Rana R Mokhtar1, Michael F Holick1, Fernando Sempértegui2, Jeffrey K Griffiths3, Bertha Estrella2, Lynn L Moore4, Matthew P Fox5, Davidson H Hamer6. 1. 1Section of Endocrinology,Diabetes & Nutrition,Department of Medicine,Vitamin D,Skin, and Bone Research Laboratory,Boston University School of Medicine (BUSM),85 East Newton Street,Boston,MA 02118,USA. 2. 3Facultad de Medicina,Universidad Central del Ecuador,Quito,Ecuador. 3. 4Department of Public Health and Community Medicine,Tufts University School of Medicine,Boston,MA,USA. 4. 6Preventive Medicine & Epidemiology,Department of Medicine,BUSM,Boston,MA,USA. 5. 7Department of Epidemiology,BUSPH,Boston,MA,USA. 6. 2Department of Global Health,Boston University School of Public Health (BUSPH),Boston,MA,USA.
Abstract
OBJECTIVE: There is limited knowledge on vitamin D status of children residing in the Andes and its association with undernutrition. We evaluated the vitamin D status of children residing in a low socio-economic status (SES) setting in the Ecuadorian Andes and assessed the association between vitamin D status, stunting and underweight. We hypothesized that children who were underweight would have lower serum25-hydroxyvitamin D (25(OH)D) levels and lower 25(OH)D levels would be associated with a higher risk of stunting. DESIGN: We conducted a cross-sectional secondary analysis of a randomized controlled trial, the Vitamin A, Zinc and Pneumonia study. Children had serum 25(OH)D concentrations measured. A sensitivity analysis was undertaken to determine a vitamin D cut-off specific for our endpoints. Associations between serum 25(OH)D and underweight (defined as weight-for-age Z-score≤-1) and stunting (defined as height-for-age Z-score≤-2) were assessed using multivariate logistic regression. SETTING: Children residing in five low-SES peri-urban neighbourhoods near Quito, Ecuador. SUBJECTS:Children (n 516) aged 6-36 months. RESULTS:Mean serum 25(OH)D concentration was 58·0 (sd 17·7) nmol/l. Sensitivity analysis revealed an undernutrition-specific 25(OH)D cut-off of <42·5 nmol/l; 18·6 % of children had serum 25(OH)D<42·5 nmol/l. Children who were underweight were more likely to have serum 25(OH)D<42·5 nmol/l (adjusted OR (aOR)=2·0; 95 % CI 1·2, 3·3). Children with low serum 25(OH)D levels were more likely to be stunted (aOR=2·8; 95 % CI 1·6, 4·7). CONCLUSIONS:Low serum 25(OH)D levels were more common in underweight and stunted Ecuadorian children.
RCT Entities:
OBJECTIVE: There is limited knowledge on vitamin D status of children residing in the Andes and its association with undernutrition. We evaluated the vitamin D status of children residing in a low socio-economic status (SES) setting in the Ecuadorian Andes and assessed the association between vitamin D status, stunting and underweight. We hypothesized that children who were underweight would have lower serum 25-hydroxyvitamin D (25(OH)D) levels and lower 25(OH)D levels would be associated with a higher risk of stunting. DESIGN: We conducted a cross-sectional secondary analysis of a randomized controlled trial, the Vitamin A, Zinc and Pneumonia study. Children had serum 25(OH)D concentrations measured. A sensitivity analysis was undertaken to determine a vitamin D cut-off specific for our endpoints. Associations between serum 25(OH)D and underweight (defined as weight-for-age Z-score≤-1) and stunting (defined as height-for-age Z-score≤-2) were assessed using multivariate logistic regression. SETTING:Children residing in five low-SES peri-urban neighbourhoods near Quito, Ecuador. SUBJECTS:Children (n 516) aged 6-36 months. RESULTS: Mean serum 25(OH)D concentration was 58·0 (sd 17·7) nmol/l. Sensitivity analysis revealed an undernutrition-specific 25(OH)D cut-off of <42·5 nmol/l; 18·6 % of children had serum 25(OH)D<42·5 nmol/l. Children who were underweight were more likely to have serum 25(OH)D<42·5 nmol/l (adjusted OR (aOR)=2·0; 95 % CI 1·2, 3·3). Children with low serum 25(OH)D levels were more likely to be stunted (aOR=2·8; 95 % CI 1·6, 4·7). CONCLUSIONS: Low serum 25(OH)D levels were more common in underweight and stunted Ecuadorian children.
Authors: Reagan M Mogire; Alireza Morovat; John Muthii Muriuki; Alexander J Mentzer; Emily L Webb; Wandia Kimita; Francis M Ndungu; Alex W Macharia; Clare L Cutland; Sodiomon B Sirima; Amidou Diarra; Alfred B Tiono; Swaib A Lule; Shabir A Madhi; Manjinder S Sandhu; Andrew M Prentice; Philip Bejon; John M Pettifor; Alison M Elliott; Adebowale Adeyemo; Thomas N Williams; Sarah H Atkinson Journal: BMC Med Date: 2021-05-20 Impact factor: 8.775
Authors: Andrew J Forgie; Kelsea M Drall; Stephane L Bourque; Catherine J Field; Anita L Kozyrskyj; Benjamin P Willing Journal: BMC Med Date: 2020-05-12 Impact factor: 8.775