Volume : 09, Issue : 12, December – 2022
Title:
63.THE ROLE OF VITAMIN D SUPPLEMENTS IN BONE AND TEETH HEALTH AMONG CHILDREN: A SYSTEMATIC REVIEW
Authors :
Dr.Faisal Ali alkhamisi, Alhassan naif albarakaty, Dr. Sarah talal musallem,Raid hamid G almazrwai, SAAD ABDULLAH ALGHAMDI,SURRATI, AHMED WAFA ABDULAZIZ,
Abstract :
Background: In the literature, there are many studies that were conducted to assess the effect of vitamin D supplements on skeletal and non-skeletal functions however, most of these studies had focused on adult population with little is found among children and infant. Therefore, the aim of the current study was to systematically review the previous literature considering the role of vitamin D supplements in improving the bone and teeth health among children under the age of 18 years old.
Methodology: We searched Google Scholar, PubMed, The Cochrane Library, Web of Science databases using keywords related to vitamin D supplementation as “cholecalciferol” and “vitamin D supplement”, to targeted population as “children”, “infant”, “school-aged” and “Pre-school age”, to outcomes as “Rickets”, “fracture”, “serum vitamin D over 75 nmol/L”, “dental caries”, “bone health”, and “Calcium content” and route of administration as “Oral”, “Intramuscular (IM)” and “different concentration” and included all studies published between 2000 and 2022. Moreover, manual search through study identifiers or references from previous studies was conducted. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines
Results: The electronic search strategy conducted in this review ended in 875 hits which after removing of duplicated reduced to 360 studies. These 360 studies were considered eligible for further evaluation, from which 350 studies were excluded for different reasons as 245 studies based on title and abstract, 86 studies do not relevant to the subject of this study or sitting of this review, 17 consider replies of authors, 3 books, and 28 were reviews. At end, 10 articles were included in the qualitative synthesis of the present review
Conclusion: This systematic review has proven the importance of vitamin D supplements among children in improving their bone and teeth health and reducing the prevalence of rickets, fractures, teeth caries in children. More investigation of the possible mechanisms of these relations should be conducted.
Cite This Article:
Please cite this article in press Faisal Ali alkhamisi et al, The Role Of Vitamin D Supplements In Bone And Teeth Health Among Children: A Systematic Review., Indo Am. J. P. Sci, 2022; 09(12).
Number of Downloads : 10
References:
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3. Svensson D, Nebel D, Nilsson B-O. Vitamin D3 modulates the innate immune response through regulation of the hCAP-18/LL-37 gene expression and cytokine production. Inflamm Res. 2016;65(1):25-32. doi:10.1007/s00011-015-0884-z
4. Davideau JL, Lezot F, Kato S, Bailleul-Forestier I, Berdal A. Dental alveolar bone defects related to Vitamin D and calcium status. J Steroid Biochem Mol Biol. 2004;89-90:615-618. doi:10.1016/j.jsbmb.2004.03.117
5. Raftery T, Martineau AR, Greiller CL, et al. Effects of vitamin D supplementation on intestinal permeability, cathelicidin and disease markers in Crohn’s disease: Results from a randomised double‐blind placebo‐controlled study. United Eur Gastroenterol J. 2015;3(3):294-302. doi:10.1177/2050640615572176
6. Skaaby T, Husemoen LLN, Pisinger C, et al. Vitamin D status and incident cardiovascular disease and all-cause mortality: a general population study. Endocrine. 2013;43(3):618-625. doi:10.1007/s12020-012-9805-x
7. Abhimanyu A, Coussens AK. The role of UV radiation and vitamin D in the seasonality and outcomes of infectious disease. Photochem Photobiol Sci. 2017;16(3):314-338. doi:10.1039/C6PP00355A
