title: Vitamin D status in pre-school children in rural Nepal.
abstract: OBJECTIVE
  Vitamin D plays a major role in Ca and bone metabolism, and its extraskeletal functions are being appraised. Although inadequate vitamin D concentrations have been reported in populations worldwide, too little is known about vitamin D status and its determinants among children in developing countries. We aimed to determine vitamin D status and its determinants in Nepalese children of pre-school age.
  
  
  METHODS
  A community-based, cross-sectional study.
  
  
  METHODS
  Rural Nepal at latitude 27.39° N.
  
  
  METHODS
  Healthy children (n 280) aged 12-60 months, selected randomly from the records of a vitamin A supplementation programme. Blood samples were collected using the dried blood spot technique and analysed for serum 25-hydroxyvitamin D (s-25(OH)D) concentration using liquid chromatography-tandem mass spectrometry. Ca intake and background variables were assessed with a structured questionnaire.
  
  
  RESULTS
  Hypovitaminosis D, defined as s-25(OH)D concentration less than 50 nmol/l, was found in 91.1% of the children. S-25(OH)D concentration was not related to gender, socio-economic indicators, sun exposure or nutritional status. Currently breast-fed children had higher s-25(OH)D concentrations (36.4 (sd 13.2) nmol/l) than those who were not (28.6 (sd 9.8) nmol/l, P<0.001). Adjustment for sociodemographic factors did not alter the results.
  
  
  CONCLUSIONS
  There is widespread vitamin D deficiency among pre-school children in a rural area of Nepal. In our sample, sociodemographic factors did not affect the vitamin D status of children, but prolonged breast-feeding was associated with higher s-25(OH)D concentrations. Further research is required to investigate the health consequences of poor vitamin D status for this population.
authors.affiliation: 1Department of Community Medicine,Institute of Health and Society,University of Oslo,Postboks 1130,Blindern 0318 Oslo,Norway.
authors.forename: Diana
authors.initials: D
authors.lastname: Avagyan
authors.affiliation: 2Norwegian Centre for Addiction Research (SERAF),Institute of Clinical Medicine,University of Oslo,Oslo,Norway.
authors.forename: Sudan Prasad
authors.initials: SP
authors.lastname: Neupane
authors.affiliation: 3Vitas Analytical Laboratory,Oslo Innovation Park,Oslo,Norway.
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Gundersen
authors.affiliation: 1Department of Community Medicine,Institute of Health and Society,University of Oslo,Postboks 1130,Blindern 0318 Oslo,Norway.
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Madar
mesh_terms: D001942:Breast Feeding; D002136:Calcium, Dietary / Q000008:administration & dosage / Q000097:blood; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D016014:Linear Models; D008297:Male; D009390:Nepal / Q000453:epidemiology; D015596:Nutrition Assessment; D009752:Nutritional Status; D015995:Prevalence; D012424:Rural Population; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D053719:Tandem Mass Spectrometry; D014807:Vitamin D / Q000008:administration & dosage / Q000097:blood*; D014808:Vitamin D Deficiency / Q000097:blood / Q000453:epidemiology*
chemical_list: D002136:Calcium, Dietary; D014807:Vitamin D
keywords: 25-Hydroxyvitamin D; Breast-feeding; Dried blood spots; Nepal; Nutritional status; Vitamin D status; Young children
references.citation: Clin Rev Bone Miner Metab. 2009;7:94-106
references.pmid: 25110467
references.citation: Nutr Rev. 2008 Oct;66(10 Suppl 2):S153-64
references.pmid: 18844843
references.citation: Br J Nutr. 2011 Nov;106(9):1383-9
references.pmid: 21736816
references.citation: J Steroid Biochem Mol Biol. 2004 May;89-90(1-5):611-4
references.pmid: 15225848
references.citation: Drug Alcohol Depend. 2013 Dec 1;133(2):480-5
references.pmid: 23916323
references.citation: J Nutr. 2005 May;135(5):1106-12
references.pmid: 15867289
references.citation: Eur J Clin Nutr. 2004 Apr;58(4):563-7
references.pmid: 15042122
references.citation: Am J Clin Nutr. 2005 May;81(5):1060-4
references.pmid: 15883429
references.citation: JPEN J Parenter Enteral Nutr. 2012 Jan;36(1 Suppl):9S-19S
references.pmid: 22179524
references.citation: Acta Paediatr. 1998 Jul;87(7):737-40
references.pmid: 9722245
references.citation: Arch Osteoporos. 2012;7:155-72
references.pmid: 23225293
references.citation: Br J Nutr. 2008 Apr;99(4):876-82
references.pmid: 17903343
references.citation: Acta Paediatr. 2010 Mar;99(3):389-93
references.pmid: 19900174
references.citation: Nutr Rev. 2008 Oct;66(10 Suppl 2):S182-94
references.pmid: 18844847
references.citation: Pediatrics. 2008 Nov;122(5):1142-52
references.pmid: 18977996
references.citation: Pediatrics. 2008 Aug;122(2):398-417
references.pmid: 18676559
references.citation: Am J Clin Nutr. 2000 Aug;72(2):472-5
references.pmid: 10919943
references.citation: Clin Endocrinol (Oxf). 2009 May;70(5):680-4
references.pmid: 18673464
references.citation: Mol Nutr Food Res. 2010 Aug;54(8):1134-47
references.pmid: 20440690
references.citation: J Steroid Biochem Mol Biol. 2010 Jul;121(1-2):297-300
references.pmid: 20197091
references.citation: Osteoporos Int. 2009 Nov;20(11):1807-20
references.pmid: 19543765
references.citation: J Nutr. 2013 Oct;143(10):1540-8
references.pmid: 23966331
references.citation: Am J Clin Nutr. 2005 Aug;82(2):477-82
references.pmid: 16087996