• Childhood Kidney Diseases
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• v.26 no.1
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• pp.63-67
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• 2022

Nephrocalcinosis often occurs in infants and is caused by excessive calcium or vitamin D supplementation, neonatal primary hyperparathyroidism, and genetic disorders. Idiopathic infantile hypercalcemia (IIH), a rare cause of nephrocalcinosis, results from genetic defects in CYP24A1 or SLC34A1. Mutations in CYP24A1, which encodes 25-hydroxyvitamin D 24-hydroxylase, disrupt active vitamin D degradation. IIH clinically manifests as failure to thrive and hypercalcemia within the first year of life and usually remits spontaneously. Herein, we present a case of IIH wih CYP24A1 mutations. An 11-month-old girl visited our hospital with incidental hypercalcemia. She showed failure to thrive, and her oral intake had decreased over time since the age of 6 months. Her initial serum parathyroid hormone level was low, 25-OH vitamin D and 1,25(OH)₂ vitamin D levels were normal, and renal ultrasonography showed bilateral nephrocalcinosis. Whole-exome sequencing revealed compound heterozygous variants in CYP24A1 (NM_000782.4:c.376C>T [p.Pro126Ser] and c.1310C>A [p.Pro437His]). Although her hypercalcemia and poor oral intake spontaneously resolved in approximately 8 months, we suggested that her nephrocalcinosis and renal function be regularly checked in consideration of potential asymptomatic renal damage. Hypercalcemia caused by IIH should be suspected in infants with severe nephrocalcinosis, especially when presenting with failure to thrive.

• Nutrition Research and Practice
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• v.10 no.2
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• pp.206-211
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• 2016

BACKGROUND/OBJECTIVES: Obesity, which is a known risk factor for many chronic diseases, has also been associated with vitamin D deficiency. This study explored the relationship between serum 25-hydroxy-vitamin D [25(OH)D] concentrations and adiposity measures in a general Korean population using the most recent, nationally representative survey data. SUBJECTS/METHODS: The study sample consisted of 4,771 Korean adults (${\geq}19years$) who participated in the fifth Korean National Health and Nutrition Examination Surveys. Serum 25(OH)D was determined by radioimmunoassay. Body mass index (BMI), waist circumference (WC) and total body fat content were measured as adiposity measurements. Total body fat content was measured by dual-energy X-ray absorptiometry. RESULTS: The serum 25(OH)D level was significantly higher in men than in women. Serum 25(OH)D concentration was positively correlated with energy intake, and it was negatively correlated with total body fat content (P < 0.0001) and percentage body fat (P < 0.0001) after adjustment for age in both sexes, while was inversely correlated with BMI only in women. In multivariable regression analysis, serum 25(OH)D was inversely associated with the total body fat content after adjustment for age, BMI, education, region, smoking, alcohol consumption, physical activity, and energy intake only in men (P = 0.0047). However, the serum 25(OH)D concentration was not associated with WC or BMI, indicators of adiposity after adjustment for potential risk factors. CONCLUSIONS: Serum 25(OH)D concentration was independently associated with the total body fat content in a general Korean population, but it may be not associated with the indicators for estimating adiposity, such as WC or BMI.

• Journal of Nutrition and Health
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• v.49 no.6
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• pp.437-446
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• 2016

Purpose: The purpose of this study was to estimate dietary intake of vitamin D and the relationship between serum 25-hydroxyvitamin D (25OHD) concentration and bone mineral density (BMD) in Korean adults using the 2011 data from the Korea National Health and Nutrition Examination Survey. Methods: Daily intake of vitamin D and ratio of subjects that consumed less vitamin D than adequate intake (AI) were estimated in 4,879 Korean adults. The relationship between daily intake of vitamin D and serum 25OHD and BMD were analyzed. Results: Average daily intakes of vitamin D were $3.84{\pm}0.23{\mu}g/day$ for men and $2.22{\pm}0.11{\mu}g/day$ for women. Approximately 72~97% of men and 80~99% of women consumed less than the AI of vitamin D for Koreans. Serum 25OHD concentration increased with age, and the ratios of serum vitamin D deficiency (< 20 ng/mL) were 47.8~81.1% for men and 59.4~92.8% for women. Average intake of vitamin D was higher in subjects aged < 50 yr than in those ${\geq}50yr$, but lower in serum 25OHD concentration. In subjects aged < 50 yr, serum 25OHD was higher in subjects that consumed $10{\mu}g/day$ of vitamin D than in those that consumed less than $5{\mu}g/day$. In female subjects aged ${\geq}50yr$, average intake of vitamin D was associated with higher bone mineral density. Conclusion: It was found that dietary intake of vitamin D could increase serum 25OHD concentration in young adults and bone mineral density in old women. Therefore, nutrition policies for enriched foods with vitamin D and nutrition education to consume more vitamin D-rich foods are needed to ameliorate vitamin D status of the Korean population. Adequate intake for Korean population aged < 50 yr might be adjusted upwardly up to $10{\mu}g/day$.

