Vitamin D insufficiency/deficiency – a conundrum

Excerpt

In this issue of the journal, Drs. Kathy Keller and Patrick Barnes present a commentary on the nutritional state of children in different parts of the world. For radiologists, the vitamin D insufficiency/deficiency pandemic might come as a surprise; however, as Keller and Barnes point out, the actual vitamin D level in children throughout the world is both a nutritional and a cultural problem and is quite well reported: “… 52% of Hispanic and black adolescents in a study in Boston and 48% of white preadolescent girls in a study in Maine had 25-hydroxyvitamin D levels below 20 ng per milliliter” [1‐3]. The accepted level for deficiency of vitamin D is less than 20 ng/ml and of insufficiency is less than 30 ng/ml. Holick’s article [1] is quite informative and worth reading in its entirety. However, Keller and Barnes do not stop at informing us about this deficiency but go on to postulate that the lack of vitamin D in some children is responsible for skeletal lesions that are characteristic of child abuse. In a related commentary, Dr. Russell Chesney [4], noted nephrologist and chairman of the Department of Pediatrics at the University of Tennessee Health Science Center, helps us understand the pediatric view on both issues. A third commentary by Dr. Carole Jenny [5], head of the American Academy of Pediatrics Section on Child Abuse, discusses why the vitamin D problem and child abuse are clearly two separate entities and when they are, in fact, related and when they are not. …