Vitamin D Deficiency in Pediatric Fracture Patients: Prevalence, Risk Factors, and Vitamin D Supplementation

J Clin Res Pediatr Endocrinol. 2016 Dec 1;8(4):445-451. doi: 10.4274/jcrpe.3474. Epub 2016 Aug 23.

Abstract

Objective: Although vitamin D levels are not routinely monitored in pediatric fracture patients, identification of children with a vitamin D deficiency may be clinically relevant because of the potential role of vitamin D in fracture healing. This study aimed to determine the prevalence of vitamin D deficiency in a pediatric fracture population and to identify risk factors for deficiency.

Methods: All pediatric patients (<18 years) who were treated for a fracture of the upper or lower extremity from September 2012 to October 2013 in the outpatient setting of a level one trauma center were included in this cross-sectional study. Vitamin D deficiency was defined as a serum calcidiol <50 nmol/L. Potential risk factors for vitamin D deficiency were analysed using multivariable logistic regression analysis.

Results: A total of 108 boys (58%) and 79 girls, of a mean age 11.1 years (standard deviation 3.9), who had undergone 189 fractures were included in the study. Sixty-four children (34%) were vitamin D deficient. Of those with follow-up measurements, 74% were no longer deficient after supplementation. Vitamin D status did not influence the occurrence of complications during fracture treatment. Independent risk factors for vitamin D deficiency were older age, season (spring), and a non-Caucasian skin type.

Conclusion: Clinicians who treat children with a fracture should inform patients and parents on vitamin D supplementation. Vitamin D measurement and supplementation may be needed for children with a non-Caucasian skin type or for those who present with a fracture during spring months.

MeSH terms

  • Adolescent
  • Bone Density Conservation Agents / administration & dosage
  • Bone Density Conservation Agents / therapeutic use
  • Child
  • Comorbidity
  • Cross-Sectional Studies
  • Dietary Supplements
  • Female
  • Fractures, Bone / epidemiology
  • Fractures, Bone / therapy*
  • Humans
  • Logistic Models
  • Male
  • Multivariate Analysis
  • Netherlands / epidemiology
  • Outpatients / statistics & numerical data*
  • Prevalence
  • Risk Factors
  • Vitamin D / administration & dosage
  • Vitamin D / therapeutic use*
  • Vitamin D Deficiency / diagnosis
  • Vitamin D Deficiency / drug therapy*
  • Vitamin D Deficiency / epidemiology

Substances

  • Bone Density Conservation Agents
  • Vitamin D