title: Vitamin D sufficiency screening in preoperative pediatric orthopaedic patients.
abstract: BACKGROUND
  Vitamin D is a critical factor in bone metabolism. Vitamin D levels in both children and adults have been reevaluated to assess standards for sufficiency and deficiency. In the adult population, the currently recommended level for Vitamin D sufficiency is greater than 32 ng/mL measured by 25-hydroxyvitamin D assay. Recommended levels for growing children have not been definitively determined; however, scales based on available literature have been used. The purpose of this study was to evaluate Vitamin D sufficiency in pediatric orthopaedic patients admitted to the hospital for surgical procedures which require bone healing.
  
  
  METHODS
  Serum 25 hydroxyvitamin D (25 OHD) levels measured by immunochemoluminometric assay were obtained on consecutive pediatric orthopaedic patients admitted electively for long bone osteotomies or spinal fusions over a 10-month period. Seventy patients ranging in age from 2 to 19 years were screened for Vitamin D sufficiency. Vitamin D levels were examined for correlation with age, sex, ethnicity, body mass index (BMI), BMI percentile, orthopaedic diagnosis, and season.
  
  
  RESULTS
  Total 90% of the screened patients had 25 OH vitamin D levels below 32 ng/mL. African American children were more likely to have severe Vitamin D deficiency (P=0.013). Vitamin D levels were lower in the winter months (P=0.046). When 20 ng/mL was used as a cutoff, the average age of children below this cutoff was higher than those above (P=0.018). There was no correlation of Vitamin D levels with sex, BMI, BMI percentile, residence in Mexico, and diagnosis.
  
  
  CONCLUSIONS
  Total 90% of the children in the screening group were at risk for poor bone healing owing to Vitamin D deficiency or insufficiency. African American children, in particular, should be evaluated for Vitamin D sufficiency before orthopaedic surgeries. Further work must be done to determine the impact of Vitamin D insufficiency on surgical outcomes.
  
  
  METHODS
  Diagnostic study, III.
authors.affiliation: University of Texas Medical School at Houston, Houston, TX, USA.
authors.forename: Joshua
authors.initials: J
authors.lastname: Parry
authors.forename: Elroy
authors.initials: E
authors.lastname: Sullivan
authors.forename: Allison Cooper
authors.initials: AC
authors.lastname: Scott
mesh_terms: D000293:Adolescent; D001741:Black or African American; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008163:Luminescent Measurements; D008297:Male; D010027:Osteotomy / Q000379:methods*; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D012621:Seasons; D013123:Spinal Fusion / Q000379:methods*; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000175:diagnosis*; D055815:Young Adult
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D