Search

Summary: Background: The impact of vitamin D status on body composition is not well understood. Objectives: Evaluate how vitamin D supplementation in infancy affects body composition at 3 years of age. Methods: Double‐blind randomized trial of 132, 1‐month‐old healthy, breastfed infants randomly assigned to receive oral vitamin D3 supplements of 400, 800, 1200 or 1600 IU d−1 for 11 months. In the present analysis, 87 (66%) returned at 3 years of age. Body composition was measured using dual‐energy x‐ray absorptiometry and plasma 25‐hydroxyvitamin D [25(OH)D] concentrations by liquid chromatography tandem mass spectrometry. Results: Anthropometry, body composition, diet, activity and demographics were similar across dosage groups at 3 years. Mean 25(OH)D concentration from 1 month to 3 years was higher (P < 0.001) in the 1200 IU group than 800 and 400 IU groups. Children with 25(OH)D concentrations above 75 nmol L−1 had lower fat mass (~450 g; P = 0.049). In multiple linear regression, mean 25(OH)D was associated with lean mass percent (β = 0.06; CI: 0.00, 0.12; P = 0.042), fat mass (β = −11.29; CI: −22.06, −0.52; P = 0.048) and body fat percent (β = −0.06; CI: −0.12, −0.01; P = 0.045). Conclusions: Higher vitamin D status from infancy through to 3 years of age associates with leaner body composition. [ABSTRACT FROM AUTHOR]

We evaluated five children with prolonged primary hypothyroidism and noted a significant reduction in renal function (40%), which was reversible with hormonal replacement. This decline was higher than reported in adults and was of sufficient magnitude to warrant altering drug-dosing schedules. Furthermore, patients with moderately reduced renal function should be carefully evaluated for signs and symptoms of hypothyroidism. [ABSTRACT FROM AUTHOR]

Unlabelled: This report describes a successful treatment with megestrol acetate in a child with persistent hyperinsulinemic hypoglycemia of infancy (PHHI). An 8-y-old child with PHHI treated with octreotide had marked impairment of appetite sensation and feeding skills. Within 3 wk of starting megestrol acetate (8 mg/kg/d) to stimulate her appetite, she had a significant improvement. By 1 y postinitiation, she had acquired age-appropriate eating habits. The megestrol acetate caused hyperglycemia, necessitating the discontinuation of all other therapy for her hypoglycemia. Her height growth remained normal but she was found to have asymptomatic adrenal suppression.Conclusion: Megestrol acetate appeared to stimulate appetite and regulate glucose homeostasis in this child with PHHI. Additional studies will be required to document its efficacy and safety in other children with this disorder. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate the uptake of a free vitamin D infant prescription programme and to determine the incidence of nutritional rickets., Methods: This was a retrospective cohort study of infants from Quebec, Canada, involving term infants born between 1998 and 2008 and covered by the public insurance programme. Data were extracted from the Quebec Pregnancy Cohort. Predictors of programme participation were identified through logistic regression., Results: A total of 123 018 infants were eligible, and the mean annual prevalence of supplemental vitamin D exposure was 17.9 ± 5.6%. The median age for obtaining the first bottle was 36 days and half only obtained one bottle of 50 doses. Mothers with higher socio-economic status, those who lived as a couple, older mothers or a prescription by a paediatrician significantly increased the odds of obtaining vitamin D. There was a decline in programme participation over time (OR 0.89/year, 95% CI = 0.88-0.90). The incidence of rickets was 23.9 cases per 100 000 live births, with an annual increase of 1.12 cases/year (95% CI = 1.01-1.24)., Conclusion: Without educational measures, a free prescription programme for vitamin D failed to encourage participation or adherence. Moreover, participation decreased with time. New strategies, including educational support, need to be developed to increase vitamin D supplementation rates., (©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)