Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy.
Pediatric Department, Buzzi Children's Hospital, 20154 Milano, Italy.
Nutrients. 2024 Mar 27;16(7):971. doi: 10.3390/nu16070971.
The identification of vitamin D (VitD) deficiency in pediatric populations is essential for preventive healthcare. We refined and tested the Evaluation of Deficiency Questionnaire (EVIDENCe-Q) for its utility in detecting VitD insufficiency among children.
We enrolled 201 pediatric patients (aged between 3 and 18 years). Clinical evaluation and serum vitamin D levels were assessed in all subjects. The EVIDENCe-Q was updated to incorporate factors influencing VitD biosynthesis, intake, assimilation, and metabolism, with scores spanning from 0 (optimal) to 36 (poor).
We established scores for severe deficiency (<10 mg/dL) at 20, deficiency (<20 mg/dL) at 22, and insufficiency (<30 mg/dL) at 28. A score of 20 or greater was determined as the optimal cut-off for distinguishing VitD deficient from sufficient statuses, as evidenced by ROC curve analysis AUC = 0.7066; SE = 0.0841; sensitivity 100%, 95% CI 0.561-1. The most accurate alignment was seen with VitD insufficiency, defined as 25-OH-D3 < 20 ng/mL.
This study confirms that the EVIDENCe-Q is a valid instrument for assessing the risk of vitamin D deficiency and insufficiency in children. It offers a practical approach for determining the need for clinical intervention and dietary supplementation of VitD in the pediatric population.
在儿科人群中识别维生素 D(VitD)缺乏对于预防保健至关重要。我们对评估缺乏问卷(EVIDENCe-Q)进行了改进和测试,以确定其在检测儿童 VitD 不足方面的实用性。
我们招募了 201 名儿科患者(年龄在 3 至 18 岁之间)。所有受试者均进行了临床评估和血清维生素 D 水平检测。EVIDENCe-Q 已更新,纳入了影响 VitD 生物合成、摄入、吸收和代谢的因素,评分范围从 0(最佳)到 36(最差)。
我们确定了严重缺乏症(<10mg/dL)的评分为 20,缺乏症(<20mg/dL)的评分为 22,不足症(<30mg/dL)的评分为 28。评分≥20 被确定为区分 VitD 缺乏和充足状态的最佳截断值,这一点通过 ROC 曲线分析 AUC=0.7066;SE=0.0841;敏感性 100%,95%CI 0.561-1 得到证明。与 VitD 不足症(定义为 25-OH-D3<20ng/mL)的吻合度最高。
本研究证实,EVIDENCe-Q 是评估儿童 VitD 缺乏和不足风险的有效工具。它提供了一种实用的方法,用于确定儿科人群中临床干预和 VitD 饮食补充的必要性。