Electronic letters to:

Research:
Leanne M. Ward, MD, Isabelle Gaboury, MSc, Moyez Ladhani, MD, and Stanley Zlotkin, MD PhD
Vitamin D–deficiency rickets among children in Canada
CMAJ 2007; 177: 161-166 [Abstract] [Full text] [PDF]
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Electronic letters published:

[Read eLetter] Vitamin D3 deficiency among Italian children.
Giuseppe Lippi   (23 July 2007)

Vitamin D3 deficiency among Italian children. 23 July 2007
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Giuseppe Lippi
Sez. Chimica Clinica, Dip. Scienze Morfologico-Biomediche, Università di Verona

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Re: Vitamin D3 deficiency among Italian children.

ulippi{at}tin.it Giuseppe Lippi

Giuseppe Lippi (1), MD, Martina Montagnana (1), MD, Giovanni Targher (2), MD.

1. Sezione di Chimica Clinica, Dipartimento di Scienze Morfologico- Biomediche, Università di Verona, Italy.

2. Sezione di Endocrinologia e Malattie del Metabolismo, Dipartimento di Scienze Biomediche e Chirurgiche, Università di Verona, Italy.

We read with interest the recent article of Ward et al. on the incidence of vitamin D-deficiency rickets among Canadian children. They found that the overall annual incidence rate was 2.9 cases per 100,000 (1). Accordingly, we have recently performed a retrospective analysis on database of our Laboratory Information System at the University Hospital of Verona (a town in the northern Italy), to retrieve the results of vitamin D tests, which have been performed on children up to and including 18 years of age, who had this test requested by the pediatricians over the last 3 years (June 2004-June 2007). Results of serum 25 hydroxy-vitamin D tests [25(OH)D as measured by a chemiluminescence assay; Diasorin LIAISON] were retrieved for 192 children (mean age: 7.2 years, range: 1 week-17.9 years). The median value (25-75th percentile distribution) of 25(OH)D was 121 nmol/L (69-188 nmol/L). Overall, 12 (6.2% of total) children had a serum 25(OH)D concentration less than 27.5 nmol/L (a cut-off used by Ward et al. for diagnosing vitamin D deficiency). Since our Clinical Chemistry Laboratory serves an area with a population of 130,400 inhabitants, 22,300 of whom under 18 years of age, the overall annual incidence rate of vitamin D deficiency can be estimated at nearly 18 cases per 100,000 children, 5-folds greater than that reported by Ward et al. (1). Our findings confirm and extend those reported by Ward et al. (1) suggesting that children and young adults are at high risk for vitamin D deficiency even in the sunniest areas (1-3). Heightened efforts and a more rigorous national surveillance should be undertaken by health care providers to ensure adequate vitamin D intake for pregnant and lactating women, to improve the health and well-being of children and youth (4).

References

1. Ward LM, Gaboury I, Ladhani M, Zlotkin S. Vitamin D-deficiency rickets among children in Canada. CMAJ 2007; 177: 161-166.

2. Holick MF. Vitamin D deficiency. N Engl J Med 2007; 357: 266-281.

3. Cigolini M, Miconi V, Soffiati G, Fortanato A, Iagulli MP, Lombardi S, Targher G. Hypovitaminosis D among unselected medical inpatients and outpatients in Northern Italy. Clin Endocrinol (Oxf) 2006; 64: 475.

4. Grenier D. Active surveillance: an essential tool in safeguarding the health and well-being of children and youth. CMAJ 2007; 177: 169-171.

Conflict of Interest:

None declared