Prevalence of Vitamin D Deficiency in Children with Type 1 Diabetes Mellitus

Carakushansky, Mauri; Patel, Priya; Khallouq, Bertha A. Ben; Gurnurkar, Shilpa

doi:10.7759/cureus.7836

Cited by 17 publications

(17 citation statements)

References 23 publications

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“…We observed a higher prevalence of vitamin D deficiency (89%) in children with T1D than few other studies. [20,23] Majority (64%) of controls had low serum levels of 25(OH)D levels in this study, comparable to a study conducted in a healthy pediatric population from India. [21,24] In our study, there was no significant correlation between vitamin D levels and duration of sun exposure, calcium intake, time spent on screen, HbA1c levels, duration of disease, and physical activity score in cases.…”

Section: Intra-assay Coefficient Of Variation (%)supporting

confidence: 84%

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Evaluation of bone mineral density in children with type 1 diabetes: A cross-sectional case–control study

Kumar

Sahoo

2022

JPED

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Objectives: To compare the bone mineral density (BMD) and vitamin D levels of children with type 1 diabetes (T1D) with normal children. Material and Methods: Children with T1D, aged 4–18 years, and age- and gender-matched healthy controls, were recruited. Children with chronic systemic disorders and those taking medications that impair BMD were excluded from the study. Dual-energy X-ray absorptiometry, vitamin D, intact parathyroid hormone, calcium, phosphorus, alkaline phosphatase, osteocalcin, and spot urine deoxypyridinoline crosslinks (Pyrilinks-D)/ creatinine ratio were estimated in both cases and controls. Results: Thirty-seven children with T1D with a mean age of 9.7 ± 2.1 years were enrolled and compared with controls. The bone mineral content (BMC) in cases was 24.5 g (20.3–30.6) and in controls 25.5 g (23.5–26.8) (P = 0.66) and BMD in cases was 0.68 ± 0.165 g/cm2 and in controls 0.69 ± 0.149 g/cm2 (P = 0.76). However, the prevalence of low BMD (BMD <-2 Z-score) was seen in only 3 (8%) cases (P – <0.001). Serum 25-hydroxyvitamin D [25(OH)D] levels were also lower in cases 14.1 ng/mL (12.05–14.75 ng/mL) as compared to controls 15.73 ng/mL (13.1–23.2 ng/mL) (P = 0.01). Thirty-three (89%) cases and 24 (64%) controls had low 25(OH)D levels (<20 ng/mL). There was no significant difference in the bone turnover markers between cases and controls. Conclusion: Children with T1D have similar BMD and lower vitamin D levels compared to healthy children.

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Section: Intra-assay Coefficient Of Variation (%)supporting

confidence: 84%

“…The previous studies showed mixed results pertaining to these biochemical parameters. Few studies showed comparable results to our study [22,23,25,26] and few other studies had contradicting results. [19,22] Bone turnover markers predict the increased fracture risk and rapid bone loss, independent of BMD.…”

Section: Intra-assay Coefficient Of Variation (%)supporting

confidence: 76%

Evaluation of bone mineral density in children with type 1 diabetes: A cross-sectional case–control study

Kumar

Sahoo

2022

JPED

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“…The geographic location of Poland with low sunlight and insufficient exposure to ultraviolet light is probably the main cause of such finding. However, VDD in individuals with T1D is very common, even in a sun-rich environment (23). Moreover, the prevalence of VDD is higher in young patients with T1D compared to adolescents without diabetes (24)(25)(26).…”

Section: Discussionmentioning

confidence: 99%

Vitamin D Deficiency as a Predictor of a High Prevalence of Coronary Artery Disease in Pancreas Transplant Candidates With Type 1 Diabetes