8. White Z, White S, Dalvie T, Kruger MC, Van Zyl A, Becker P. Bone health, body composition, and vitamin D status of black preadolescent children in South Africa. Nutrients. 2019;11(6):1-12. doi:10.3390/nu11061243
9. Ong YL, Quah PL, Tint MT, Aris IM, Wei L. Europe PMC Funders Group The association of maternal vitamin D status with infant birth outcomes , postnatal growth and adiposity in the first two years of life in a multi-ethnic Asian population : the GUSTO cohort study. Br J Nutr. 2016;116(4):621-631. doi:10.1017/S0007114516000623.The
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11. Minshull C, Biant LC, Ralston SH, Gleeson N. A Systematic Review of the Role of Vitamin D on Neuromuscular Remodelling Following Exercise and Injury. Calcif Tissue Int. 2016;98(5):426-437. doi:10.1007/s00223-015-0099-x
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13. El-Hajj Fuleihan G, Nabulsi M, Tamim H, et al. Effect of Vitamin D Replacement on Musculoskeletal Parameters in School Children: A Randomized Controlled Trial. J Clin Endocrinol Metab. 2006;91(2):405-412. doi:10.1210/jc.2005-1436
14. Gordon CM, DePeter KC, Feldman HA, Grace E, Emans SJ. Prevalence of Vitamin D Deficiency Among Healthy Adolescents. Arch Pediatr Adolesc Med. 2004;158(6):531. doi:10.1001/archpedi.158.6.531
15. Lehtonen-Veromaa MK, Möttönen TT, Nuotio IO, Irjala KM, Leino AE, Viikari JS. Vitamin D and attainment of peak bone mass among peripubertal Finnish girls: a 3-y prospective study. Am J Clin Nutr. 2002;76(6):1446-1453. doi:10.1093/ajcn/76.6.1446
16. Greer FR. 25-Hydroxyvitamin D: functional outcomes in infants and young children. Am J Clin Nutr. 2008;88(2):529S-533S. doi:10.1093/ajcn/88.2.529S
17. Vieth R. Why the minimum desirable serum 25-hydroxyvitamin D level should be 75 nmol/L (30 ng/ml). Best Pract Res Clin Endocrinol Metab. 2011;25(4):681-691. doi:10.1016/j.beem.2011.06.009
18. Prentice A, Goldberg GR, Schoenmakers I. Vitamin D across the lifecycle: physiology and biomarkers. Am J Clin Nutr. 2008;88(2):500S-506S. doi:10.1093/ajcn/88.2.500S
19. Clemens TL, Henderson SL, Adams JS, Holick MF. INCREASED SKIN PIGMENT REDUCES THE CAPACITY OF SKIN TO SYNTHESISE VITAMIN D3. Lancet. 1982;319(8263):74-76. doi:10.1016/S0140-6736(82)90214-8
20. Öhlund I, Silfverdal S-A, Hernell O, Lind T. Serum 25-Hydroxyvitamin D Levels in Preschool-Age Children in Northern Sweden Are Inadequate After Summer and Diminish Further During Winter. J Pediatr Gastroenterol Nutr. 2013;56(5):551-555. doi:10.1097/MPG.0b013e3182838e5b
21. Glatt DU, McSorley E, Pourshahidi LK, et al. Vitamin D Status and Health Outcomes in School Children in Northern Ireland: Year One Results from the D-VinCHI Study. Nutrients. 2022;14(4):804. doi:10.3390/nu14040804
22. Amrein K, Scherkl M, Hoffmann M, et al. Vitamin D deficiency 2.0: an update on the current status worldwide. Eur J Clin Nutr. 2020;74(11):1498-1513. doi:10.1038/s41430-020-0558-y
23. Yao P, Bennett D, Mafham M, et al. Vitamin D and Calcium for the Prevention of Fracture. JAMA Netw Open. 2019;2(12):e1917789. doi:10.1001/jamanetworkopen.2019.17789
24. Kong SH, Jang HN, Kim JH, Kim SW, Shin CS. Effect of Vitamin D Supplementation on Risk of Fractures and Falls According to Dosage and Interval: A Meta-Analysis. Endocrinol Metab. 2022;37(2):344-358. doi:10.3803/EnM.2021.1374
25. LeBoff MS, Chou SH, Ratliff KA, et al. Supplemental Vitamin D and Incident Fractures in Midlife and Older Adults. N Engl J Med. 2022;387(4):299-309. doi:10.1056/NEJMoa2202106
26. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med. 2009;6(7):e1000097. doi:10.1371/journal.pmed.1000097
27. Ward LM, Gaboury I, Ladhani M, MD SZ. Vitamin D–deficiency rickets among children in Canada. Can Med Assoc or its Licens. 2007;177(5):8.
