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Journal of Pediatric Endocrinology and Metabolism

Editor-in-Chief: Kiess, Wieland

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Volume 27, Issue 5-6 (May 2014)


Prevalence of risk of deficiency and inadequacy of 25-hydroxyvitamin D in US children: NHANES 2003–2006

Vytas P. Karalius
  • Department of Preventive Medicine and Epidemiology, Loyola University Chicago, Maywood, IL, USA
  • Other articles by this author:
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/ Daniel Zinn
  • Department of Pediatrics, Loyola University Chicago, Maywood, IL, USA
  • Department of Internal Medicine, Loyola University Chicago, Maywood, IL, USA
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/ James Wu / Guichan Cao
  • Department of Preventive Medicine and Epidemiology, Loyola University Chicago, Maywood, IL, USA
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/ Carla Minutti / Amy Luke
  • Department of Preventive Medicine and Epidemiology, Loyola University Chicago, Maywood, IL, USA
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/ Holly Kramer
  • Corresponding author
  • Department of Preventive Medicine and Epidemiology, Loyola University Chicago, Maywood, IL, USA
  • Email
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/ Ramon Durazo-Arvizu
  • Department of Preventive Medicine and Epidemiology, Loyola University Chicago, Maywood, IL, USA
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Published Online: 2014-03-12 | DOI: https://doi.org/10.1515/jpem-2013-0246


Aim: To assess prevalence and population estimates of increased risk of 25-hydroxyvitamin D [25(OH)D] deficiency and inadequacy in US children based on the current Institute of Medicine Committee to Review Dietary References Intakes for Vitamin D and Calcium guidelines.

Methods: The analysis was limited to a nationally representative sample of non-institutionalized US children and adolescents aged 6–18 years who participated in the National Health and Nutrition Examination Survey completed in 2003–2006 and had complete data on 25(OH)D measurements (n=2877). The 25(OH)D levels were adjusted for assay drift and prevalence, and population estimates of increased risk of 25(OH)D deficiency (<12 ng/mL), risk of inadequacy (<16 ng/mL), and adequacy (>20 ng/mL) were calculated.

Results: Overall, 4.61% of children and adolescents are at increased risk of deficiency (population estimate 2.5 million) and 10.3% are at risk of inadequacy (population estimate 5.5 million) based on the Institute of Medicine guidelines.

Conclusion: Approximately 10.3% of US children aged 6–18 years (population estimate 5.5 million) have 25(OH)D levels <16 ng/mL.

Keywords: deficiency; IOM guidelines; prevalence; supplementation; vitamin D


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About the article

Corresponding author: Holly Kramer, MD, MPH, Department of Preventive Medicine and Epidemiology, Loyola University Medical Center, 2160 S First Avenue, Maywood, IL 60153, USA, Phone: +1-708-327-9039, Fax: +1-708-327-9007, E-mail:

Received: 2013-06-14

Accepted: 2013-12-02

Published Online: 2014-03-12

Published in Print: 2014-05-01

Citation Information: Journal of Pediatric Endocrinology and Metabolism, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem-2013-0246.

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