Pediatric Endocrine Fellow Baylor College of Medicine/Texas Children’s Hospital Baylor College of Medicine Department of Pediatrics Pearland, Texas, United States
Background: Vitamin D deficiency is a substantial comorbidity in 50% of pediatric patients and is linked with poorer health outcomes in children. Given this high prevalence, it is important for pediatricians to know how to screen and monitor vitamin D deficiency. Despite the overall lack of consensus regarding the vitamin D deficiency screening and monitoring in pediatric patients, most organizations recommend re-evaluating vitamin D status within 2-3 months of initial vitamin D deficient level. The aim of this study was to evaluate the screening and monitoring practices of vitamin D deficiency in pediatric patients at a large children’s hospital.
Objective:
Design/Methods: We performed a retrospective study from 2009 to 2020 examining medical information from electronic medical records of all children with a serum 25-hydroxyvitamin D [25(OH)D] level. Vitamin D deficiency was defined as 25(OH)D level < 20 ng/mL. Data collection comprised of age at initial screen, gender, race/ethnicity, BMI data, 25(OH)D levels, and dates of 25(OH)D levels.
Results: 18,252 children had at least one 25(OH)D level drawn. Of these, 36% were identified with vitamin D deficiency; mean age of 10.3 ± 5 years. Average BMI was 22.3 ± 11.9 kg/m2 (81%ile) in females and 20.7 ± 8.7 kg/m2 (89% ile) in males. Fifty-three percent were female. In the vitamin D deficient group, 45% were Hispanic, 26% were African-American, 21% were non-Hispanic white, 6% were Asian, and <1% were American Native or Pacific Islander. Deficient 25(OH)D levels were more frequently observed in the month of January (11%) and least observed in July (7%). Mean initial 25(OH)D level was 14.4 ng/mL. Fifty-two percent of the vitamin D deficient cohort had repeat 25(OH)D levels within one year of the initial level. The average number of 25(OH)D tests per patient was five. Within one year of vitamin D deficiency, 27% of the cohort were no longer deficient (25(OH)D levels > or = 20 ng/mL). Conclusion(s): These preliminary findings suggest that about half of the pediatric patients with vitamin D deficiency did not have repeat levels drawn within one year after diagnosis. Furthermore, the majority of the individuals with vitamin D deficiency with subsequent monitoring did not achieve vitamin D sufficiency. These findings indicate that vitamin D deficiency is not being adequately monitored and treated in our patients. Further work should determine if a standardized protocol for the screening and monitoring of vitamin D deficiency in pediatric patients would improve these metrics.
Authors/Institutions: Olivia Ginnard, Baylor College of Medicine Department of Pediatrics, Pearland, Texas, United States; Stephanie Sisley, Baylor College of Medicine, Houston, Texas, United States
