Vitamin D deficiency in healthy adolescents aged 12–17 years in Kirikkale, Turkey Vitamin D deficiency adolescents

Main Article Content

Ramazan Dulkadir
Hacer Fulya Gülerman
Selda Fatma Hızel Bülbül

Abstract

Objective: This study was performed to determine the prevalence of vitamin D deficiency and associated factors in apparently-healthy adolescents in the Central Anatolia region of Turkey where nutritional rickets is common.


Materials and Methods: This prospective cohort study was performed in the Kirikkale province of Central Anatolia, Turkey. Adolescents aged 1 to 17 years old with no health complaints were enrolled between February 2012 and February 2013. Adolescents younger than 12 and older than 17 age, those with chronic diseases, and those using any medications known to affect vitamin D metabolism were excluded. A total of 358 adolescents, consisting of 235 (65.5%) girls and 123 (34.5%) boys with an average age of 14.6 ± 1.58 years, were included in this study.  Serum concentrations of 25-hydroxy vitamin D [25(OH)D] and other bone mineralization markers were measured in the summer and winter.


Results: In blood samples, phosphorus (P), alkaline phosphatase (ALP), bone-ALP (B-ALP), parathyroid hormone (PTH), and 25(OH)D levels were considerably lower in female adolescents than in male adolescents. The rate of vitamin D deficiency was higher in girls than in boys. B-ALP level was compared to Vitamin D level in each season; there was no significant relation in winter, but vitamin D level decreased with increasing B-ALP level in summer. B-ALP level was compared to vitamin D level according to sex; there was no significant relation in male adolescents, but vitamin D level decreased while B-ALP level increased in female adolescents.


Conclusion: This study showed that vitamin D deficiency or inadequacy is very common among adolescents, particularly in females in Central Anatolia region of Turkey.

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How to Cite
Dulkadir, R., Gülerman, H. F., & Bülbül, S. F. H. . (2022). Vitamin D deficiency in healthy adolescents aged 12–17 years in Kirikkale, Turkey: Vitamin D deficiency adolescents. Medical Science and Discovery, 9(12), 656–661. Retrieved from https://medscidiscovery.com/index.php/msd/article/view/832
Section
Research Article
Received 2022-10-17
Accepted 2022-12-17
Published 2022-12-27

References

Holick MF. Resurrection of vitamin D deficiency and rickets. J Clin Invest 2006;116(8): 2062-2072.

Holick MF, Chen TC. Vitamin D deficiency: a worldwide problem with health consequences. Am J Clin Nutr 2008;87(4): 1080S-1086S.

Kimball S, Fuleihan Gel H, Vieth R. Vitamin D: a growing perspective. Crit Rev Clin Lab Sci 2008; 45(4): 339-414.

El-Hajj Fuleihan, Vieth R. Vitamin D insufficiency and musculoskeletal health in children and adolescents. International Congress Series 1297. 2007: 91-108.

Gultekin A, Ozalp I, Hasanoglu A, Unal A. Serum-25-hydroxycholecalciferol levels in children and adolescents. Turk J Pediatr 1987;29(3): 155-62.

Olmez D, Bober E, Buyukgebiz A, Cimrin D. The frequency of vitamin D insufficiency in healthy female adolescents. Acta Paediatr 2006;95(10): 1266 ?

Hatun S, Bereket A, Calıkoglu A., Ozkan B. Vitamin D insuffiency and nutritional rickets nowadays. J Pediatr 2003; 46: 224-241.

Pettifor JM, Thandrayen K, Thacher TD. Vitamin D deficiency and nutritional rickets in children. InVitamin D 2018 Jan 1 (pp. 179-201). Academic Press.

Lips P. Vitamin D physiology. Prog Biophys Mol Biol 2006; 92: 4–8.

Holick MF. Vitamin D deficiency. N Engl J Med 2007; 357: 266–281.

Acar MN. Cesur Y. Vitamin D levels amongst adolescent in Van region. Department of Pediatrics, Medicine of Yuzuncu Yıl University. Thesis, Van, 2005.

Hatun S, Islam O, Cizmecioglu F, Kara B, Babaoglu K, Berk F, et al. Subclinical vitamin D deficiency is increased in adolescent girls who wear concealing clothing. J Nutr 2005;135(2): 218-222.

Ölmez D, Büyükgebiz A. Subclinical Vitamin D deficiency amongst healty adolescent girls who lives in two distinct socio-economic residental area in Izmir. Department of Pediatrics, Medicine Faculty of Dokuz Eylül University, Thesis, İzmir 2004.

Demirçeken F, Zorlu P, Kutlu AO, Teziç T, Darı S. Adolescent rickets due to lack of sun light exposure.: A Case report. Turk J Pediatr 2001; 44: 79–81.

Özkan B, Yıldırım ZK. Rikets. Current Child Healt 2008; 1(3): 158-170,75

Narchi H, El Jamil M, Kulaylat N: Symptoamatic rickets in adolescence, Arch Dis Child 2001; 84: 501–503.

