Abstract
Background and aimLong standing vitamin D deficiency in children causes rickets with growth impairment. We investigated whether sub-ischial leg length (SLL) is shorter, and cephalo-caudal length:length (CCL:L) ratio and sitting height:height (SH:H) ratio larger, with lower cord s-25-hydroxyvitamin D (25OHD) in the population-based prospective Odense Child Cohort, Denmark.MethodsWe included healthy singletons born to term with available measures of cord 25OHD and anthropometrics up to three years’ age. Linear regression was stratified by sex a priori and adjusted for maternal ethnicity, pre-pregnancy body mass index and smoking during pregnancy, season of blood sampling and child age.ResultsMedian (IQR) cord 25OHD was 48.0 (34.0–62.4) nmol/L. At mean age 19.1 months, n = 504, mean (SD) SLL was 31.7 (1.7) cm; CCL:L-ratio 0.62 (0.01). At 36.3 months, n = 956, mean SLL was 42.9 (2.0) cm; SH:H-ratio 0.56 (0.01). No participants had rickets. In adjusted analyses, 19-months-old boys had 0.1 cm shorter SLL (p = 0.009) and 0.1% higher CCL:L-ratio (p = 0.04) with every 10 nmol/L increase in cord 25OHD. Similar findings were seen for late pregnancy 25OHD. In the highest cord 25OHD quartile (>60.7 nmol/L), SLL was 0.8 cm shorter (95% C.I.: 1.36;-0.29, linear trend, p = 0.004), and CCL:L-ratio 0.8% higher (95% C.I. 8.0x10-05;0.01, linear trend, p = 0.01), compared to lowest quartile (<30.7 nmol/L). Similar associations with cord 25OHD were observed in 3-year-old boys. No consistent associations between 25OHD and anthropometrics were seen in girls at either age.ConclusionNo leg shortening was found with decreasing cord s-25OHD in a healthy population of infants. A small, yet significant inverse association between cord 25OHD and SLL in boys 1½-3 years warrants further investigations.
Highlights
Vitamin D is well known for its calciotropic effects being pivotal to bone mineralization and linear bone growth in children
In the highest cord S-25-hydroxyvitamin D. cephalo-caudal length: length (CCL) (25OHD) quartile (>60.7 nmol/L), sub-ischial leg length (SLL) was 0.8 cm shorter (95% C.I.: 1.36;-0.29, linear trend, p = 0.004), and CCL:L-ratio 0.8% higher
No leg shortening was found with decreasing cord s-25OHD in a healthy population of infants
Summary
Vitamin D is well known for its calciotropic effects being pivotal to bone mineralization and linear bone growth in children. Parathyroid-hormone-related protein (PTHrP) is the primary regulator of the mineral homeostasis and bone mineralization, which in the foetus is independent of maternal vitamin D and occurs uncomplicated as long as sufficient calcium and phosphorous is supplied from the maternal circulation across the placenta. This transport is independent of active vitamin D [9, 10]. We investigated whether sub-ischial leg length (SLL) is shorter, and cephalo-caudal length: length (CCL:L) ratio and sitting height:height (SH:H) ratio larger, with lower cord s-25-hydroxyvitamin D (25OHD) in the population-based prospective Odense Child Cohort, Denmark
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