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Neonatal vitamin D status from archived dried blood spots and future risk of fractures in childhood: results from the D-tect study, a population-based case-cohort study.
Am J Clin Nutr. 2017 Jul; 106(1):155-161.AJ

Abstract

Background:

Whether antenatal and neonatal vitamin D status have clinical relevance in fracture prevention has not been examined extensively, although observational studies indicate that fetal life may be a sensitive period in relation to bone growth and mineralization during childhood.

Objective:

We examined whether 25-hydroxyvitamin D3 [25(OH)D3] concentrations in stored neonatal dried blood spot (DBS) samples are associated with pediatric fracture risk. We hypothesized that in particular, low neonatal vitamin D status may be a risk factor for fracture incidence among children.

Design:

In a register-based case-cohort study design, the case group was composed of 1039 individuals who were randomly selected from a total of 82,154 individuals who were born during 1989-1999 and admitted to a Danish hospital with a fracture of the forearm, wrist, scaphoid bone, clavicle, or ankle at age 6-13 y. The subcohort was composed of 1600 individuals randomly selected from all Danish children born during 1989-1999. The neonatal 25(OH)D3 concentrations in DBS samples were assessed by using highly sensitive chromatography-tandem mass spectrometry.

Results:

The mean ± SD 25(OH)D3 concentration for all subjects was 27.7 ± 18.9 nmol/L [median (IQR): 23.5 nmol/L (13.3, 37.3 nmol/L)] and showed significant monthly variation (P < 0.0001) with the highest values in July and August. Individuals in the middle quintile of neonatal 25(OH)D3 had lower odds of sustaining a fracture than did those in the lowest quintile (adjusted OR: 0.75; 95% CI: 0.58, 0.96), but a global test did not show any significant overall association (adjusted P = 0.13).

Conclusions:

This study suggested that neonatal vitamin D status does not influence subsequent fracture risk in childhood. This is in accordance with studies that report no association between antenatal maternal vitamin D status and childhood fractures. Further studies are needed to examine fracture risk in relation to prenatal vitamin D status in a randomized controlled setting.

Authors+Show Affiliations

Department of Clinical Research, University of Southern Denmark, Odense Patient Data Explorative Network, Odense University Hospital, Odense, Denmark; mhandel@health.sdu.dk. Research Unit for Dietary Studies, The Parker Institute and the Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark.Research Unit for Dietary Studies, The Parker Institute and the Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark.Danish Center for Neonatal Screening, Department of Clinical Biochemistry and Immunology, Statens Serum Institute, Copenhagen, Denmark.Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom.Research Unit for Dietary Studies, The Parker Institute and the Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark. National Institute of Public Health, University of Southern Denmark, Odense, Denmark. Department of Public Health, Section for Clinical Practice, University of Copenhagen, Copenhagen, Denmark. The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, University of Sydney, Sydney, Australia; and.Department of Clinical Research, University of Southern Denmark, Odense Patient Data Explorative Network, Odense University Hospital, Odense, Denmark. Department of Medicine, Holbæk Hospital, Holbæk, Denmark.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28515065

Citation

Händel, Mina Nicole, et al. "Neonatal Vitamin D Status From Archived Dried Blood Spots and Future Risk of Fractures in Childhood: Results From the D-tect Study, a Population-based Case-cohort Study." The American Journal of Clinical Nutrition, vol. 106, no. 1, 2017, pp. 155-161.
Händel MN, Frederiksen P, Cohen A, et al. Neonatal vitamin D status from archived dried blood spots and future risk of fractures in childhood: results from the D-tect study, a population-based case-cohort study. Am J Clin Nutr. 2017;106(1):155-161.
Händel, M. N., Frederiksen, P., Cohen, A., Cooper, C., Heitmann, B. L., & Abrahamsen, B. (2017). Neonatal vitamin D status from archived dried blood spots and future risk of fractures in childhood: results from the D-tect study, a population-based case-cohort study. The American Journal of Clinical Nutrition, 106(1), 155-161. https://doi.org/10.3945/ajcn.116.145599
Händel MN, et al. Neonatal Vitamin D Status From Archived Dried Blood Spots and Future Risk of Fractures in Childhood: Results From the D-tect Study, a Population-based Case-cohort Study. Am J Clin Nutr. 2017;106(1):155-161. PubMed PMID: 28515065.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neonatal vitamin D status from archived dried blood spots and future risk of fractures in childhood: results from the D-tect study, a population-based case-cohort study. AU - Händel,Mina Nicole, AU - Frederiksen,Peder, AU - Cohen,Arieh, AU - Cooper,Cyrus, AU - Heitmann,Berit Lilienthal, AU - Abrahamsen,Bo, Y1 - 2017/05/17/ PY - 2016/09/15/received PY - 2017/04/19/accepted PY - 2017/5/19/pubmed PY - 2017/8/2/medline PY - 2017/5/19/entrez KW - development KW - dried blood spots KW - epidemiology KW - fractures KW - osteoporosis KW - vitamin D SP - 155 EP - 161 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 106 IS - 1 N2 - Background: Whether antenatal and neonatal vitamin D status have clinical relevance in fracture prevention has not been examined extensively, although observational studies indicate that fetal life may be a sensitive period in relation to bone growth and mineralization during childhood.Objective: We examined whether 25-hydroxyvitamin D3 [25(OH)D3] concentrations in stored neonatal dried blood spot (DBS) samples are associated with pediatric fracture risk. We hypothesized that in particular, low neonatal vitamin D status may be a risk factor for fracture incidence among children.Design: In a register-based case-cohort study design, the case group was composed of 1039 individuals who were randomly selected from a total of 82,154 individuals who were born during 1989-1999 and admitted to a Danish hospital with a fracture of the forearm, wrist, scaphoid bone, clavicle, or ankle at age 6-13 y. The subcohort was composed of 1600 individuals randomly selected from all Danish children born during 1989-1999. The neonatal 25(OH)D3 concentrations in DBS samples were assessed by using highly sensitive chromatography-tandem mass spectrometry.Results: The mean ± SD 25(OH)D3 concentration for all subjects was 27.7 ± 18.9 nmol/L [median (IQR): 23.5 nmol/L (13.3, 37.3 nmol/L)] and showed significant monthly variation (P < 0.0001) with the highest values in July and August. Individuals in the middle quintile of neonatal 25(OH)D3 had lower odds of sustaining a fracture than did those in the lowest quintile (adjusted OR: 0.75; 95% CI: 0.58, 0.96), but a global test did not show any significant overall association (adjusted P = 0.13).Conclusions: This study suggested that neonatal vitamin D status does not influence subsequent fracture risk in childhood. This is in accordance with studies that report no association between antenatal maternal vitamin D status and childhood fractures. Further studies are needed to examine fracture risk in relation to prenatal vitamin D status in a randomized controlled setting. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/28515065/Neonatal_vitamin_D_status_from_archived_dried_blood_spots_and_future_risk_of_fractures_in_childhood:_results_from_the_D_tect_study_a_population_based_case_cohort_study_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.116.145599 DB - PRIME DP - Unbound Medicine ER -