Epidemiology of Vitamin D Deficiency in Children Presenting to a Pediatric Orthopaedic Service in the UK

Background: Vitamin D deficiency may increase predisposition to a number of pediatric orthopaedic conditions and the prevalence of vitamin D deficiency is increasing in children in developed countries. The aim of this study was to determine the epidemiology of vitamin D deficiency and insufficiency in children presenting to a regional pediatric orthopaedic service. We also examined the relationships between vitamin D status, social deprivation, and ethnicity. Methods: Individuals of age 18 years and younger presenting to the regional pediatric orthopaedic service at Southampton, UK from 2008 to 2010 were investigated. Deprivation index scores were calculated from indices of deprivation. Results: A total of 187 children (97 male, 90 female, mean age 7.1 y) underwent serum 25-hydroxyvitamin D level measurement. Of them 82% were white British and 11% were of Asian ethnicity. The calculation of the total depravation index for the whole cohort showed 34 patients (18%) were in quartile 1 (most deprived), 54 (29%) in quartile 2, 49 (26%) in quartile 3, and 50 (27%) in quartile 4 (least deprived). Sixty patients (32%) had vitamin D insufficiency with 25-(OH) levels < 50 nmol/L and 15 patients (8%) had vitamin D deficiency. No relationship was identified between vitamin D level and social deprivation score. Conclusions: There is a need for awareness of the prevalence of vitamin D deficiency in the pediatric orthopaedic population presenting with bone pain and lower limb deformity before commencing "observation or orthopaedic surgical treatment."