Vitamin D deficiency in children and adolescents with type 1 diabetes

J Clin Res Pediatr Endocrinol. 2011;3(4):179-83. doi: 10.4274/jcrpe.430.

Abstract

Objective: To investigate the frequency and effects of vitamin D deficiency in children with type 1 diabetes (T1D) in a region which is known to have a high rate of vitamin D deficiency among adolescents.

Methods: In this prospective cross-sectional study, 120 children and adolescents with T1D (55 girls and 65 boys) aged 3-20 years were evaluated. Serum 25-hydroxyvitamin D [25(OH)D], parathormone (PTH), and alkaline phosphatase (ALP) levels were measured. Hemoglobin A1c levels and daily insulin requirement were also evaluated. Classification of vitamin D status was made according to the American Academy of Pediatrics (AAP)/LWEPS's recommendations. The patients were divided into 2 groups according to their vitamin D status and also according to the season of the year in which 25(OH)D sampling was done.

Results: Serum 25(OH)D levels revealed vitamin D deficiency or insufficiency in 38% of the patients. Higher PTH levels were found in the patient group whose mean 25(OH)D level was < 20 ng/mL as compared to the group whose mean 25(OH)D level was > 20 ng/mL (p < 0.05). Only 11% of patients had secondary hyperparathyroidism. The 25(OH)D levels of patients whose serum samples were taken in summer and spring months were significantly different (p < 0.05). There were no significant correlations between 25(OH)D level and daily insulin dose.

Conclusion: Although we could not show a significant association between vitamin D deficiency and metabolic parameters, the frequency of vitamin D deficiency in T1D children is substantial. Vitamin D status should be assessed also in patients who do not have signs of rickets.

MeSH terms

  • Adolescent
  • Alkaline Phosphatase / blood
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 1 / blood*
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / epidemiology
  • Female
  • Humans
  • Male
  • Parathyroid Hormone / blood
  • Prevalence
  • Prospective Studies
  • Seasons
  • Turkey / epidemiology
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood
  • Vitamin D / therapeutic use
  • Vitamin D Deficiency / epidemiology
  • Vitamin D Deficiency / etiology*
  • Young Adult

Substances

  • Parathyroid Hormone
  • Vitamin D
  • 25-hydroxyvitamin D
  • Alkaline Phosphatase