The role of vitamin D replacement therapy in serum FGF23 concentration in children with myelomeningocele compared with healthy children – a preliminary study

2019 ◽  
Vol 32 (11) ◽  
pp. 1259-1264
Author(s):  
Joanna Bagińska ◽  
Alicja Liszewska ◽  
Agata Korzeniecka-Kozerska

Abstract Background Fibroblast growth factor 23 (FGF23) is a recently discovered bone-derived regulator of vitamin D metabolism and phosphate homeostasis. It inhibits phosphate reabsorption and calcitriol production by the kidney. Myelomeningocele (MMC) remains the most severe form of neural tube defects involving serious locomotor disability, osteoporosis and pathologic fractures. We aimed to investigate the influence of vitamin D replacement therapy on serum FGF23 concentration in children with MMC and compare the results with healthy participants. Methods This prospective analysis was conducted on 16 children with MMC and 20 healthy children. Serum FGF23 levels were measured; for the studied group, before and after vitamin D replacement therapy with cholecalciferol (vitamin D3). The children’s medical charts were analyzed to determine age, sex, anthropometric measurements, calcium and phosphate, cholecalciferol and renal function parameters. Results There were significant differences in vitamin D and FGF23 serum concentrations between the studied groups. The median vitamin D levels in the MMC group increased during replacement therapy (7 vs. 18.5 ng/mL, p = 0.29) in comparison to the median of 25.5 ng/mL in the control group. In MMC children we found a significant decrease in median serum FGF23 after vitamin D replacement therapy (from 42.1 to 0 RU/mL, p < 0.001). FGF23 correlated positively with albumin, serum and urine phosphate levels and negatively with alkaline phosphatase. Conclusions 1. Serum concentration of FGF-23 is increased in MMC children in comparison to a healthy control group. 2. Vitamin D replacement therapy decreases FGF23 concentrations in MMC children, although further studies are still warranted to gain detailed insight on the FGF23 in the MMC population. 3. Children with MMC present vitamin D deficiency. Nutrition supplemented with low doses of cholecalciferol (vitamin D3) (intakes reaching recommended daily allowances) was insufficient to correct 25(OH)-D level in that population of patients.

2020 ◽  
Author(s):  
Şükrü Güngör ◽  
Can Acıpayam

INTRODUCTION: We aimed to compare the mean platelet volume (MPV) and plateletcrit (PCT) and vitamin-mineral levels in pediatric celiac disease patients with the healthy control group and to compare the results with the literature. METHODS: In this study, clinical and laboratory data of 80 pediatric patients diagnosed with celiac disease (CD) between July 2017 and December 2018 and 42 healthy children in the same age group were retrospectively analyzed. RESULTS: There was no significant difference between the groups in terms of age and gender (p=0.383, and p=0.462, respectively). The frequency of anemia, folate, iron and vitamin D deficiencies was higher in celiac patients compared to the control group (p=0.001, p=0.027, p<0.001, and p<0.001, respectively). When the patients were evaluated according to their complete blood count and vitamin-mineral levels; hemoglobin (Hb), mean corpuscular volume (MCV), ferritin and vitamin D levels were found to be significantly lower in the CD group compared to the control group (p<0.001, p=0.026, p<0.00, and p=0.001, respectively). Platelet (PLT), PCT, MPV levels were found to be significantly higher in the CD group compared to the control group (p=0.010, p<0.001, and p<0.001, respectively). We found a weakly negative correlation between the vitamin D levels and the degree of the Marsh classification (r: -0.273, and p=0.023). DISCUSSION AND CONCLUSION: Our study have shown that MPV, PCT values are higher and Hb, folate, iron and vitamin D levels are lower in patients with CD compared to healthy controls. We recommend investigating other nutrient deficiencies besides iron deficiency, especially in treatment-resistant anemias. We think that the correlation between vitamin D levels and the degree of histological damage should be elucidated with larger-scale and more comprehensive studies.


2018 ◽  
Vol 29 (10) ◽  
pp. 2583-2592 ◽  
Author(s):  
Cassianne Robinson-Cohen ◽  
Traci M. Bartz ◽  
Dongbing Lai ◽  
T. Alp Ikizler ◽  
Munro Peacock ◽  
...  

