Background. A significant increase in understanding of the role of vitamin D in the body, more effective detection of celiac disease, and the need to monitor the health of children against the background of long-term adherence to a gluten-free diet were prerequisites for our study. The study was aimed to analyze the level of vitamin D in children with celiac disease. Materials and methods. The results of the examination of 29 children aged from 6 months to 18 years with a verified diagnosis of celiac disease were analyzed. Serum vitamin D levels were measured by the electrochemiluminescent method (Roche Diagnostics GmBH, Mannheim, Germany). The results of vitamin D supplementation in patients with celiac disease were compared with the control group of 30 healthy children aged from 1 to 18. Mathematical processing of the material included a standard algorithm for statistical research using Microsoft Excel 2016, Attestat. Results. Among the patients included in the study, typical celiac disease was found in 24 (82.7 %) cases, which is 4.8 times more common than atypical — in 5 (17.4 %) children. The gastrointestinal symptoms dominated in a clinical picture. Manifestation of the disease in most patients was observed in the first year of life — in 17 (58.6 %) cases, in 7 (24.1 %) patients aged from 1 to 3 years, and only in 5 (17.4 %) children older than 3 years. The average rate of vitamin D in children with celiac disease was probably lower than in healthy children and accounted for 24.4 ± 1.2; 21.2 [16.45–35.21] ng/ml. The number of children with normal vitamin D content is the highest among young patients, while the frequency of vitamin D deficiency is the lowest. The median serum vitamin D in patients on a gluten-free diet was 1.4 times higher (p < 0.05) than in the acute period, but 1.3 times lower (p < 0.05) than in the control group. Adherence to a gluten-free diet leads to increased levels of vitamin D but does not allow reaching the level in healthy children. Conclusions. Vitamin D deficiency is registered in children with celiac disease. All patients with celiac disease, regardless of the stage of the disease and adherence to a gluten-free diet, need to be monitored for vitamin D levels.
Annotation. The literature is devoted to the analysis of scientific literature for the last 10 years from the electronic databases "PubMed" and "National Library of Ukraine named after V. I. Vernadsky", which are devoted to the study of the formation and development of organs and structures of the urinary system. The consequences of perinatal morphogenesis play the most essential role in the causes and contribution to many congenital malformations (CM), stillbirths, and infant morbidity. According to the Medical and Genetic Service of the Ministry of Health of Ukraine, up to 3,000 cases of CM of various organs and systems are recorded annually among newborns in Ukraine. CM of the genitourinary system ranks 3rd in frequency, among which CM of the female genitalia is up to 6 %. These figures are somewhat subjective, as a certain percentage of pathology of the female reproductive system is detected only when a girl reaches childbearing age, which greatly complicates the choice of methods and effectiveness of treatment. The rapid development of the genitourinary system of the fetus requires morphologists to comprehensively study the patterns of morphogenesis and the development of topographic and anatomical relationships of the reproductive system and urinary tract in the early period of human ontogenesis. The problem of combining information about the structural organization of the urinary tract and genital system into a consolidated morphofunctional unit is one of the cardinal problems of perinatal urology. The final formation of the urogenital organs is as follows. The initial kidneys' replacement with the permanent ones, metanephros, begins to form, from the same nephrogenic cord that gave rise to the primary kidney. The proper permanent renal parenchyma develops from the nephrogenic cord (renal tubuli). From the 3rd month, the permanent kidneys replace the mesonephros as the excretory organs already function. Thus, the embryonic development of the genitals is closely related to the development of the urinary tract and kidneys. Therefore, the CM of these two systems often occurs together. Active introduction of perinatal prophylaxis of urogenital organs requires modern approaches and methods of examination of intrauterine life. Therefore, the complex of embryotopographic studies attains special significance, having combined the consideration of organically critical periods of development with the understanding of the peculiarities of the spatial relationships of organs and structures of the genitourinary system.
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