- © 2007 Canadian Medical Association or its licensors
We read with interest the recent article by Leanne Ward and colleagues on the incidence of vitamin D–deficiency rickets among Canadian children.1 Using our laboratory database at the University Hospital of Verona, Italy, we recently conducted a retrospective analysis of the results of vitamin D testing in children up to and including 18 years of age that was performed at the request of the child's pediatrician between June 2004 and June 2007.
Results of serum 25-hydroxyvitamin D tests (measured by chemiluminescence, DiaSorin LIAISON automated immunoassay analyzer) were retrieved for 192 children (mean age 7.2 years, age range 1 week–17.9 years). The median serum 25-hydroxyvitamin D concentration was 121 nmol/L (limits of interquartile range [25–75th percentile] 69–188 nmol/L). Overall, 12 children (6.2%) had a serum 25-hydroxyvitamin D concentration less than 27.5 nmol/L, which was the cutoff used by Ward and colleagues to diagnose vitamin D deficiency. Our clinical chemistry laboratory serves a region of 130 400 people, 22 300 of whom are under 18 years of age. Thus, our annual incidence rate is nearly 18 cases per 100 000 children, 6 times higher than the rate reported by Ward and colleagues.
Children and young adults are at high risk for vitamin D deficiency even in sunny regions.1–3 We agree with Danielle Grenier that, in addition to heightened efforts by individual health care providers, more rigorous national surveillance is needed to ensure adequate vitamin D intake by pregnant and lactating women and to improve the health and well-being of children and youth.4
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Competing interests: None declared.