• Clinical and Experimental Pediatrics
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• v.58 no.8
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• pp.283-287
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• 2015

Purpose: We assessed the relationships between iron and vitamin D statuses in breastfed infants and their mothers and evaluated the determinants of iron and vitamin D deficiencies in breastfed infants. Methods: Seventy breastfed infants aged 4-24 months and their mothers participated in this study from February 2012 to May 2013. Complete blood counts, total iron binding capacity, and levels of C-reactive protein, iron, ferritin, calcium, phosphate, alkaline phosphatase, and 25-hydroxyvitamin D (25(OH)D) in infants and their mothers were measured. Results: A history of maternal prepregnancy anemia was associated with lower ferritin and 25(OH)D levels in both infants and their mothers. The 25(OH)D level of infants correlated with maternal 25(OH) D levels. The independent risk factors for iron deficiency in breastfed infants were the duration of breastfeeding (odds ratio [OR], 6.54; 95% confidence interval [CI], 1.09-39.2; P=0.04) and infant body weight (OR, 2.65; 95% CI, 1.07-6.56; P=0.04). The determinants for vitamin D deficiency were the infant's age (OR, 0.15; 95% CI, 0.02-0.97; P=0.046) and maternal 25(OH)D level (OR, 0.74; 95% CI, 0.59-0.92; P=0.01). Conclusion: A maternal history of prepregnancy anemia requiring iron therapy was associated with lower current ferritin and 25(OH)D levels in both infants and their mothers. Therefore, physicians should monitor not only iron but also vitamin D levels in infants who are breastfed by mothers who had prepregnancy anemia.

• Nutrition Research and Practice
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• v.6 no.2
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• pp.162-168
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• 2012

Vitamin D deficiency is a risk factor for metabolic syndromes. We examined whether vitamin D deficiency altered the prevalence of cardiovascular disease (CVD) in older Koreans. Cross-sectional analysis of data from the Korean National Health and Nutrition Examination Survey IV 2008-2009 was used to examine the association between serum 25-hydroxyvitamin D (25(OH)D) levels and the prevalence of CVD in a representative population-based sample of 5,559 men and women aged ${\geq}50$ years. CVD was defined as angina pectoris, myocardial infarction, or stroke. The prevalence of CVD (7.0%) in the older Korean population was lower than that in the older US population, although average serum 25(OH)D levels were much lower in the Korean population. Additionally, serum 25(OH)D levels did not differ significantly between the CVD and non-CVD groups. However, subjects in the lowest category (< 25 nmol/l) of serum 25(OH)D level had the greatest prevalence of CVD, about two-fold higher than subjects in the highest category (> 75 nmol/l), after adjusting for age, gender, body mass index, education level, residence location, and region. The prevalence of other risk factors for CVD, including higher waist circumference, fasting glucose, low-density lipoprotein (LDL) cholesterol, and triglyceride levels and lower high-density lipoprotein (HDL) cholesterol levels, was also higher among subjects in the lowest category than among those in the highest category. In conclusion, low serum 25(OH)D may be an independent risk factor for CVD in older Koreans.

• Clinical and Experimental Pediatrics
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• v.56 no.5
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• pp.205-210
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• 2013

Purpose: The aim of this study was to recognize the state of vitamin D among healthy infants aged 1 to 6 months in South Korea, and also to identify the risk factors affecting the level of vitamin D. Methods: A total of 117 infants were enrolled in this study for 12 months, from March 1, 2011 to February 29, 2012. Serum levels of 25-hydroxyvitamin D (25[OH]D), calcium, phosphorus, and alkaline phosphatase were measured and data including birth weight, body weight, sex, feeding pattern, delivery mode, siblings and maternal age and occupation were collected. Data was mainly analyzed with independent t-test model. Results: We determined that the prevalence of vitamin D deficiency (serum 25[OH]D<20 ng/mL [50 mmol/L]) was 48.7% in the population investigated. Particularly in breastfed infants, the prevalence of vitamin D deficiency was strikingly high (90.4%). The mean serum level of 25(OH)D in breastfed infants was lower than that of formula fed infants (9.35 ng/mL vs. 28.79 ng/mL). Also female infants showed lower mean serum level of 25(OH)D than male. Mean serum values of calcium and phosphorus had positive correlation with vitamin D state (P<0.001). Conclusion: Vitamin D deficiency was found to be very common in infants aged 1 to 6 months in South Korea, and breast feeding was the most critical risk factor of vitamin D deficiency. Therefore we suggest to start vitamin D supplementation in South Korea, as soon as possible, to all infants, including breastfed and female infants.

