Low Vitamin D Status Among Obese Adolescents: Prevalence and Response to Treatment

Journal of Adolescent Health, Volume 48, Issue 5 , Pages 448-452, May 2011
Zeev Harel, M.D
Patricia Flanagan, M.D.
Michelle Forcier, M.D.
Dalia Harel, M.Sc. Received 19 September 2010; accepted 20 January 2011.
Affiliations
Division of Adolescent Medicine, Hasbro Children's Hospital, Providence, Rhode Island
Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, Rhode Island
Corresponding Author InformationAddress correspondence to: Zeev Harel, M.D., Division of Adolescent Medicine, Hasbro Children's Hospital, 593 Eddy Street, Providence, RI 02903

Purpose
To explore the prevalence of low vitamin D status among obese adolescents and to examine the effect of current management of low vitamin D status in these patients.

Methods
A retrospective chart review of obese adolescents who had been screened for vitamin D status by serum total 25-hydroxyvitamin D (25(OH)D) level. Vitamin D deficiency was defined as 25(OH)D level of <20 ng/mL, vitamin D insufficiency as 25(OH)D level of 20–30 ng/mL, and vitamin D sufficiency as 25(OH)D level of >30 ng/mL.
Adolescents with vitamin D deficiency were treated with 50,000 IU of vitamin D once a week for 6–8 weeks, whereas adolescents with vitamin D insufficiency were treated with 800 IU of vitamin D daily for 3 months. Repeat 25(OH)D was obtained after treatment.

Results
The prevalence rate of low vitamin D status among 68 obese adolescents (53% females, 47% males, age: 17 ± 1 years, body mass index: 38 ± 1 kg/m2, Hispanic: 45%, African American: 40%, Caucasian: 15%) was 100% in females and 91% in males. Mean (±SE) 25(OH)D level was significantly higher in summer (20 ± 8 ng/mL) than in spring (14 ± 4 ng/mL, p < .02), and significantly lower in winter (15 ± 7 ng/mL) than in fall (25 ± 15 ng/mL, p < .05). Although there was a significant (p < .00001) increase in mean 25(OH)D after the initial course of treatment with vitamin D, 25(OH)D levels normalized in only 28% of the participants.

Repeat courses with the same dosage in the other 72% did not significantly change their low vitamin D status

Conclusions
Increased surveillance and possibly higher vitamin D doses are warranted for obese adolescents whose total 25(OH)D levels do not normalize after the initial course of treatment.
– – – – – – –

Yes, if a person is in more than a just one group which is typically at-risk of being vitamin D deficient – dark skin, obese, elderly, pregnant, medical problem, etc. – then more vitamin D is needed for repletion.

- - - - - - - - - - -

See also Vitamin D Life

• All items in Skin Color and vitamin D 177 items Dec 2011
• Overview Dark Skin Vitamin D
• The darker the skin the less the vitamin D – July 2010
• Lack of vitamin D closely associated with black health disparities – Nov 2010 - Great charts
• Perhaps just 40 ng of vitamin D if high latitude or dark skin
• Vitamin D insufficiency in UK youths – 37X more likely if dark skin – July 2011
• Blacks may need less vitamin D than whites – PTH Aug 2010
• Striking ethnic health disparity – blacks dying due to lack of vitamin D – Nov 2011
• Do blacks have a 5 year life penalty due to low vitamin D
• Improved blood flow in blacks with just 2000 IU of vitamin D – Feb 2011
• Blacks may not need as much Vitamin D many articles
• Hypothesis that lack of vitamin D increases blood pressure in blacks – July 2010
• 88 percent of African immigrants to Melborne had less than 20 ng of vitamin D
• Vitamin D Council vs FDA concerning vitamin D deficiency in blacks and others - June 2011
• Race vs vitamin D level - Veith May 2011
• 82 percent of black US adults less than 20 ng of vitamin D – Jan 2011