28. Gallo S, Comeau K, Vanstone C, et al. Effect of different dosages of oral vitamin D supplementation on vitamin D status in healthy, breastfed infants: A randomized trial. Jama. 2013;309(17):1785-1792. doi:10.1001/jama.2013.3404
29. Anderson LN, Heong SW, Chen Y, et al. Vitamin D and Fracture Risk in Early Childhood: A Case-Control Study. Am J Epidemiol. 2017;185(12):1255-1262. doi:10.1093/aje/kww204
30. El-Sakka A, Penon C, Hegazy A, Elbatrawy S, Gobashy A, Moreira A. Evaluating Bone Health in Egyptian Children with Forearm Fractures: A Case Control Study. Int J Pediatr. 2016;2016:1-6. doi:10.1155/2016/7297092
31. Ponnapakkam T, Bradford E, Gensure R. A treatment trial of vitamin d supplementation in breast-fed infants: Universal supplementation is not necessary for rickets preventio in southern louisiana. Clin Pediatr (Phila). 2010;49(11):1053-1060. doi:10.1177/0009922810376320
32. Uush T. Prevalence of classic signs and symptoms of rickets and vitamin D deficiency in Mongolian children and women. J Steroid Biochem Mol Biol. 2013;136(1):207-210. doi:10.1016/j.jsbmb.2012.10.014
33. Mondal K, Seth A, Marwaha RK, et al. A randomized controlled trial on safety and efficacy of single intramuscular versus staggered oral dose of 600 000IU Vitamin D in treatment of nutritional rickets. J Trop Pediatr. 2014;60(3):203-210. doi:10.1093/tropej/fmt105
34. Gyll J, Ridell K, Öhlund I, Karlsland Åkeson P, Johansson I, Lif Holgerson P. Vitamin D status and dental caries in healthy Swedish children. Nutr J. 2018;17(1):11. doi:10.1186/s12937-018-0318-1
35. Vitamin OA, Childhood E, Original C, et al. Impact of vitamin D on development of early childhood caries. Pak Armed Forces Med J. 2017;67(25):429-433.
36. Wheeler BJ, Dickson NP, Houghton LA, Ward LM, Taylor BJ. Incidence and characteristics of Vitamin D deficiency rickets in New Zealand children: A New Zealand Paediatric Surveillance Unit study. Aust N Z J Public Health. 2015;39(4):380-383. doi:10.1111/1753-6405.12390
37. Hill TR, Aspray TJ. The role of vitamin D in maintaining bone health in older people. Ther Adv Musculoskelet Dis. 2017;9(4):89-95. doi:10.1177/1759720X17692502
38. Laird E, Ward M, McSorley E, Strain JJ, Wallace J. Vitamin D and Bone Health; Potential Mechanisms. Nutrients. 2010;2(7):693-724. doi:10.3390/nu2070693
39. Sunyecz J. The use of calcium and vitamin D in the management of osteoporosis. Ther Clin Risk Manag. 2008;Volume 4:827-836. doi:10.2147/TCRM.S3552
40. Schoenau E, Neu CM, Beck B, Manz F, Rauch F. Bone Mineral Content per Muscle Cross-Sectional Area as an Index of the Functional Muscle-Bone Unit. J Bone Miner Res. 2002;17(6):1095-1101. doi:10.1359/jbmr.2002.17.6.1095
41. Arabi A, Tamim H, Nabulsi M, et al. Sex differences in the effect of body-composition variables on bone mass in healthy children and adolescents. Am J Clin Nutr. 2004;80(5):1428-1435. doi:10.1093/ajcn/80.5.1428
42. Ross AC, Taylor CL, Yaktine AL, Valle HB Del. DIETARY REFERENCE INTAKES (Calcium, Vitamin D). National Academy Press; 2011. https://www.ncbi.nlm.nih.gov/books/NBK56070/pdf/Bookshelf_NBK56070.pdf
43. Vogiatzi MG, Jacobson-Dickman E, DeBoer MD. Vitamin D Supplementation and Risk of Toxicity in Pediatrics: A Review of Current Literature. J Clin Endocrinol Metab. 2014;99(4):1132-1141. doi:10.1210/jc.2013-3655
44. Brustad N, Yousef S, Stokholm J, Bønnelykke K, Bisgaard H, Chawes BL. Safety of High-Dose Vitamin D Supplementation Among Children Aged 0 to 6 Years. JAMA Netw Open. 2022;5(4):e227410. doi:10.1001/jamanetworkopen.2022.7410
45. MARKESTAD T, HALVORSEN S, HALVORSEN KS, AKSNES L, AARSKOG D. Plasma Concentrations of Vitamin D Metabolites before and during Treatment of Vitamin D Deficiency Rickets in Children. Acta Paediatr. 1984;73(2):225-231. doi:10.1111/j.1651-2227.1984.tb09933.x
46. Holick MF. Resurrection of vitamin D deficiency and rickets. J Clin Invest. 2006;116(8):2062-2072. doi:10.1172/JCI29449
