Effects of ethnicity and vitamin D supplementation on vitamin D status and changes in bone mineral content in infants

Steven A Abrams, Keli M Hawthorne, Stefanie P Rogers, Penni D Hicks, Thomas O Carpenter, Steven A Abrams, Keli M Hawthorne, Stefanie P Rogers, Penni D Hicks, Thomas O Carpenter

Abstract

Background: To evaluate the effects on serum 25(OH)D and bone mineralization of supplementation of breast-fed Hispanic and non-Hispanic Caucasian infants with vitamin D in infants in Houston, Texas.

Methods: We measured cord serum 25(OH)D levels, bone mineral content (BMC), bone mineral density (BMD) and their changes over 3 months of life with 400 IU/day of vitamin D3 supplementation.

Results: Cord serum 25(OH)D was significantly lower in Hispanic than non-Hispanic Caucasian infants (16.4 ± 6.5 ng/mL, n = 27, vs 22.3 ± 9.4 n = 22, p = 0.013). Among 38 infants who completed a 3 month vitamin D supplementation intervention, provision of 400 IU/day of vitamin D increased final 25(OH)D to a higher level in non-Hispanic Caucasian compared to Hispanic infants. There was no significant relationship between cord serum 25(OH)D and BMC or BMD in the first week of life (n = 49) or after 3 months of vitamin D supplementation.

Conclusion: Low cord 25(OH)D levels are seen in Hispanic infants, but their functional significance is uncertain related to bone health in a southern US setting. Daily vitamin D intake of 400 IU during the first months of life appears adequate to increase serum 25(OH)D and support BMC increases despite low initial 25(OH)D levels in some infants.

Trial registration: ClincalTrials.gov NCT00697294.

Figures

Figure 1
Figure 1
Relationship between changes in 25(OH)D level during 3 months of supplementation and change in total body bone mineral content, r = 0.17, p = 0.30, effect size = 0.18. Note that values in ng/mL can be converted to nmol/L by multiplying by 2.5.
Figure 2
Figure 2
Baseline and final values for 25(OH)D in 38 subjects based on initial values above or below 20 ng/mL. Note that values in ng/mL can be converted to nmol/L by multiplying by 2.5.

References

    1. Greer FR. Issues in establishing vitamin D recommendations for infants and children. Am J Clin Nutr. 2004;80(6 Suppl1):1759–1762S.
    1. Institute of Medicine. Dietary Reference Intakes for calcium and vitamin D. Washington, DC: National Academies Press; 2011.
    1. Wagner CL, Greer FR. American Academy of Pediatrics, Section on Breastfeeding and Committee on Nutrition. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics. 2008;122:1142–1152. doi: 10.1542/peds.2008-1862. [published correction appears in Pediatrics. 2009;123:197]
    1. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM. Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2011;96:1911–1930. doi: 10.1210/jc.2011-0385.
    1. Greer FR, Searcy JE, Levin RS, Steichen JJ, Asch PS, Tsang RC. Bone mineral content and serum 25-hydroxyvitamin D concentration in breast-fed infants with and without supplemental vitamin D. J Pediatr. 1981;98:696–701. doi: 10.1016/S0022-3476(81)80827-X.
    1. Bowyer L, Catling-Paull C, Diamond T, Homer C, Davis G, Craig ME. Vitamin D, PTH and calcium levels in pregnant women and their neonates. Clin Endocrinol (Oxf) 2009;70:372–377. doi: 10.1111/j.1365-2265.2008.03316.x.
    1. Abrams SA. In utero physiology: role in nutrient delivery and fetal development for calcium, phosphorus and vitamin D. Am J Clin Nutr. 2007;85:604S–607S.
    1. Tu YK, Gilthorpe MS. Revisiting the relation between change and initial value: A review and evaluation. Statist Med. 2007;26:443–457. doi: 10.1002/sim.2538.
    1. Ramavat LG. Vitamin D deficiency rickets at birth in Kuwait. Indian J Pediatr. 1999;66:37–43. doi: 10.1007/BF02752349.
    1. Fuleihan GET. Vitamin D Deficiency in the Middle East and its health consequences for children and adults. Clinic Rev Bone Miner Metab. 2009;7:77–93. doi: 10.1007/s12018-009-9027-9.
    1. Hirsch DS, Dillon C, Lorenz JM, Holick MF. Current AAP vitamin D supplementation guidelines may be inappropriate for some breastfeeding term Hispanic neonates. Pediatr Res. 2004;55:2523. (Abstract)
    1. Zeghoud F, Vervel C, Guillozo H, Walrant-Debray O, Boutignon H, Garabedian M. Subclinical vitamin D deficiency in neonates: definition and response to vitamin D supplements. Am J Clin Nutr. 1997;65:771–778.
    1. Merewood A, Mehta SD, Grossman X, Chen TC, Mathieu JS, Holick MF, Bauchner H. Widespread vitamin D deficiency in urban Massachusetts newborns and their mothers. Pediatrics. 2010;125:640–647. doi: 10.1542/peds.2009-2158.
    1. Kaplan W, Karaviti LP, McKay SV. Hypocalcemia of infancy: effects of formula and ethnicity. Int Pediatr J Miami Child. 2005;20:34–39.
    1. Park MJ, Namgung R, Kim DH. et al.Bone mineral content is not reduced despite low vitamin D status in breast milk-fed infants versus cow's milk based formula-fed infants. J Pediatr. 1998;132:641–645. doi: 10.1016/S0022-3476(98)70353-1.
    1. Greer FR, Marshall S. Bone mineral content, serum vitamin D metabolite concentrations, and ultraviolet B light exposure in infants fed human milk with and without vitamin D2 supplements. J Pediatr. 1989;114:204–212. doi: 10.1016/S0022-3476(89)80784-X.
    1. Aloia JF, Patel M, Dimaano R, Li-Ng M, Talwar SA, Mikhail M, Pollack S, Yeh JK. Vitamin D intake to attain a desired serum 25-hydroxyvitamin D concentration. Am J Clin Nutr. 2008;87:1952–1958.
    1. Abrams SA, Copeland KC, Gunn SK, Stuff JE, Clarke LL, Ellis KJ. Calcium absorption and kinetics are similar in 7- and 8-year-old Mexican-American and Caucasian girls despite hormonal differences. J Nutr. 1999;129:666–671.

Source: PubMed

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