Vitamin D in pediatric age: consensus of the Italian Pediatric Society and the Italian Society of Preventive and Social Pediatrics, jointly with the Italian Federation of Pediatricians

Abstract

Vitamin D plays a pivotal role in the regulation of calcium-phosphorus metabolism, particularly during pediatric age when nutritional rickets and impaired bone mass acquisition may occur.Besides its historical skeletal functions, in the last years it has been demonstrated that vitamin D directly or indirectly regulates up to 1250 genes, playing so-called extraskeletal actions. Indeed, recent data suggest a possible role of vitamin D in the pathogenesis of several pathological conditions, including infectious, allergic and autoimmune diseases. Thus, vitamin D deficiency may affect not only musculoskeletal health but also a potentially wide range of acute and chronic conditions. At present, the prevalence of vitamin D deficiency is high in Italian children and adolescents, and national recommendations on vitamin D supplementation during pediatric age are lacking. An expert panel of the Italian Society of Preventive and Social Pediatrics reviewed available literature focusing on randomized controlled trials of vitamin D supplementation to provide a practical approach to vitamin D supplementation for infants, children and adolescents.

Family‐related factors may affect serum vitamin D levels

“…1 Vitamin D deficiency is identified by measuring serum 25-hydroxy-vitamin D levels and studies of levels between parents and their offspring, and among siblings, suggest the family environment may play a role. Epidemiological studies have shown that it can lead to rickets in children and osteomalacia in adults and may play a role in a variety of extraskeletal disorders, including asthma, type 1 diabetes, infectious and cardiovascular diseases and cancer.…”

“…Epidemiological studies have shown that it can lead to rickets in children and osteomalacia in adults and may play a role in a variety of extraskeletal disorders, including asthma, type 1 diabetes, infectious and cardiovascular diseases and cancer. 1 Vitamin D deficiency is identified by measuring serum 25-hydroxy-vitamin D levels and studies of levels between parents and their offspring, and among siblings, suggest the family environment may play a role. 2 Other risk factors for vitamin D deficiency include adiposity and female gender.…”

Association of Vitamin D Levels with the Metabolic Profile and Sexual Maturation Stage of Adolescents

“…Furthermore, studies with adult patients showed that the supplementation with this vitamin could not reduce adiposity. These findings show that hypovitaminosis D does not necessarily lead to obesity [12] [18] [19].…”

“…Deficiency of VD is observed worldwide at any age. According to Saggese et al [12], the prevalence of VD deficiency ranges from 9% to 18%, and hypovitaminosis may reach 51% to 61%. A meta-analysis with almost 15,000 European pediatric patients showed that the deficiency might reach 4% to 7% in children with 1 -6 years; 1% to 8% in 7 -14 years, and 12% to 40% in 15 -18 years.…”

“…In adolescents, hypovitaminosis D is also related to defective bone mineralization [20], increases the risk of urinary and respiratory infections, tuberculosis [21] [22], allergies [12] [23], asthma [24], celiac disease [25], inflammatory bo- [26], type 1 diabetes [27], obesity and metabolic syndrome [28].…”