47. Ganmaa D, Holick MF, Rich-Edwards JW, et al. Vitamin D deficiency in reproductive age Mongolian women: A cross sectional study. J Steroid Biochem Mol Biol. 2014;139:1-6. doi:10.1016/j.jsbmb.2013.09.011
48. Uush T. Prevalence of classic signs and symptoms of rickets and vitamin D deficiency in Mongolian children and women. J Steroid Biochem Mol Biol. 2013;136:207-210. doi:10.1016/j.jsbmb.2012.10.014
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2. Reichrath J, Saternus R, Vogt T. Challenge and perspective: the relevance of ultraviolet (UV) radiation and the vitamin D endocrine system (VDES) for psoriasis and other inflammatory skin diseases. Photochem Photobiol Sci. 2017;16(3):433-444. doi:10.1039/C6PP00280C
3. Svensson D, Nebel D, Nilsson B-O. Vitamin D3 modulates the innate immune response through regulation of the hCAP-18/LL-37 gene expression and cytokine production. Inflamm Res. 2016;65(1):25-32. doi:10.1007/s00011-015-0884-z
4. Davideau JL, Lezot F, Kato S, Bailleul-Forestier I, Berdal A. Dental alveolar bone defects related to Vitamin D and calcium status. J Steroid Biochem Mol Biol. 2004;89-90:615-618. doi:10.1016/j.jsbmb.2004.03.117
5. Raftery T, Martineau AR, Greiller CL, et al. Effects of vitamin D supplementation on intestinal permeability, cathelicidin and disease markers in Crohn’s disease: Results from a randomised double‐blind placebo‐controlled study. United Eur Gastroenterol J. 2015;3(3):294-302. doi:10.1177/2050640615572176
6. Skaaby T, Husemoen LLN, Pisinger C, et al. Vitamin D status and incident cardiovascular disease and all-cause mortality: a general population study. Endocrine. 2013;43(3):618-625. doi:10.1007/s12020-012-9805-x
7. Abhimanyu A, Coussens AK. The role of UV radiation and vitamin D in the seasonality and outcomes of infectious disease. Photochem Photobiol Sci. 2017;16(3):314-338. doi:10.1039/C6PP00355A
8. White Z, White S, Dalvie T, Kruger MC, Van Zyl A, Becker P. Bone health, body composition, and vitamin D status of black preadolescent children in South Africa. Nutrients. 2019;11(6):1-12. doi:10.3390/nu11061243
9. Ong YL, Quah PL, Tint MT, Aris IM, Wei L. Europe PMC Funders Group The association of maternal vitamin D status with infant birth outcomes , postnatal growth and adiposity in the first two years of life in a multi-ethnic Asian population : the GUSTO cohort study. Br J Nutr. 2016;116(4):621-631. doi:10.1017/S0007114516000623.The
10. Al-Jwadi RF, Jespersen E, Dalgård C, Bilenberg N, Christesen HT. S-25OHD Is Associated With Hand Grip Strength and Myopathy at 5 Years in Girls: An Odense Child Cohort Study. J Clin Endocrinol Metab. 2018;103(7):2630-2639. doi:10.1210/jc.2018-00281
11. Minshull C, Biant LC, Ralston SH, Gleeson N. A Systematic Review of the Role of Vitamin D on Neuromuscular Remodelling Following Exercise and Injury. Calcif Tissue Int. 2016;98(5):426-437. doi:10.1007/s00223-015-0099-x
12. Tomlinson PB, Joseph C, Angioi M. Effects of vitamin D supplementation on upper and lower body muscle strength levels in healthy individuals. A systematic review with meta-analysis. J Sci Med Sport. 2015;18(5):575-580. doi:10.1016/j.jsams.2014.07.022
13. El-Hajj Fuleihan G, Nabulsi M, Tamim H, et al. Effect of Vitamin D Replacement on Musculoskeletal Parameters in School Children: A Randomized Controlled Trial. J Clin Endocrinol Metab. 2006;91(2):405-412. doi:10.1210/jc.2005-1436
14. Gordon CM, DePeter KC, Feldman HA, Grace E, Emans SJ. Prevalence of Vitamin D Deficiency Among Healthy Adolescents. Arch Pediatr Adolesc Med. 2004;158(6):531. doi:10.1001/archpedi.158.6.531
15. Lehtonen-Veromaa MK, Möttönen TT, Nuotio IO, Irjala KM, Leino AE, Viikari JS. Vitamin D and attainment of peak bone mass among peripubertal Finnish girls: a 3-y prospective study. Am J Clin Nutr. 2002;76(6):1446-1453. doi:10.1093/ajcn/76.6.1446
