Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Pediatric Nephrology Unit, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
Eur J Pediatr. 2021 Aug;180(8):2637-2644. doi: 10.1007/s00431-021-04143-7. Epub 2021 Jun 15.
Cholecalciferol (vitamin D) is essentially known for its role in the phosphocalcic metabolism and its associated pathologies, such as rickets. In Switzerland, 35 to 50% of children are vitamin D deficient. Due to skin colour, poor nutrition, living conditions and cultural practices, migrant population is particularly at risk. Our aim is to attest the prevalence of hypovitaminosis D in children arriving in Switzerland. We retrospectively assessed 528 children's vitamin D status and parathyroid hormone, phosphate and calcium levels between 2015 and 2018 by electrochemiluminescence and spectrophotometry. Cholecalciferol was considered insufficient under 50 nmol/L and severely deficient below 25 nmol/L. Seventy-three percent of children showed hypovitaminosis D and 28% had a severe deficiency. Highest prevalence of deficiency was found in children from Eastern Mediterranean (80%) and African regions (75%). Severe deficiency was more prevalent in the South East Asian (39%) and Eastern Mediterranean regions (33%) and more frequent in females. Deficiency was more frequent and more severe in winter. Hypovitaminosis D increased with age. Two children presented with all three biological manifestations associated to severe hypovitaminosis D (hyperparathyroidism, hypocalcaemia and hypophosphatemia).Conclusion: A majority of migrant children presented with hypovitaminosis D. They should be supplemented to prevent complications. A strategy could be to supplement all children at arrival and during wintertime without regular vitamin D level checks. What is Known: Hypovitaminosis D is frequent in children and can lead to bone-related complications. Migrant children are particularly at risk of deficiency. What is New: Three-quarters of migrant children evaluated at our migrant clinic in Geneva's children hospital are deficient in vitamin D, one third severely. A strategy to correct the deficiency would be to supplement all migrant children at arrival and in winter.
胆钙化醇（维生素 D）主要因其在磷钙代谢及其相关疾病（如佝偻病）中的作用而闻名。在瑞士，35%至 50%的儿童维生素 D 缺乏。由于肤色、营养不良、生活条件和文化习俗，移民群体尤其面临风险。我们的目的是证明抵达瑞士的儿童维生素 D 缺乏症的流行程度。我们通过电化学发光和分光光度法回顾性评估了 2015 年至 2018 年间 528 名儿童的维生素 D 状态和甲状旁腺激素、磷酸盐和钙水平。当维生素 D 低于 50nmol/L 时被认为不足，低于 25nmol/L 时则严重缺乏。73%的儿童出现维生素 D 缺乏症，28%的儿童存在严重缺乏症。来自东地中海和非洲地区的儿童维生素 D 缺乏症的发病率最高（分别为 80%和 75%）。东南亚和东地中海地区的严重缺乏症更为常见（分别为 39%和 33%），女性更为常见。冬季缺乏症更为频繁且更为严重。维生素 D 缺乏症随年龄增长而增加。有两名儿童出现了与严重维生素 D 缺乏症相关的三种生物学表现（甲状旁腺功能亢进、低钙血症和低磷血症）。结论：大多数移民儿童存在维生素 D 缺乏症。应该进行补充以预防并发症。一种策略是在抵达时和冬季为所有儿童补充维生素 D，而无需定期检查维生素 D 水平。已知：维生素 D 缺乏症在儿童中很常见，可能导致骨骼相关并发症。移民儿童尤其容易缺乏维生素 D。新发现：在我们位于日内瓦儿童医院的移民诊所评估的移民儿童中，四分之三存在维生素 D 缺乏症，三分之一存在严重缺乏症。纠正缺乏症的策略是在抵达时和冬季为所有移民儿童补充维生素 D。
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