BackgroundFibroblast growth factor 23 (FGF23), a bone-derived hormone that regulates phosphorus and vitamin D metabolism, contributes to the pathogenesis of mineral and bone disorders in CKD and is an emerging cardiovascular risk factor. Central elements of FGF23 regulation remain incompletely understood; genetic variation may help explain interindividual differences.MethodsWe performed a meta-analysis of genome-wide association studies of circulating FGF23 concentrations among 16,624 participants of European ancestry from seven cohort studies, excluding participants with eGFR<30 ml/min per 1.73 m2 to focus on FGF23 under normal conditions. We evaluated the association of single-nucleotide polymorphisms (SNPs) with natural log–transformed FGF23 concentration, adjusted for age, sex, study site, and principal components of ancestry. A second model additionally adjusted for BMI and eGFR.ResultsWe discovered 154 SNPs from five independent regions associated with FGF23 concentration. The SNP with the strongest association, rs17216707 (P=3.0×10−24), lies upstream of CYP24A1, which encodes the primary catabolic enzyme for 1,25-dihydroxyvitamin D and 25-hydroxyvitamin D. Each additional copy of the T allele at this locus is associated with 5% higher FGF23 concentration. Another locus strongly associated with variations in FGF23 concentration is rs11741640, within RGS14 and upstream of SLC34A1 (a gene involved in renal phosphate transport). Additional adjustment for BMI and eGFR did not materially alter the magnitude of these associations. Another top locus (within ABO, the ABO blood group transferase gene) was no longer statistically significant at the genome-wide level.ConclusionsCommon genetic variants located near genes involved in vitamin D metabolism and renal phosphate transport are associated with differences in circulating FGF23 concentrations.


2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e20000-e20000
Author(s):  
Nurdan Tacyildiz ◽  
Gulsah oktay Tanyildiz ◽  
Deniz Tekin ◽  
Can Ates ◽  
Handan Dincaslan ◽  
...  

e20000 Background: There is increasing interest in the possible association between cancer incidence and vitamin D through its role as a regulator of cell growth and differentiation. Although there are several studies related cancer risk and prognosis of cancer, related vit D levels in adult patients there are only few recent studies in pediatric patients. Methods: Between 2010 and 2011, D Vit levels of 45 patients (25 boys, 20 girls; age range: 6 months-17 years, median: 11 years) have been compared to D Vit levels of 22 healthy children with similar age group. Patient groups were leukemias, lymphomas, bone tumors, retinoblastoma (RB), and other tumors. Kruskal-Wallis and Spearman nonparametric correlations test of SPSS has been used for statistics. Results: Although there was no statistically significant difference for vit D levels between control group (range: 7.2-22.8; median: 14.75 ng/ml) and patients (range: 5.5-40.2; median: 16.0 ng/ml),difference between patients groups were significant (Table). Patients with RB have statistically lower level of Vit D than leukemia (p:0.016) and lymphoma groups ( p: 0.047). “Other tumors group” has lower vit D levels than leukemia group (p: 0.024). Since RB and other tumors group have younger age than other patients, Spearsman’s nonparametric correlation has been performed to exclude age effect on the results and no statistically significant correlation between D vit levels and age (p: 0.779) was found, although there was an inverse correlation between age and vit D levels in patient group (p: 0.03). Conclusions: According to our preliminary results, most of the patients and healthy children have low level of Vit D. Especially patients with RB have statistically significant lower level of Vit D than other malignancies which can be subject to future studies for confirmation of our results. In addition, etiologic studies related RB may have a new area. [Table: see text]


2020 ◽  
Vol 48 (7) ◽  
pp. 030006052093463
Author(s):  
Esma Şengenç ◽  
Ertuğrul Kıykım ◽  
Sema Saltik

Objective This study aimed to investigate the relationship between autism spectrum disorder (ASD) and vitamin D levels in children and adolescents. Methods We measured serum 25-hydroxyvitamin D (25-OHD) levels in 1529 patients with ASD aged 3 to 18 years, without any additional chronic diseases. Levels of 25-OHD were compared according to sex, age (<11 or ≥11 years), and birth season. Additionally, laboratory parameters (calcium, phosphorus, alkaline phosphatase, and 25-OHD) of 100 selected patients with ASD were compared with those of the healthy control group. Results Vitamin D deficiency or insufficiency was found in approximately 95% of all patients. Levels of 25-OHD in adolescent patients with ASD aged 11 to 18 years were significantly lower than those in patients aged younger than 11 years. In the 100 selected patients with ASD, mean serum 25-OHD levels were significantly lower and alkaline phosphatase levels were higher compared with those in healthy children. Conclusion Our study suggests a relationship between vitamin D and ASD in children. Monitoring vitamin D levels is crucial in autistic children, especially adolescents, to take protective measures and treat this condition early.


