Preschool Children from Non-Western Immigrant Families have Lower Vitamin D Levels than Children from Western Families: A Target Kids! Study
Notice bibliographique
Résumé
BACkgROuND: Toronto's multiculturalism plays an important role in shaping its population.National data suggests that infants of immigrant families are at increased risk of vitamin D deficiency rickets.Preschool children from immigrant families may also be at risk of low 25-hydroxyvitamin D levels.There is emerging data connecting low vitamin D levels and poor health outcomes, suggesting the importance of identifying subgroups at risk and targeting interventions.OBjECTIVES: To determine if preschool children from non-western immigrant families have lower serum 25-hydroxyvitamin D levels than children from western born families.Secondary objective was to examine which biological, ethnic, demographic and environmental factors influence this relationship.DESIgN/METhODS: Cross-sectional study using data from the TARGet Kids! cohort of healthy children ages one to five years recruited during routine primary care.For the primary analysis, 25-hydroxyvitamin D levels of children from non-western immigrant families (defined as children born outside of Europe, North America, Australia or New Zealand or had a parent who immigrated from a non-western country) was compared to children from western families.Linear regression was used to identify biological, ethnic, demographic and environmental factors which might influence this relationship.RESulTS: 1235 children enrolled in TARGet Kids! between July 2007 and August 2011 had measured 25-hydroxyvitamin D and were included in the analysis.Children from non-western immigrant families made up 29% of the population.The mean age was 35months (SD 18), 51% were male, 83% had 'light' skin pigmentation (Fitzpatrick scale I, II or III), 57% took vitamin D supplements and average milk intake was 436 ml/day (SD 304).Mean 25-hydroxyvitamin D level was 88.5 nmol/L (SD 32).Univariable analysis revealed that children from non-western immigrant families had 5nmol/L lower 25-hydroxyvitamin D than children from western families (p=0.0046).Linear regression modeling revealed that this association is primarily influenced by cow's milk intake (p<0.0001),vitamin D supplementation (p=0.0001) and season (p=0.0008).After adjusting for these variables the residual 25-hydroxyvitamin D difference was no longer significant.Subgroup analysis of children <36 months revealed that those with East Asian ethnicity appear to be at highest risk of low 25-hydroxyvitamin D. CONCluSIONS: Preschool children from non-western immigrant families have lower 25-hydroxyvitamin D levels than children from western families.This finding may be explained by lower cow's milk intake and less frequent vitamin D supplementation, which represent two modifiable targets for future intervention studies to increase 25-hydroxyvitamin D in this vulnerable population.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,002 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».