Evaluating Vitamin D Deficiency and Toxicity in Indian Children: A Retrospective Study.

BACKGROUND

Vitamin D is essential for bone health, immune function, and overall growth in children. Its deficiency or excess can lead to significant health issues. Despite its importance, there is little systematic data on vitamin D levels in healthy children in Eastern India, with disparities observed across age, gender, and geographical factors. This study investigates the trends in serum vitamin D levels among Indian children, with a specific focus on age- and gender-related variations, and evaluates the implications of current supplementation practices.

OBJECTIVE

To evaluate vitamin D levels in Eastern Indian children (one month to 18 years) and assess the impact of age, gender, and healthcare settings on vitamin D status.

METHODS

A retrospective hospital-based study analyzed vitamin D levels in pediatric patients across different age groups, genders, and healthcare settings (outpatient department (OPD), inpatient department (IPD), and intensive care unit (ICU)). We reviewed data on supplementation practices, clinical manifestations, and underlying conditions, but the retrospective nature of the study limited detailed histories. Data were represented as mean, SD, median, and IQR. An appropriate nonparametric test was applied to find the statistical difference in the data.

RESULTS

Of the total of 1,384 children, the mean age was 11.2 ± 4.9 years. A statistically significant age-related decline was seen (p<0.001) in vitamin D levels. Males had higher vitamin D compared to females (25.75 ± 3.09 vs. 22.85 ± 18.84 ng/ml). Hypovitaminosis D was significantly more prevalent in adolescents aged 11-18 years, with 693 (80.6%) having levels <30 ng/ml (p<0.001). In contrast, hypervitaminosis D (>100 ng/ml) was more common in infants under one year, affecting four (6.5%) (p=0.012). Healthcare settings like OPD, IPD, and ICU did not affect the vitamin D levels significantly.

CONCLUSION

Vitamin D supplementation in neonates has effectively maintained optimal levels, but careful monitoring is essential to prevent hypervitaminosis. Targeted interventions, especially for adolescents and females, are critical to addressing hypovitaminosis and improving overall vitamin D status in children. A well-defined supplementation protocol, combined with regular screening, can ensure balanced levels in children.