[Prevention of child and adolescent vitamin D deficiency. II. Validation of a decision-making abacus based on sun exposure and vitamin D intakes].
OBJECTIVE
Rickets can still be observed among children and adolescents living in Europe, and a significant proportion of healthy children and adolescents presents serum 25-hydroxyvitamin D (25-(OH)D) values below the threshold indicating an insufficient vitamin D status. We have previously proposed detecting at risk individuals with a decision-making abacus based on questionnaires assessing calcium and vitamin D intakes and vitamin D production via sun exposure.


METHODS
We tested the validity of this detection by receiver operating characteristic (ROC) analysis, using, as the main outcome measure, the serum 25-(OH)D values measured at the time of questionnaires presentation. In addition, the original questionnaires have been simplified by limiting the items to those significantly associated with 25-(OH)D values. The study group included 116 children and adolescents aged 6 to 17 years, seen at the end of the winter, and randomized in 2 groups: "test", for the development of the tool (n =75), and "validation" (n =41).


RESULTS
The present analysis shows that the proposed decision-making abacus has a sufficient ability to detect children at risk of vitamin D deficiency (with 25-(OH)D values below 10 ng/ml): area under the curve 0.748/0.895, sensibility 0.71/0.83, and specificity 0.62/0.80, in the test and validation groups, respectively.


CONCLUSIONS
These questionnaire and abacus may offer a substantial help to detect children and adolescents at risk of vitamin D deficiency in both a private office or hospital environment.
Garabédian
M
M
INSERM U561, hôpital Saint-Vincent-de-Paul, 82 avenue Denfert-Rochereau, 75674 Paris cedex 14, France. cnrs.svp@wanadoo.fr
Menn
S
S
Walrant-Debray
O
O
Teinturier
C
C
Delaveyne
R
R
Roden
A
A
D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D013472:Sunlight; D011795:Surveys and Questionnaires; D014807:Vitamin D / Q000008:administration & dosage*; D014808:Vitamin D Deficiency / Q000517:prevention & control*
D014807:Vitamin D