16. Greer FR. 25-Hydroxyvitamin D: functional outcomes in infants and young children. Am J Clin Nutr. 2008;88(2):529S-533S. doi:10.1093/ajcn/88.2.529S
17. Vieth R. Why the minimum desirable serum 25-hydroxyvitamin D level should be 75 nmol/L (30 ng/ml). Best Pract Res Clin Endocrinol Metab. 2011;25(4):681-691. doi:10.1016/j.beem.2011.06.009
18. Prentice A, Goldberg GR, Schoenmakers I. Vitamin D across the lifecycle: physiology and biomarkers. Am J Clin Nutr. 2008;88(2):500S-506S. doi:10.1093/ajcn/88.2.500S
19. Clemens TL, Henderson SL, Adams JS, Holick MF. INCREASED SKIN PIGMENT REDUCES THE CAPACITY OF SKIN TO SYNTHESISE VITAMIN D3. Lancet. 1982;319(8263):74-76. doi:10.1016/S0140-6736(82)90214-8
20. Öhlund I, Silfverdal S-A, Hernell O, Lind T. Serum 25-Hydroxyvitamin D Levels in Preschool-Age Children in Northern Sweden Are Inadequate After Summer and Diminish Further During Winter. J Pediatr Gastroenterol Nutr. 2013;56(5):551-555. doi:10.1097/MPG.0b013e3182838e5b
21. Glatt DU, McSorley E, Pourshahidi LK, et al. Vitamin D Status and Health Outcomes in School Children in Northern Ireland: Year One Results from the D-VinCHI Study. Nutrients. 2022;14(4):804. doi:10.3390/nu14040804
22. Amrein K, Scherkl M, Hoffmann M, et al. Vitamin D deficiency 2.0: an update on the current status worldwide. Eur J Clin Nutr. 2020;74(11):1498-1513. doi:10.1038/s41430-020-0558-y
23. Yao P, Bennett D, Mafham M, et al. Vitamin D and Calcium for the Prevention of Fracture. JAMA Netw Open. 2019;2(12):e1917789. doi:10.1001/jamanetworkopen.2019.17789
24. Kong SH, Jang HN, Kim JH, Kim SW, Shin CS. Effect of Vitamin D Supplementation on Risk of Fractures and Falls According to Dosage and Interval: A Meta-Analysis. Endocrinol Metab. 2022;37(2):344-358. doi:10.3803/EnM.2021.1374
25. LeBoff MS, Chou SH, Ratliff KA, et al. Supplemental Vitamin D and Incident Fractures in Midlife and Older Adults. N Engl J Med. 2022;387(4):299-309. doi:10.1056/NEJMoa2202106
26. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med. 2009;6(7):e1000097. doi:10.1371/journal.pmed.1000097
27. Ward LM, Gaboury I, Ladhani M, MD SZ. Vitamin D–deficiency rickets among children in Canada. Can Med Assoc or its Licens. 2007;177(5):8.
28. Gallo S, Comeau K, Vanstone C, et al. Effect of different dosages of oral vitamin D supplementation on vitamin D status in healthy, breastfed infants: A randomized trial. Jama. 2013;309(17):1785-1792. doi:10.1001/jama.2013.3404
29. Anderson LN, Heong SW, Chen Y, et al. Vitamin D and Fracture Risk in Early Childhood: A Case-Control Study. Am J Epidemiol. 2017;185(12):1255-1262. doi:10.1093/aje/kww204
30. El-Sakka A, Penon C, Hegazy A, Elbatrawy S, Gobashy A, Moreira A. Evaluating Bone Health in Egyptian Children with Forearm Fractures: A Case Control Study. Int J Pediatr. 2016;2016:1-6. doi:10.1155/2016/7297092
31. Ponnapakkam T, Bradford E, Gensure R. A treatment trial of vitamin d supplementation in breast-fed infants: Universal supplementation is not necessary for rickets preventio in southern louisiana. Clin Pediatr (Phila). 2010;49(11):1053-1060. doi:10.1177/0009922810376320
32. Uush T. Prevalence of classic signs and symptoms of rickets and vitamin D deficiency in Mongolian children and women. J Steroid Biochem Mol Biol. 2013;136(1):207-210. doi:10.1016/j.jsbmb.2012.10.014
33. Mondal K, Seth A, Marwaha RK, et al. A randomized controlled trial on safety and efficacy of single intramuscular versus staggered oral dose of 600 000IU Vitamin D in treatment of nutritional rickets. J Trop Pediatr. 2014;60(3):203-210. doi:10.1093/tropej/fmt105
34. Gyll J, Ridell K, Öhlund I, Karlsland Åkeson P, Johansson I, Lif Holgerson P. Vitamin D status and dental caries in healthy Swedish children. Nutr J. 2018;17(1):11. doi:10.1186/s12937-018-0318-1
35. Vitamin OA, Childhood E, Original C, et al. Impact of vitamin D on development of early childhood caries. Pak Armed Forces Med J. 2017;67(25):429-433.
