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T1 Diabetes associated with low vitamin D - Nov 2014

Vitamin D Abnormalities: More Common in US Children with T1D than in Healthy Children

Journal of Diabetes Mellitus, 2014,4, 324-333
Craig Sheedy1, Meng Xu2, Ben Saville2, Jill Simmons3
department of Emergency Medicine, Vanderbilt University School of Medicine, Nashville, USA department of Biostatistics, Vanderbilt University School of Medicine, Nashville, USA department of Pediatrics, Division of Endocrinology and Diabetes, Vanderbilt University School of Medicine, Nashville, USA
Email: iill.h.simmons at vanderbilt.edu


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Background: Pediatric patients with type 1 diabetes (T1D) have increased risk for low bone mineral density, which may be due in part to low 25-hydroxyvitamin D levels. Vitamin D levels are influenced by sunlight exposure and thus display geographical variation. We hypothesize that the prevalence of 25-hydroxyvitamin D deficiency (<20 ng/mL) and insufficiency (20 - 29 ng/mL) in children with T1D living in the United States is higher than in healthy children and that diabetes duration, HbA1c, and insulin dose/kg are inversely associated with 25-hydroxyvitamin D levels.

Methods: Medical records of patients with T1D being followed in Tennessee were reviewed for demographics, medical information, and 25-hydroxyvitamin D levels during the previous 2 years. Control subjects were obtained from a de-identified database of healthy pediatric subjects living in a similar geographical area. Chi squared tests and multivariable linear regression were performed.

Results: Children and adolescents with T1D (n = 276; median age 14 years) have a significantly higher percentage of vitamin D deficiency and insufficiency compared with healthy pediatric controls (n = 100; median age 11.2 years) (68% versus 44%; p < 0.001). The median 25-hy- droxyvitamin D level is 24 ng/mL versus 31 ng/mL, respectively. After adjusting for age, race, gender, UV light exposure, BMI, and multivitamin supplementation, children and adolescents with T1D have a serum 25-hydroxyvitamin D level 6.7 ng/mL lower than the control population [CI (4.11, 9.21), p < 0.0001]. Within the T1D population, there is no clear association between diabetes duration, HbA1c, or insulin dose/kg and 25-hydroxyvitamin D levels.

Conclusions: There is an increased prevalence of 25-hydroxyvitamin D deficiency and insufficiency in US. children with T1D compared with geographically similar children without diabetes. Further research is needed to determine whether decreased serum 25-hydroxyvitamin D can be alleviated via dietary or behavioral modifications in this population.


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Attached files

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4560 T1 F2.jpg admin 09 Nov, 2014 41.21 Kb 1530
4559 T1 F1.jpg admin 09 Nov, 2014 29.15 Kb 3754
4558 Vitamin D Abnormalities T1 Diabetes.pdf admin 09 Nov, 2014 2.58 Mb 909