Does vitamin D status track through adolescence?(1)

Background: To our knowledge, no studies have reported on the long-term variability of vitamin D status in adolescents. Objective: To determine whether tracking of vitamin D status occurs in healthy adolescents, we assessed the variability of 25-hydroxyvitamin D [25(OH)D] every 2 y over a 10-y period in a longitudinal cohort of adolescents living in Johannesburg, South Africa (latitude 26°S). Design: Healthy adolescents who had blood samples available on ≥3 occasions between 11 and 20 y of age were included in the study. Of the cohort of 504 children, 99 met the criteria. The mean 25(OH)D concentration at each time point was measured, and the individual 25(OH)D z scores based on year 11 values were used as the reference. All 25(OH)D concentrations for a subject were measured in a single assay. Results: No significant correlation was found between 25(OH)D in the earlier and later years of adolescence, although significant correlations were found between year 11 and year 13 (r = 0.71, P < 0.0001) and between years 15, 17, and 20 (r ≥ 0.65, P < 0.0001). The percentage of adolescents whose 25(OH)D concentration changed by >20 nmol/L from year 11 was calculated for all age groups: 12% of the cohort had a change of >20 nmol/L at 13 y of age compared with 46% at 20 y of age. Just more than one-half (53%) of the cohort changed their category of vitamin D status between the ages of 11 and 20 y, and one-third of adolescents changed from being replete to insufficient over the same period. Conclusions: The data suggest that the measurement of 25(OH)D at a single time point does not reflect the long-term vitamin D status of an adolescent. These findings may cast doubt on the veracity of those studies that suggest an association of vitamin D status with various disease states in which vitamin D status was measured only once.