36. Wheeler BJ, Dickson NP, Houghton LA, Ward LM, Taylor BJ. Incidence and characteristics of Vitamin D deficiency rickets in New Zealand children: A New Zealand Paediatric Surveillance Unit study. Aust N Z J Public Health. 2015;39(4):380-383. doi:10.1111/1753-6405.12390
37. Hill TR, Aspray TJ. The role of vitamin D in maintaining bone health in older people. Ther Adv Musculoskelet Dis. 2017;9(4):89-95. doi:10.1177/1759720X17692502
38. Laird E, Ward M, McSorley E, Strain JJ, Wallace J. Vitamin D and Bone Health; Potential Mechanisms. Nutrients. 2010;2(7):693-724. doi:10.3390/nu2070693
39. Sunyecz J. The use of calcium and vitamin D in the management of osteoporosis. Ther Clin Risk Manag. 2008;Volume 4:827-836. doi:10.2147/TCRM.S3552
40. Schoenau E, Neu CM, Beck B, Manz F, Rauch F. Bone Mineral Content per Muscle Cross-Sectional Area as an Index of the Functional Muscle-Bone Unit. J Bone Miner Res. 2002;17(6):1095-1101. doi:10.1359/jbmr.2002.17.6.1095
41. Arabi A, Tamim H, Nabulsi M, et al. Sex differences in the effect of body-composition variables on bone mass in healthy children and adolescents. Am J Clin Nutr. 2004;80(5):1428-1435. doi:10.1093/ajcn/80.5.1428
42. Ross AC, Taylor CL, Yaktine AL, Valle HB Del. DIETARY REFERENCE INTAKES (Calcium, Vitamin D). National Academy Press; 2011. https://www.ncbi.nlm.nih.gov/books/NBK56070/pdf/Bookshelf_NBK56070.pdf
43. Vogiatzi MG, Jacobson-Dickman E, DeBoer MD. Vitamin D Supplementation and Risk of Toxicity in Pediatrics: A Review of Current Literature. J Clin Endocrinol Metab. 2014;99(4):1132-1141. doi:10.1210/jc.2013-3655
44. Brustad N, Yousef S, Stokholm J, Bønnelykke K, Bisgaard H, Chawes BL. Safety of High-Dose Vitamin D Supplementation Among Children Aged 0 to 6 Years. JAMA Netw Open. 2022;5(4):e227410. doi:10.1001/jamanetworkopen.2022.7410
45. MARKESTAD T, HALVORSEN S, HALVORSEN KS, AKSNES L, AARSKOG D. Plasma Concentrations of Vitamin D Metabolites before and during Treatment of Vitamin D Deficiency Rickets in Children. Acta Paediatr. 1984;73(2):225-231. doi:10.1111/j.1651-2227.1984.tb09933.x
46. Holick MF. Resurrection of vitamin D deficiency and rickets. J Clin Invest. 2006;116(8):2062-2072. doi:10.1172/JCI29449
47. Ganmaa D, Holick MF, Rich-Edwards JW, et al. Vitamin D deficiency in reproductive age Mongolian women: A cross sectional study. J Steroid Biochem Mol Biol. 2014;139:1-6. doi:10.1016/j.jsbmb.2013.09.011
48. Uush T. Prevalence of classic signs and symptoms of rickets and vitamin D deficiency in Mongolian children and women. J Steroid Biochem Mol Biol. 2013;136:207-210. doi:10.1016/j.jsbmb.2012.10.014
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