Effect of Low-Dose Vitamin D Supplementation on Serum 25(OH)D in School Children and White-Collar Workers

Objective: Our study aimed to investigate the nutritional vitamin D status of school children aged 9–15 years and white-collar workers in Zhejiang province, and evaluate the efficacy of low-dose-oral vitamin D supplementation in both populations. Methods: We conducted a prospective controlled trial during March 2014 to November 2015, comparing the efficacy of vitamin D supplements (400 IU/day) with non-intervention for 18 months in school children aged 9–15 years. Meanwhile, a before-after study was conducted among white-collar workers for 1 year. Serum 25(OH)D concentration was measured at baseline and after vitamin D supplementation, respectively. Results: At the baseline, 95% of school children and 84% of adult participants had vitamin D deficiency (<20 ng/mL). In school children, no difference was observed between the intervention and control groups with regard to anthropometric data. Serum 25(OH)D concentrations of the school children intervention group, school children control group and white-collar workers were 12.77 ± 3.01 ng/mL, 14.17 ± 3.59 ng/mL and 16.58 ± 3.66 ng/mL at baseline and increased to 17.34 ± 3.78 ng/mL, 18.04 ± 4.01 ng/mL and 17.75 ± 5.36 ng/mL after vitamin D supplementation, respectively. Although, after adjusting for potential confounders, the 400 IU oral vitamin D supplementation increased serum 25(OH)D concentration in school children (β = 0.81, p = 0.0426) as well as in white-collar workers (p = 0.0839), the prevalence of vitamin D deficiency was still very high among school children (79.23% in intervention group and 72.38% in control group) and white-collar workers (76.00%). Conclusions: High prevalence of vitamin D deficiency was common in these two study populations. Daily doses of 400 IU oral vitamin D supplementation was not able to adequately increase serum 25(OH)D concentrations. A suitable recommendation regarding the level of vitamin D supplementation is required for this Chinese population.

[1]  E. Akl,et al.  Vitamin D replacement in children, adolescents and pregnant women in the Middle East and North Africa: A systematic review and meta-analysis of randomized controlled trials. , 2017, Metabolism: clinical and experimental.

[2]  N. Resnick,et al.  Vitamin D deficiency is associated with functional decline and falls in frail elderly women despite supplementation , 2017, Osteoporosis International.

[3]  Hongwei Xu,et al.  Nutrient Status of Vitamin D among Chinese Children , 2017, Nutrients.

[4]  J. Marshall,et al.  Impact of High-Dose Vitamin D3 Supplementation in Patients with Crohn’s Disease in Remission: A Pilot Randomized Double-Blind Controlled Study , 2017, Digestive Diseases and Sciences.

[5]  Christine L. Taylor,et al.  Vitamin D Deficiency - Is There Really a Pandemic? , 2016, The New England journal of medicine.

[6]  Mingyao Li,et al.  Vitamin D modifies the associations between circulating betatrophin and cardiometabolic risk factors among youths at risk for metabolic syndrome , 2016, Cardiovascular Diabetology.

[7]  M. Loeb,et al.  Effect of Vitamin D3 Supplementation on Respiratory Tract Infections in Healthy Individuals: A Systematic Review and Meta-Analysis of Randomized Controlled Trials , 2016, PloS one.

[8]  Hong-qun Tao,et al.  Vitamin D status among infants, children, and adolescents in southeastern China , 2016, Journal of Zhejiang University-SCIENCE B.

[9]  C. Herrmann-Lingen,et al.  Association of circulating 25-hydroxyvitamin D with mental well-being in a population-based, nationally representative sample of German adolescents , 2016, Quality of Life Research.

[10]  G. Chrousos,et al.  Serum 25-hydroxyvitamin D status among Saudi children with and without a history of fracture , 2016, Journal of Endocrinological Investigation.

[11]  Shan-shan Geng,et al.  Vitamin D Insufficiency and Its Association with Biochemical and Anthropometric Variables of Young Children in Rural Southwestern China , 2016, Chinese medical journal.

[12]  M. Youssef,et al.  Predictors of Serum 25-Hydroxyvitamin D Concentrations among a Sample of Egyptian Schoolchildren , 2016, TheScientificWorldJournal.

[13]  Fei Xu,et al.  Vitamin D Status among Young Children Aged 1–3 Years: A Cross-Sectional Study in Wuxi, China , 2015, PloS one.

[14]  B. de Courten,et al.  Vitamin D supplementation for the prevention of type 2 diabetes in overweight adults: study protocol for a randomized controlled trial , 2015, Trials.

[15]  J. Reginster,et al.  The clinical use of vitamin D metabolites and their potential developments: a position statement from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) and the International Osteoporosis Foundation (IOF) , 2015, Endocrine.