Rajeswari J, Balasubramanian K, Bhatia V, Sharma VP, Agarwal AK. Aetiology and clinical profile of osteomalacia in adolescent girls in nothern İndia. Natl J India 2003; 16:139–142.

Moussavi M, Heidarpour R, Aminorroaya A, Pournaghshband Z, Amini M. Prevalence of vitamin D deficiency in Isfahani high school students in 2004. Horm Res 2005; 64:144–148

Chapuy MC, Arlot ME, Duboeuf F, Brun J, Crouzet B. Vitamin D3 and calcium to prevent hip fractures in elderly women. N Engl J Med 1992; 327:1637-1642.

Bener A, Al-Ali M, Hoffmann GF. Vitamin D deficiency in healthy children in a sunny country: associated factors. Int J of Food Sciences and Nutr 2008; 60:60-70.

Hooper JL. Seeman AE. The bone density of female twins discordant for tobacco use. N Engl J Med 1994;330:387–392.

Puri S, Marwaha RK, Agarwal N et all. Vitamin D status of apperently healthy schoolgirls from different socioeconomic strata in Delhi: relation nutrition and lifestyle. British J of Nutr 2008; 99:876–882.

Ergur AT, Berberoğlu M, Atasay B et al. Vitamin D deficiency in Tukish mothers and their neonates and woman reproductive age. JCRPE 2009; 1:266-9

Karagüzel G, Dilber B, Çan G, Ökten A, Değer O, Holick MF. Seasonal vitamin D status of healthy schoolchildren and predictors of low vitamin D status. J Pediatr Gastroenterol Nutr. 2014; 58:654–660.

Smith GR, Collinson PO, Kiely PD. Diagnosing hypovitaminosis D:serum measurements of calcium, phosphate, and alkaline phosphatase are unreliable, even in the presence of secondary hyperparathyroidism. J Rheumatol 2005;32(4):684-689.

Cheng S, Tylavsky F, Kröger H et all. Association of low 25-hydroxyvitamin D concertrations with elevated parathyroid hormone concentrations and low cortical bone density in early pubertal and prepubertal Finnsh girls. Am J Clin Nutr 2003; 78: 485–492.

Özkan B. Evaluation of bone turnover parameters. Endocrinological tests for children and adolescents. Ankara: Güneş Kitabevi. 2006; 269–288.

Guillemant J, Le HT, Maria A et al. Wintertime vitamin D deficiency in male adolescents: effects on paratyroid function and responce to vitamin D3 supplements. Osteoporos Int 2001; 12:875–879.

Abdullah MA, Salhi HS, Barky LA et all. Adolescent rickets in Saudi Arabia: A rich and sunny country. J PedEndoc & Metab 2002; 15:1017–1025.

Richardson JP. Vitamin D deficiency – the once and present epidemic. Am Fam Physician 2005; 71:241–242.

Turkey Ministry of Halth documents 2005;14:5

Gartner LM. Greer FR. American Academy of Pediatrics. Clinical Report: Prevention of rickets and vitamin D deficiency: New guidelines for vitamin D. Pediatrics. 2003;111: 908–910.

Cizmecioğlu F. M., N. Etiler, U. Görmüş¸, O. Hamzaoğlu, and S. Hatun, Hypovitaminosis D in obese and overweight schoolchildren. J Clin Res Ped Endocrinol, vol. 1, no. 2, pp. 89–96, 2008.

Saki F, Dabbaghmanesh MH, Omrani GR, Bakhshayeshkaram M. Vitamin D deficiency and its associated risk factors in children and adolescents in southern Iran. Public Health Nutr 2015; 8:1-6.

Saki F, Dabbaghmanesh MH, Bakhshayeshkaram M... Vitamin D deficiency and its associated risk factors in children and adolescents in southern Iran. Public Health Nutr 2017; 20(10):1851-1856

Holick MF. Vitamin D status: measurement, interpretation, and clinical application. Ann Epidemiol. 2009; 19(2):73-8.

Kurdoglu G, Günay S, Sökücü S. Nutrition and Nutritional Disorders. Neyzi O (Author). Pediatrics. Istanbul: Fatih Youth Foundation Printing Press, 1989: 395–401.

Republic of Turkey, Ministry of Health. General Directorate of Mother-Child Care and Family Planning. Vitamin D supplement programme for pregnant women (www. saglik.gov.tr/ACSAP)

Andersen R, Molgaard C, Skovgaard LT et al. Teenage girls and elderly women living in northern Europe have low winter vitamin D status. Eur J Clin Nutr 2005; 59: 533–541.

Holick MF, Binkley NC, Bischoff-Ferrari HA et al. (2011) Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96, 1911–1930.

SACN (Scientific Advisory Committee on Nutrition) 2007. Update on vitamin D. Position statement. London: The Stationary Office.

IOM (Institute of Medicine) Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: The National Academies Press; 2011.

Alpcan A, Tursun S, Kandur Y. Vitamin D levels in children with COVID-19: a report from Turkey. Epidemiol Infect. 2021 Aug 10;149:e180. doi: 10.1017/S0950268821001825. PMID: 34375576; PMCID: PMC8365038.