduwole A, Frew E, Aguiar M, Tulchinsky T, Butler G, Högler W. Global consensus recommendations on prevention and management of nutritional rickets. J. Clin. Endocrinol. Metab, 2016, 101(2): 394–415.
16. Pludowski P, Holick MF, Grant WB, Konstantynowicz J, Mascarenhas MR, Haq A, Porovoznyuk V, Balatska N, Barbosa AP, Karonova T, Rudenka E, Misiorowski W, Zakharova I, Rudenka A, Lucaszkeiewicz J, Marcinowska-Suchowierska E, Laszcz N, Abramowicz P, Bhattoa HP, Wimalawansa SJ. Vitamin D supplementation guidelines. J. Steroid Biochem. Mol. Biol., 2017 Feb 12.
17. Pludowski P, Karczmarewicz E, Bayer M, Carter G, Chlebna-Sokol D, Czech-Kowalska J, Debski R,Desci T, Dobrzanska A, Franek E, Gluszko P, Grant WB, Holick MF, Yankovskaya L, Konstantynowicz J, Ksiazyk JB, Ksiezopolska-Orlowska K, Lewinski A, Litwin M, Lohner S, Lorenc RS, Lukaszkiewicz J, Marcinowska-Suchowierska E, Milewicz A, Misiorowski W, Nowicki M, Porovoznyuk V, Rozentryt P, Rudenka E, Shoenfeld Y, Socha P, Solnica B, Szalecki M, Talalaj M, Varbiro S, Zmijewski MA. Practical guidelines for the supplementation of vitamin D and the treatment of deficits in Central 28 Europe – recommended vitamin D intakes in the general population and groups at risk of vitamin D deficiency. Endokrynologia Polska, 2013, 64(4): 319–327.
18. Smith TJ, Tripkovic L, Damsgaard CT, Mølgaard C, Ritz C, Wilson-Barnes SL, Dowling KG, Hen nessy A, Cashman KD, Kiely M, Lanham-New SA. Estimation of the dietary requirement for vitamin D in adolescents aged 14-18 y: a dose-response, double-blind, randomized placebo-controlled trial. Am. J. Clin. Nutr., 2016, 104(5): 1301–1309.
19. Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, Durazo-Arvizu RA, Gallagher JC, Gallo RL, Jones G, Kovacs CS, Mayne ST, Rosen CJ, Shapses SA. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J. Clin. Endocrinol. Metab., 2011, 96(1): 53–58.
20. Thacher T.D., Pludowski P., Kiely M. Nutritional rickets – global guidelines for prevention and treatment. Standardy Medyczne pediatria, 2015, 12(5): 769–773.
21. Uitterlinden AG, Fang Y, van Meurs JBJ, Pols HAP, van Leeuwen JPTM. Genetics and biology of vitamin D receptor polymorphisms: Review. Gene, 2004, 338: 143–156.
22. Wang L, Wang H, Wen H, Tao H, Zhao X. Vitamin D status among infants, children, and adolescents in southeastern China. J. Zhejiang University Science B, 201 6, 17(7): 545–552.
Review
For citations:
ZAKHAROVA IN, SOLOVYEVA EA, KLIMOV LY, VASILYEVA SV, TVOROGOVA TM, SUGYAN NG, RAKHTEENKO AV, KURYANINOVA VA, PLUDOVSKI P(. EFFECTIVENESS OF CORRECTION OF HYPOVITAMINOSIS D IN ADOLESCENTS LIVING IN MOSCOW CITY. Meditsinskiy sovet = Medical Council. 2017;(9):136-142. (In Russ.) https://doi.org/10.21518/2079-701X-2017-9-136-142