[16]  J. Buttriss,et al.  Vitamin D: An overview of vitamin D status and intake in Europe , 2014, Nutrition bulletin.

[17]  J. Wielders,et al.  Automated Competitive Protein‐Binding Assay for Total 25‐OH Vitamin D, Multicenter Evaluation and Practical Performance , 2014, Journal of clinical laboratory analysis.

[18]  M. Vogiatzi,et al.  Vitamin D supplementation and risk of toxicity in pediatrics: a review of current literature. , 2014, The Journal of clinical endocrinology and metabolism.

[19]  J. Powell,et al.  Vitamin D and cardiovascular disease. , 2014, Circulation research.

[20]  M. Gleeson,et al.  Measurement of Circulating 25-Hydroxy Vitamin D Using Three Commercial Enzyme-Linked Immunosorbent Assay Kits with Comparison to Liquid Chromatography: Tandem Mass Spectrometry Method , 2013, ISRN nutrition.

[21]  P. Jakobs,et al.  Is There an Epidemic Vitamin D Deficiency in German Orthopaedic Patients? , 2013, Clinical orthopaedics and related research.

[22]  J. Gallagher,et al.  Dose Response to Vitamin D Supplementation in Postmenopausal Women , 2012, Annals of Internal Medicine.

[23]  Christine L. Taylor,et al.  IOM committee members respond to Endocrine Society vitamin D guideline. , 2012, The Journal of clinical endocrinology and metabolism.

[24]  Lynette M. Smith,et al.  Dose Response to Vitamin D Supplementation in Postmenopausal Women , 2012, Annals of Internal Medicine.

[25]  J. Shao,et al.  High prevalence of vitamin D deficiency among children aged 1 month to 16 years in Hangzhou, China , 2012, BMC Public Health.

[26]  D. Rao,et al.  Osteomalacia as a result of vitamin D deficiency. , 2012, Rheumatic diseases clinics of North America.

[27]  C. Gordon,et al.  Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. , 2011, The Journal of clinical endocrinology and metabolism.

[28]  JoAnn E. Manson,et al.  The 2011 Report on Dietary Reference Intakes for Calcium and Vitamin D from the Institute of Medicine: What Clinicians Need to Know , 2010, The Journal of clinical endocrinology and metabolism.

[29]  P. van Assema,et al.  Vitamin D supplementation in young children: associations with Theory of Planned Behaviour variables, descriptive norms, moral norms and habits , 2010, Public Health Nutrition.

[30]  D. Bikle,et al.  Vitamin D and the skin , 2010, Journal of Bone and Mineral Metabolism.

[31]  C. Camargo,et al.  Serum 25-Hydroxyvitamin D Levels Among US Children Aged 1 to 11 Years: Do Children Need More Vitamin D? , 2009, Pediatrics.

[32]  Z. M. Shariff,et al.  Food variety score is associated with dual burden of malnutrition in Orang Asli (Malaysian indigenous peoples) households: implications for health promotion. , 2009, Asia Pacific journal of clinical nutrition.

[33]  Gert B. M. Mensink,et al.  Higher prevalence of vitamin D deficiency is associated with immigrant background among children and adolescents in Germany. , 2008, The Journal of nutrition.

[34]  Z. Mahfoud,et al.  Short- and long-term safety of weekly high-dose vitamin D3 supplementation in school children. , 2008, The Journal of clinical endocrinology and metabolism.

[35]  《中华儿科杂志》编辑委员会 中华医学会儿科学分会儿童保健学组 全国佝偻病防治病科研协作组 维生素D缺乏性佝偻病防治建议专家讨论会纪要 , 2008 .

[36]  Yan Liu,et al.  Prospective study of predictors of vitamin D status and cancer incidence and mortality in men. , 2006, Journal of the National Cancer Institute.

[37]  W. Parnell,et al.  Season and ethnicity are determinants of serum 25-hydroxyvitamin D concentrations in New Zealand children aged 5-14 y. , 2005, The Journal of nutrition.

[38]  A. Bonny,et al.  Calcium and vitamin D status in the adolescent: key roles for bone, body weight, glucose tolerance, and estrogen biosynthesis. , 2005, Journal of pediatric and adolescent gynecology.

[39]  K. Ge,et al.  Vitamin D deficiency and associated factors in adolescent girls in Beijing. , 2001, The American journal of clinical nutrition.

[40]  S. Cabrol,et al.  Statut vitaminique D de l'adolescent : variations saisonnières et effets d'une supplémentation hivernale par la vitamine D3 , 1998 .

[41]  G. Peres,et al.  [Vitamin D status in the adolescent: seasonal variations and effects of winter supplementation with vitamin D3]. , 1998, Archives de pediatrie : organe officiel de la Societe francaise de pediatrie.