• Journal of Nutrition and Health
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• v.51 no.4
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• pp.287-294
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• 2018

Purpose: This study was conducted to evaluate the association between serum 25-hydroxyvitamin D (25(OH)D) levels and dental caries experience in Korean adolescents based on the 2010 ~ 2014 Korean National Health and Nutrition Examination Surveys. Methods: The study subjects were 2,655 Korean adolescents aged 10 to 18 years. Subjects were classified into four groups according to their serum 25(OH)D levels. We used logistic regression to evaluate the relationship between vitamin D and for dental caries experience after adjusting for age, household income level, recipient of basic livelihood, tooth brushing and visiting dental clinics. Result: Multiple logistic regression analysis showed that serum 25(OH)D insufficiency (20 ng/mL ${\leq}25(OH)D$ < 30 ng/mL) was associated with increased odd ratios (ORs) for dental caries experience in boys (OR = 2.577, 95% CI = 1.013-6.557), compared with serum 25(OH)D sufficiency (25(OH)D ${\geq}30ng/mL$). Conclusion: The serum 25(OH)D levels were found to be related to risk of dental caries experience in Korean adolescent boys.

• Clinical and Experimental Pediatrics
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• v.60 no.8
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• pp.248-253
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• 2017

Purpose: Vitamin D plays a key role in immune function. Vitamin D deficiency may play a role in the pathogenesis of infections, and low levels of circulating vitamin D are strongly associated with infectious diseases. In this study, we aimed to evaluate the effects of low vitamin D levels in cord blood on neonatal sepsis in preterm infants. Methods: One hundred seventeen premature infants with gestational age of <37 weeks were enrolled. In the present study, severe vitamin D deficiency (group 1) was defined as a 25-hydroxyvitamin D (25(OH)D) concentration <5 ng/mL; vitamin D insufficiency (group 2), 25(OH)D concentration ${\geq}5ng/mL$ and <15 ng/mL; and vitamin D sufficiency (group 3), 25(OH)D concentration ${\geq}15ng/mL$. Results: Sixty-three percent of the infants had deficient levels of cord blood vitamin D (group 1), 24% had insufficient levels (group 2), and 13% were found to have sufficient levels (group 3). The rate of neonatal sepsis was higher in group 2 than in groups 1 and 3. Conclusion: There was no significant relationship between the cord blood vitamin D levels and the risk of neonatal sepsis in premature infants.

• Journal of Environmental Health Sciences
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• v.44 no.2
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• pp.188-195
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• 2018

Objectives: This study aimed to investigate the association between vitamin D deficiency and the risk of diabetes mellitus, and also examined whether their association is differed by sex and age. Methods: We analyzed the data from 28,135 subjects ${\geq}20years$ old who were registered for the Korea National Health and Nutrition Examination Survey (KNHANES) 2008-2014. Vitamin D was measured using serum 25-hydroxyvitamin D (25(OH)D) concentrations. Results: After adjusting for potential confounders (age, sex, education, income, total energy intake, smoking, physical activity, body mass index, and waist circumference), lower vitamin D was dose-dependently associated with a higher risk of diabetes mellitus (p-trend=0.004). When compared with the sufficient group (25(OH)D ${\geq}30ng/mL$), the severe deficient group (25(OH)D <10 ng/mL) had 1.46 (95% CI 1.11-1.94) odds ratio for the risk of diabetes mellitus. This association was markedly strong in men and adults aged ${\geq}40$, whereas no significant association was observed in women and adults aged <40. Conclusions: We found that vitamin D deficiency may be associated with an increased risk for diabetes mellitus in Korean adults. Our findings suggest that intake of higher vitamin D may help reduce the risk of diabetes mellitus.

• The Korean Journal of Physiology and Pharmacology
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• v.17 no.5
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• pp.385-392
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• 2013

Vitamin D deficiency is prevalent, primarily due to limited sun exposure, which may be observed in urban areas, or as a result of modern lifestyles. Common myths about vitamin D persist, including that it is mostly obtained from the diet and is only essential for bone and mineral homeostasis. Nonetheless, advances in biomedical science suggest that vitamin D is a hormone that is integral to numerous physiologic functions in most cells and tissues. Therefore, abnormal vitamin D levels may contribute to health disturbances. A number of recent reports on potential associations between vitamin D deficiency and cardiovascular disease have highlighted its role in this system. A focus over the previous decade has been to better understand the mechanisms behind vitamin D regulation and the pathophysiology associated with suboptimal vitamin D levels. Vitamin D deficiency is highly associated with the incidence of cardiovascular diseases, even when considering other well-known risk factors. In this process, the renin-angiotensin system is disrupted, and hypertension and endothelial dysfunction contribute to the risk of cardiovascular disease. Likewise, clinical outcomes upon the normalization of vitamin D levels have been investigated in different patient populations. It makes sense that vitamin D supplementation to improve vitamin D status among vitamin D-deficient individuals could be useful without requiring a sudden lifestyle change. This manuscript provides a brief overview of vitamin D metabolism and the vitamin D receptor. It also summarizes the current clinical research relating to vitamin D supplementation and its effects on hypertension and endothelial dysfunction in cardiovascular medicine.