Modifiable and non-modifiable risk factors for vitamin d deficiency in infants and young children

Vorobyova O.A., Drozdov V.N., Kazakov R.E., Fedorova T.A., Shikh E.V.

1) I.M. Sechenov First Moscow State Medical University (Sechenov University), Department of Clinical Pharmacology and Propaedeutics of Internal Diseases, N.V. Sklifosovsky Institute of Clinical Medicine, Moscow, Russia; 2) Scientific Center for Expertise of Medical Products, Moscow, Russia

Background: The high prevalence of vitamin D deficiency in children necessitates finding optimal approaches to prevention, which in turn is impossible without identifying risk factors, including in different age groups.
Objective: Determination of the contribution of modifiable risk factors and the role of genotypes of polymorphic markers Fok I and Taq I of the VDR gene in the development of vitamin D deficiency in infants and young children.
Materials and methods: 94 children aged 4.5 to 18 months were examined. The study included determination of blood vitamin D levels (25-hydroxyergocalciferol + 25-hydroxycholecalciferol), determination of Fok I and Taq I polymorphisms of the VDR gene. The following anamnestic data were analyzed: maternal intake of vitamin D during pregnancy, type of feeding, consistency of drug prophylaxis of vitamin D deficiency in children. For each of the listed factors, the risk levels (and their statistical significance) for the development of vitamin D deficiency were determined.
Results: With seasonal intake of vitamin D, the risk of a decrease in plasma 25-OH-D to a level of less than 30 ng/ml increased by 10.36 times (p=0.0001) compared with year-round prophylaxis; refusal of maternal vitamin D intake during pregnancy resulted in a 2.95-fold (p=0.006) increase in the risk of vitamin D deficiency compared to children whose mothers took vitamin D during pregnancy. Breastfeeding did not statistically significantly increase the risk of vitamin D deficiency in children. It was found that homozygous carriers of minor alleles of Fok I (TT) had a 2.67-fold increase in the risk of developing this condition (p=0.015).
Conclusion: Modifiable risk factors are of the greatest importance. Irregularity of drug prophylaxis of vitamin D deficiency (seasonal intake) and refusal to take vitamin D during pregnancy increase the risk of vitamin D deficiency in infants and young children. Homozygous carriage of minor alleles of the Fok I gene does not correlate with the blood vitamin D level in the of children, but increases the risk of developing vitamin D deficiency.

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About the Authors

Olga A. Vorobyova, Teaching Assistant of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases, N.V. Sklifosovsky Institute of Clinical Medicine., I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; vorobeva_o_a@staff.sechenov.ru,
ORCID: https://orcid.org/0000-0001-9292-4769 (corresponding author)
Vladimir N. Drozdov, Dr. Sci. (Med.), Professor, I.M. Sechenov First Moscow State Medical University (Sechenov University), Department of Clinical Pharmacology and Propaedeutics of Internal Diseases, N.V. Sklifosovsky Institute of Clinical Medicine, Moscow, Russia; ORCID: https://orcid.org/0000-0002-0535-2916
Ruslan E. Kazakov, Cand. Sci. (Biol,), Head of the Department of Personalized Medicine and Clinical Pharmacogenetics, Scientific Center for Expertise of Medical Products, Moscow, Russia; ORCID: https://orcid.org/0000-0003-0802-4229
Tatiana A. Fedorova, I.M. Sechenov First Moscow State Medical University (Sechenov University), Department of Clinical Pharmacology and Propaedeutics of Internal Medicine, N.V. Sklifosovsky Institute of Clinical Medicine, Moscow, Russia; ORCID: https://orcid.org/0000-0003-1762-6934
Evgenia V. Shikh, Dr. Sci. (Med.), Corresponding Member of the Russian Academy of Sciences, Head of the Department of Clinical Pharmacology and Propaedeutics of Internal Medicine, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; ORCID: https://orcid.org/0000-0001-6589-7654

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