title: Vitamin D deficiency and its associated risk factors in children and adolescents in southern Iran.
abstract: OBJECTIVE
  To evaluate prevalence of vitamin D deficiency and its associated factors in southern Iranian children.
  
  
  METHODS
  Cross-sectional study. Anthropometric and pubertal characteristics were assessed by a trained physician. Physical activity and sun exposure were evaluated using standard questionnaires. Body composition measurements were performed using dual-energy X-ray absorptiometry. Serum Ca, P alkaline phosphatase and 25-hydroxyvitamin D (25(OH)D) were assessed in all children. Statistical analysis was done using the statistical software package IBM SPSS Statistics 18·0.
  
  
  METHODS
  Iranian children (n 477) aged 9-18 years.
  
  
  METHODS
  Fars Province, Iran, 2011.
  
  
  RESULTS
  Of the children, 81·3 % were 25(OH)D deficient. There was no significant difference in 25(OH)D concentration between boys and girls (P=0·3). 25(OH)D concentration was associated with BMI (r=-0·1, P=0·02), pubertal status (r=-0·08, P=0·04) and sun exposure (r=0·10, P=0·04). Fat mass index was associated with 25(OH)D concentration (r=-0·13, P=0·03), but not lean mass index (P=0·86). In multiple regression analysis with adjustment for confounding factors, age and puberty were found to be independently associated with 25(OH)D concentration (P=0·008 and P=0·006); there was a significant correlation between exercise and 25(OH)D concentration after adjustment for either BMI (P=0·01) or fat mass index (P=0·02).
  
  
  CONCLUSIONS
  25(OH)D deficiency is highly prevalent among children in the south of Iran. It is related to insufficient sun exposure, low physical activity, advancing age and pubertal stage. Measures should be taken to improve the health of southern Iranian children in this critical age group by preventing 25(OH)D deficiency.
authors.affiliation: Shiraz Endocrinology and Metabolism Research Center,Nemazee Hospital,Shiraz University of Medical Sciences,PO Box 71345-1744,Shiraz,Islamic Republic of Iran.
authors.forename: Forough
authors.initials: F
authors.lastname: Saki
authors.affiliation: Shiraz Endocrinology and Metabolism Research Center,Nemazee Hospital,Shiraz University of Medical Sciences,PO Box 71345-1744,Shiraz,Islamic Republic of Iran.
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Dabbaghmanesh
authors.affiliation: Shiraz Endocrinology and Metabolism Research Center,Nemazee Hospital,Shiraz University of Medical Sciences,PO Box 71345-1744,Shiraz,Islamic Republic of Iran.
authors.forename: Gholamhossein Ranjbar
authors.initials: GR
authors.lastname: Omrani
authors.affiliation: Shiraz Endocrinology and Metabolism Research Center,Nemazee Hospital,Shiraz University of Medical Sciences,PO Box 71345-1744,Shiraz,Islamic Republic of Iran.
authors.forename: Marzieh
authors.initials: M
authors.lastname: Bakhshayeshkaram
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D003430:Cross-Sectional Studies; D015444:Exercise; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D012741:Sexual Maturation; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000453:epidemiology*
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: Exercise; Puberty; Risk factors; Sun exposure; Vitamin D