Calcaterra Valeria, Cena Hellas, Biino Ginevra, Grazi Roberta, Bortoni Giulio, Braschi Valentina, Tomasinelli Chiara Elena, Schneider Laura, Zuccotti Gianvincenzo
Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy.
Pediatric Department, "Vittore Buzzi" Children's Hospital, 20154 Milano, Italy.
Children (Basel). 2022 Nov 2;9(11):1685. doi: 10.3390/children9111685.
Non-invasive screening tools to identify children at high risk of vitamin D (VitD) deficiency are proactive measures in preventive care. Recently, a validated questionnaire (Evaluation dEficieNCy Questionnaire, EVIDENCe-Q) for identifying newly diagnosed VitD-insufficient adults has been developed. We tested the EVIDENCe-Q modified for children with obesity and evaluated the correlation between VitD and questionnaire scores to adapt this tool to the pediatric population. We enrolled 120 children with obesity (BMI ≥ 2). Clinical evaluation and VitD levels were considered. The modified EVIDENCe-Q included information regarding factors affecting control of VitD, with scores ranging between 0 (best) and 36 (worst). VitD and adiposity indices were inversely correlated. The threshold values for identifying severe deficiency (<10 mg/dL), deficiency (<20 mg/dL) and insufficiency (<30 mg/dL) were scores of 21, 19 and 23, respectively. According to those thresholds, the prevalence of severe deficiency, deficiency and insufficiency was 47.5%, 69.2% and 23.3%, respectively; the best accuracy was obtained with a questionnaire score cut-off of 19 for the VitD deficiency level. A novel simple screening tool such as the modified EVIDENCe-Q would be useful in clinical practice to identify potential cases of hypovitaminosis D and select at-risk patients. Considering the limited accuracy and specificity of our results, for the pediatric population a dedicated tool should be created. Phases of childhood and the role of adipose tissue could be considered in the definition of a questionnaire intended for pediatric patients with obesity.
识别维生素D(VitD)缺乏高危儿童的非侵入性筛查工具是预防保健中的积极措施。最近,一种用于识别新诊断的VitD不足成年人的有效问卷(评估效率问卷,EVIDENCe-Q)已经开发出来。我们测试了针对肥胖儿童修改后的EVIDENCe-Q,并评估了VitD与问卷得分之间的相关性,以使该工具适用于儿科人群。我们纳入了120名肥胖儿童(BMI≥2)。进行了临床评估并检测了VitD水平。修改后的EVIDENCe-Q包括了有关影响VitD控制因素的信息,得分范围在0(最佳)至36(最差)之间。VitD与肥胖指数呈负相关。识别严重缺乏(<10mg/dL)、缺乏(<20mg/dL)和不足(<30mg/dL)的阈值分别为21分、19分和23分。根据这些阈值,严重缺乏、缺乏和不足的患病率分别为47.5%、69.2%和23.3%;对于VitD缺乏水平,问卷得分截断值为19时获得了最佳准确性。一种新颖的简单筛查工具,如修改后的EVIDENCe-Q,在临床实践中对于识别潜在的维生素D缺乏症病例和选择高危患者将是有用的。考虑到我们结果的准确性和特异性有限,对于儿科人群应创建一种专用工具。在为肥胖儿科患者定义问卷时,可以考虑儿童期阶段和脂肪组织的作用。