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Vitamin D and skeletal health in infancy and childhood

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Abstract

During growth, severe vitamin D deficiency in childhood can result in symptomatic hypocalcaemia and rickets. Despite the suggestion from some studies of a secular increase in the incidence of rickets, this observation may be driven more by changes in population demographics than a true alteration to age, sex and ethnicity-specific incidence rates; indeed, rickets remains uncommon overall and is rarely seen in fair-skinned children. Additionally, the impact of less severe vitamin D deficiency and insufficiency has received much interest in recent years, and in this review, we consider the evidence relating vitamin D status to fracture risk and bone mineral density (BMD) in childhood and adolescence. We conclude that there is insufficient evidence to support the suggestion that low serum 25-hydroxyvitamin D [25(OH)D] increases childhood fracture risk. Overall, the relationship between 25(OH)D and BMD is inconsistent across studies and across skeletal sites within the same study; however, there is evidence to suggest that vitamin D supplementation in children with the lowest levels of 25(OH)D might improve BMD. High-quality randomised trials are now required to confirm this benefit.

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Acknowledgments

This review is based on a report commissioned by the UK Department of Health and the Medical Research Council of Great Britain. We are grateful for the support from the Medical Research Council; NIHR Biomedical Research Centre in Nutrition, University of Southampton; NIHR Biomedical Research Unit, University of Oxford; Arthritis Research UK; NIHR HTA Programme; and International Osteoporosis Foundation.

Conflict of interest

RJM has nothing to declare. NCH has received consultancy, lecture fees and honoraria from Alliance for Better Bone Health, AMGEN, MSD, Eli Lilly, Servier, Shire, Consilient Healthcare and Internis Pharma. JHD has received honoraria from Pfizer, Novo Nordisk Ltd. and SANDOZ. CC has received consultancy, lecture fees and honoraria from AMGEN, GSK, Alliance for Better Bone Health, MSD, Eli Lilly, Pfizer, Novartis, Servier, Medtronic and Roche.

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Authors and Affiliations

  1. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, SO16 6YD, UK

    R. J. Moon, N. C. Harvey & C. Cooper

  2. Paediatric Endocrinology, Southampton University Hospitals NHS Foundation Trust, Southampton, SO16 6YD, UK

    R. J. Moon & J. H. Davies

  3. NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK

    N. C. Harvey & C. Cooper

  4. NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Nuffield Orthopedic Centre, Headington, Oxford, OX3 7HE, UK

    C. Cooper

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  1. R. J. Moon
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  4. C. Cooper
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Correspondence to C. Cooper.

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Moon, R.J., Harvey, N.C., Davies, J.H. et al. Vitamin D and skeletal health in infancy and childhood. Osteoporos Int 25, 2673–2684 (2014). https://doi.org/10.1007/s00198-014-2783-5

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