The differential response to vitamin D supplementation in neonates born with low vitamin D stores according to skin pigmentation
Notice bibliographique
Résumé
Vitamin D is a fat-soluble vitamin that can be obtained endogenously by exposing the skin to ultraviolet beta radiation from sunlight or exogenously from food and supplements. Due to the recommendation that infants should not be exposed to sunlight, and low vitamin D content in breast milk, this age group is recommended to be given a vitamin D supplement until a sufficient amount can be obtained from their diet. The Canadian Paediatric Surveillance Program (2002-2004) estimated a total of 104 confirmed cases of vitamin D deficiency rickets, most of which were diagnosed in the north or immigrant families. From the confirmed cases, 92 (89%) were children with intermediate to dark skin color, and 98 (94%) were children who were breastfed without suitable vitamin D supplementation. Given that vitamin D supplementation is highly recommended for infants with dark skin, how these infants respond to vitamin D supplementation if they are born with low vitamin D stores, and if a higher dosage is needed to overcome the deficiency is important to explore. Previous studies are difficult to interpret because either they studied infants with sufficient vitamin D status or lacked an objective method to measure skin color if any. The primary research objective of this thesis is to investigate if there is a difference in the response of serum 25-hydroxyvitamin D (25(OH)D) to vitamin D supplementation in neonates born with low vitamin D stores (25(OH)D <50 nmol/L) according to skin pigmentation, and if a higher dose of vitamin D supplementation will result in a faster rate of improvement of vitamin D status in infants with dark skin. Healthy term born breastfed infants were recruited from the Lakeshore General Hospital in the Greater Montreal area, latitude 45.5ᵒN (NCT02563015). Infants were screened for low serum 25(OH)D (Liaison, DiaSorin, Stillwater, MN 55082, USA) at birth and then randomized to a treatment group: 400 IU/d (n=36) or 1000 IU/d (n=36). Infants were stratified by skin pigmentation in male and female blocks. At baseline, 3, and 6 months, anthropometry, body composition, skin pigmentation, and biochemistry measurements were examined. The study sample was 50% male, 24% infants with dark skin color, and 65% breastfed until 6 months; compliance rate was 70% overall. After 6 months of supplementation, all groups had mean serum 25(OH)D concentration above the 50 nmol/L threshold as suggested by the Institute of Medicine for achievement of bone health. Overall, infant skin color did not affect the infant serum 25(OH)D response to vitamin D supplement at any time point (p=0.40). The 1000 IU/d group had a significantly higher mean concentration than the 400 IU/d group at 3 and 6 months. This study shows that skin pigmentation was not a significant determinant of infant serum 25(OH)D concentration at 3 or 6 months of age. Given the high rate of compliance observed in this study, public health efforts to improve vitamin D status in infants of all skin colors might be best focused towards improving compliance through educational means.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
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 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
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 ».