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International Journal of Endocrinology
Volume 2014, Article ID 583039, 13 pages
Research Article

Determinants of Vitamin D Levels in Italian Children and Adolescents: A Longitudinal Evaluation of Cholecalciferol Supplementation versus the Improvement of Factors Influencing 25(OH)D Status

1Health Sciences Department, University of Florence, Anna Meyer Children’s University Hospital, 50139 Florence, Italy
2Pediatric Endocrinology Unit, Health Sciences Department, University of Florence, Anna Meyer Children’s University Hospital, Viale Pieraccini 24, 50139 Florence, Italy
3Pediatric Unit, Mugello Hospital, Borgo San Lorenzo, 50032 Florence, Italy

Received 27 May 2014; Revised 6 August 2014; Accepted 25 August 2014; Published 11 November 2014

Academic Editor: Sabrina Corbetta

Copyright © 2014 Stefano Stagi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. This paper aims to assess 25(OH)D levels in Italian children and adolescents identifying risk factors for 25(OH)D deficiency and to evaluate whether a normal 25(OH)D value can be restored in 25(OH)D-deficient patients. Methods. We evaluated 25(OH)D levels in 679 Italian children and adolescents (≤10, 11–20, 21–30, and >30 ng/mL were defined as severe deficiency, deficiency, insufficiency, and sufficiency, resp.). Of these, 365 25(OH)D-deficient were followed up for 1 year; 205 were treated with cholecalciferol (Arm A: 400 I.U.) and 160 by improving the environmental variables influencing 25(OH)D levels (Arm B). Results. At cross-sectional evaluation, 11.3% showed sufficiency, 30.0% insufficiency, and 58.7% 25(OH)D deficiency. Mean 25(OH)D was  ng/mL. At the enrollment time (), no difference was found between Arms A and B with respect to distribution and 25(OH)D levels. At end time () 26.0% (29.7% in Arm A versus 20.6% in Arm B) showed sufficiency, 38.4% (42.0% versus 34.4%) insufficiency, and 35.6% (28.3% versus 45.0%) 25(OH)D deficiency. Mean 25(OH)D level was  ng/mL. Conclusions. Neither changes of lifestyle nor 400 I.U. cholecalciferol supplementation alone appears to be sufficient to restore adequate 25(OH)D levels.