The Variability of Vitamin D Concentrations in Short Children with Short Stature from Central Poland-The Effects of Insolation, Supplementation, and COVID-19 Pandemic Isolation.

The aim of the study was to investigate the effects of seasonal variability of insolation, the implementation of new recommendations for vitamin D supplementation (2018), and the SARS-CoV-2 pandemic lockdown (2020) on 25(OH)D concentrations in children from central Poland. The retrospective analysis of variability of 25(OH)D concentrations during the last 8 years was performed in a group of 1440 children with short stature, aged 3.0-18.0 years. Significant differences in 25(OH)D concentrations were found between the periods from mid-2014 to mid-2018, from mid-2018 to mid-2020, and from mid-2020 to mid-2022 (medians: 22.9, 26.0, and 29.9 ng/mL, respectively). Time series models created on the grounds of data from 6 years of the pre-pandemic period and used for prediction for the pandemic period explained over 80% of the seasonal variability of 25(OH)D concentrations, with overprediction for the first year of the pandemic and underprediction for the second year. A significant increase in 25(OH)D concentrations was observed both after the introduction of new vitamin D supplementation guidelines and during the SARS-CoV-2 pandemic; however, the scale of vitamin D deficiency and insufficiency was still too high. Time series models are useful in analyzing the impact of health policy interventions and pandemic restrictions on the seasonal variability of vitamin D concentrations.

Seasonality of vitamin D concentrations and the incidence of vitamin D deficiency in children and adolescents from central Poland.

INTRODUCTION: Vitamin D3 [25(OH)D] deficiency is a significant problem in Polish children. In many regions of the world, 25(OH)D concentrations show seasonal variation and differences between boys and girls, due to seasonal differences in insolation, as well as different sociological and cultural factors. THE AIM OF THE STUDY: The aim of the study was to assess the seasonal variations of 25(OH)D concentrations and the incidence of vitamin D deficiency in children from central Poland. MATERIAL AND METHODS: The analysis comprised 1275 children, age 3-18 (11.2 ±4.0) years, with disorders of growing and/or puberty, obesity, and other complaints that could be related to endocrine diseases, except for ones with calcium-phosphorus imbalance, impaired parathyroid hormone secretion, and diseases that may influence vitamin D supply. RESULTS: Seasonal variability of 25(OH)D concentrations was observed with maximal levels in August and minimal in January and close relationship between 25(OH)D levels and insolation in the previous two months. In all the quarters, 25(OH)D concentrations were lower in girls than in boys and in older vs. younger children. The median value of 25(OH)D concentrations was below the lower limit of optimal range during the whole year. High incidence of 25(OH)D deficiency was observed (from 10.7% in August to 80.4% in January) together with low proportion of normal 25(OH)D levels (from 3.6% in January to 42.1% in August). CONCLUSIONS: Our results are consistent with previous reports on inadequate vitamin D supplementation in Polish children and adolescents, pointing out the necessity to implement current recommendations concerning vitamin D supplementation and the need for further studies on the consequences vitamin D deficiency for health of children and adolescents, with special attention to the pleiotropic effects of vitamin D.

Management of Prader-Willi Syndrome (PWS) in adults - what an endocrinologist needs to know. Recommendations of the Polish Society of Endocrinology and the Polish Society of Paediatric Endocrinology and Diabetology.

Prader-Willi syndrome (PWS) is a complex genetic disorder characterised by a set of phenotypic traits, which include infantile hypotonia, short stature, and morbid obesity. Over the last 12 years, visible progress has been made in medical care management of PWS patients in Poland. Increasing awareness of the disorder in neonatal and paediatric care has led to early identification of the condition in neonates, followed by the institution of an appropriate dietary regime, introduction of physiotherapy, and early-onset recombinant human growth hormone (rhGH) treatment. Growth hormone (GH) therapy in Poland is conducted within the nationwide framework of the Therapeutic Programme: "Treatment of Prader-Willi Syndrome". The therapeutic interventions initiated in the paediatric centres need to be continued in multidisciplinary adult care settings. The main aim of PWS clinical management in adulthood is prevention of obesity and its comor-bidities, treatment of hormonal disorders, mental health stabilisation, nutritional guidance, as well as on-going physiotherapy. Integrated multidisciplinary therapeutic intervention is necessary if patients with such a complex genetic condition as PWS are to not only achieve an average life expectancy but also to enjoy higher quality of life.

Effects of maternal vitamin D status on pregnancy outcomes, health of pregnant women and their offspring.

OBJECTIVE: Pregnancy increases the demand for vitamins, including vitamin D. Data on effects of vitamin D deficiency for pregnant woman and fetus available in Poland are scarce. The aim of this study was to evaluate vitamin D3 concentration in pregnant women and its influence on pregnancy course, health of pregnant women and their offspring. PATIENTS AND METHODS: The study included 102 healthy pregnant women, aged 21 to 40 years, mean 30.5±4.9 years. Women were divided into three groups based on 25(OH)D serum concentration in the third trimester of pregnancy: Group I - with sufficient 25(OH)D serum concentration (>30 ng/ml), Group II - with vitamin D3 insufficiency (20-30 ng/ml), Group III - with serious vitamin D deficiency (<20 ng/ml). RESULTS: Optimal vitamin D concentrations were found only in 31.2% of women, however in winter months only in 16%. Bacterial vaginosis was significantly more common in women with vitamin D deficiency and insufficiency (p<0.05). In contrast, there were no relations between vitamin D status and the incidence of gestational diabetes, preeclampsia, mode of delivery and size of newborns. A relationship between vitamin D deficiency and insufficiency during pregnancy and subsequent incidence of respiratory infections in children (p<0.05) was demonstrated. CONCLUSIONS: 1. The current model of vitamin D supplementation in pregnant women in Poland is insufficient, particularly in winter. 2. Vitamin D deficiency in pregnant women fosters development of bacterial vaginosis during pregnancy and recurrent respiratory infections in children, suggestive of the role of vitamin D in prevention of infections.