et al. 2021

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IntroductionPancreas transplantation is a high-risk procedure in terms of cardiovascular complications. Therefore, identification of all cardiovascular risk factors is crucial to prevent cardiovascular complications after pancreas transplantation. Vitamin D deficiency (VDD) appears to be a potential risk factor for coronary artery disease.ObjectiveTo determine the prevalence of VDD in pancreas transplant candidates, and further to examine the relationship between vitamin D and the prevalence of coronary artery disease and lipid profile parameters.Materials and MethodsThis is a prospective cross-sectional study. We enrolled consecutive patients with type 1 diabetes eligible for simultaneous pancreas-kidney transplantation or pancreas transplant alone. The laboratory tests included HbA1c, lipid profile, creatinine, and total 25-hydroxyvitamin D (25(OH)D). The diagnosis of coronary artery disease was based on coronary angiography.ResultsThe study population included 48 patients. VDD was revealed in 48% of patients and coronary artery disease in 35% of patients. The mean concentration of vitamin D in the entire cohort was 21.3 ± 9.48 ng/ml. The median value of 25(OH)D in patients with coronary artery disease was significantly lower than in patients without coronary artery disease (18.5 (11.6–21.5) vs. 24.8 (18.4–31.8) ng/ml, p = 0.018). There was a significant relationship between VDD and coronary artery disease (OR = 4.36; 95% confidence interval (CI): 1.22–15.64, p = 0.034). A patient’s odds of having coronary artery disease while having a sufficient level of vitamin D was 4.36 times lower than if the patient had VDD. There was a significant relationship between VDD and hypertension (OR = 5.91; 95% CI: 1.12–31.20, p = 0.039) and hemodialysis (OR = 4.25; 95% CI: 1.25–14.5, p = 0.023). There was no significant correlation between 25(OH)D and lipid profile.ConclusionsVDD is highly prevalent in pancreas transplant candidates with type 1 diabetes. There is a significant relationship between VDD and increased prevalence of coronary disease. The lack of any significant association between serum vitamin D and lipid profile suggests that the relationship between vitamin D and coronary artery disease results from other causes.

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“…Previous prospective cohort studies have suggested that compared to other lipid pro les, LDL-C increased in childhood is the strongest predictor for the risk of dyslipidemia and cardiovascular disease in adulthood [8,9]. The de ciency or insu ciency of Vitamin D levels in T1DM children is highly prevalent [10]. Immunologic effects of Vitamin D on human health and disease have been demonstrated [11].…”

Section: Introductionmentioning

confidence: 99%

“…But the link between Vitamin D levels and LDL-C has not received much attention. Considering the high prevalence of vitamin D de ciency among T1DM children, its potential health implications, and its convenience of treatment, it is necessary to consider regularly screening T1DM children for vitamin D insu ciency or de ciency [10].…”

Section: Introductionmentioning

confidence: 99%

Vitamin D levels are associated with low-density lipoprotein cholesterol in Chinese children with type 1 diabetes

Shu

Wang

Zhang

et al. 2021

Preprint

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Objective There is an increased level of low-density lipoprotein cholesterol (LDL-C)in children with type 1 diabetes mellitus(T1DM). In addition, the Vitamin D level in T1DM patients is usually below the normal reference range. The aim of this study was to explore the relationship between Vitamin D levels and LDL-C in Chinese children with T1DM. Methods A retrospective cross-sectional study was conducted in the Endocrine inpatient wards of Tianjin Children’s Hospital, 143 children with T1DM were included. The related clinical and laboratory examinations, including anthropometric parameters, lipid profiles, and Vitamin D levels, were collected in all subjects. Results The univariate analysis results did not show a significant correlation between Vitamin D levels and LDL-C (P=0.634). Furthermore, a nonlinear relationship was observed between Vitamin D levels and LDL-C by smooth curve fitting after adjusting for potential confounders. A multivariate piecewise linear regression model revealed a significant negative association between LDL-C and Vitamin D levels when LDL-C was greater than 3.1 mmol/L(β -2.9, 95% CI -5.4,-0.5; P=0.022). However, we did not observe a significant relationship between LDL-C and Vitamin D levels when LDL-C was lower than 3.1 mmol/L(β 2.4, 95% CI -0.2,5.1; P=0.076).Conclusions This study identified a nonlinear relationship between Vitamin D levels and LDL-C independent of other potential confounding factors, suggesting that the deficiency or insufficiency of Vitamin D in T1DM children with high LDL-C levels should be considered, especially LDL-C is higher than 3.1 mmol/L, which provides evidence of the timing about Vitamin D supplementation in T1DM children.

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Prevalence of Vitamin D Deficiency in Children with Type 1 Diabetes Mellitus

Cited by 17 publications

References 23 publications

Evaluation of bone mineral density in children with type 1 diabetes: A cross-sectional case–control study

Evaluation of bone mineral density in children with type 1 diabetes: A cross-sectional case–control study

Vitamin D Deficiency as a Predictor of a High Prevalence of Coronary Artery Disease in Pancreas Transplant Candidates With Type 1 Diabetes

Vitamin D levels are associated with low-density lipoprotein cholesterol in Chinese children with type 1 diabetes

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