Vitamin D Status and Predictors of Hypovitaminosis D in Internationally Adopted Children.
OBJECTIVE
To evaluate vitamin D status in internationally adopted children at first medical evaluation in Italy and to identify possible risk factors for hypovitaminosis D in this population.


METHODS
25-hydroxyvitamin D [25(OH)D] levels were analyzed in internationally adopted children consecutively recruited at one Italian Center between 2010 and 2014 as part of the first screening protocol. Demographic, clinical and laboratory data were prospectively collected. Serum 25(OH)D levels <10 ng/mL, <20 ng/mL, and <30 ng/mL were used to define severe vitamin D deficiency, vitamin D deficiency and hypovitaminosis D, respectively.


RESULTS
962 internationally adopted children (median age: 5.47 years; IQR:3.14-7.93) were included in the study. Median 25(OH)D level was 22.0 ng/mL (IQR:15.0-30.0 ng/mL); 710/962 (73.8%) children showed hypovitaminosis D (<30 ng/mL), 388/962 (40.3%) had vitamin D deficiency (<20 ng/dL), and 92/962 (9.6%) had severe vitamin D deficiency (<10ng/mL). No case of clinical rickets was observed. Hypovitaminosis D was particularly frequent (>90%) in children adopted from Ethiopia, Peru, India, Bulgaria and Lithuania. At multivariate analysis an increased risk of hypovitaminosis D was found to be associated with: age ≥ 6 years, time spent in Italy ≥ 3 months, blood sample taken in winter, spring or fall, compared to summer. Gender, ethnicity/continent of origin, tubercular infection, intestinal parassitosis and BMI-z-score < -2 were not associated with vitamin D status.


CONCLUSIONS
Hypovitaminosis D is common in internationally adopted children, from all ethnic group. The evaluation of serum 25(OH)D level could be useful early after the adoption to promptly start vitamin D supplementation/treatment if needed.
Department of Health Sciences, Meyer Children University Hospital, University of Florence, Florence, Italy.
Elena
http://orcid.org/0000-0002-1476-4752
E
Chiappini
Pediatric Unit, S. Luca Hospital, Lucca, Italy.
Francesco
F
Vierucci
Department of Health Sciences, Meyer Children University Hospital, University of Florence, Florence, Italy.
Francesca
F
Ghetti
Department of Health Sciences, Meyer Children University Hospital, University of Florence, Florence, Italy.
Maurizio
M
de Martino
Department of Health Sciences, Meyer Children University Hospital, University of Florence, Florence, Italy.
Luisa
L
Galli
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