2021 ◽  
Vol 2 (2) ◽  
pp. 63-68
Author(s):  
Priyanka Singh ◽  
◽  
Anuj Mehta ◽  
L. Sarkar ◽  
◽  
...  

AIM: To determine the vitamin D levels in vernal keratoconjunctivitis (VKC) patients in Indian population. METHODS: A total of 30 non-atopic healthy children and 30 children having VKC were included in the study. The serum vitamin D levels and the time spent outside was compared between the two groups (P<0.05). RESULTS: The mean serum vitamin D level in the VKC group was significantly lower (mean 19.17±10.76 ng/mL) compared to the control group (mean 31.19±9.09 ng/mL) (P=0.0003). The vitamin D levels were found to be deficient (10-20 ng/mL) in 43.33%, whereas severe deficiency (<10 ng/mL) was found in 20% of the VKC patients. The deficiency of vitamin D correlated with the level of severity of VKC (P<0.02). The time spent outside in the VKC group was 1.07±0.76h, whereas in the healthy subjects it was 2.08±0.72h (P<0.0001), and it showed a significant correlation with the serum 25 (OH) D3 levels (r=0.478, P<0.001). CONCLUSION: The study shows that children with VKC had a significantly lower serum vitamin D levels as compared to the healthy children which correlated with time spent outside. The severity of VKC also correlated with the severity of vitamin D deficiency which suggests that vitamin D plays an important role in maintaining ocular surface health.


Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 403
Author(s):  
Larisa Bianca Holhoș ◽  
Mihaela Cristiana Coroi ◽  
Liviu Lazăr

Vision integrates all the senses and plays a fundamental role in the acquisition of different skills and the general development of a child. Recently, refractive errors and visual impairment have become serious health problems among children. Background and Objectives: The aim of this study was to identify the prevalence of refractive errors and visual impairment in children with disabilities. Moreover, this study aimed to explore the risk factors for visual impairment in children with respect to vitamin D levels, parental smoking, and the use of spectacles. Materials and Methods: We retrospectively analyzed 161 children aged 5–16 years old, divided into two groups: a group of 80 children with disabilities and a control group consisting of 81 clinically healthy children. All the children underwent refraction measurements, visual acuity testing, and plasmatic vitamin D level dosing, measured in ng/mL. Results: Refractive errors and visual impairment were found to have a higher prevalence in the group of children with disabilities than in the control group. Moreover, the plasma level of vitamin D was lower in the group of children with special health needs. Conclusions: Given the present results, children with disabilities should undergo special eye examinations as soon as possible to ensure the quality of their socio-academic lives.


2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Asmaa Alhusseiny Ahmed Alsharkawy ◽  
Ahmed R. Rezk

Abstract Background Community-acquired pneumonia is a major cause of death among children. Inadequate nutrition disrupts the immune system and increases the susceptibility to infections. We aimed to evaluate the association between vitamin D, serum zinc, and iron, and pneumonia. A case-control study was conducted at the outpatient clinic and emergency room of Children’s Hospital. Thirty-one patients with community-acquired pneumonia and 36 healthy children (control group) underwent serum sampling for vitamin D, zinc, and iron. Results Most patients had mild form (n = 17, 54.8%). All patients survived and were discharged. The serum iron level showed a non-significant difference between pneumonia and control groups (p ˃ 0.05). TIBC, vitamin D, and serum zinc were significantly lower in the patient group than the control group (P value = 0.04, < 0.001, and 0.03, respectively). Vitamin D deficiency was highly associated with the severity of pneumonia (P value = 0.008). Conclusion Adequate serum zinc and vitamin D levels may be protective against infection with community-acquired pneumonia in children aged from 2 months to 5 years old, but not iron.


2022 ◽  
Vol 50 (1) ◽  
pp. 030006052110660
Author(s):  
Di Che ◽  
Li Yu ◽  
Yong Guo ◽  
Hai-jin Ke ◽  
Cui Liu ◽  
...  

Objective Research is limited regarding biochemical markers of bone metabolism among children with cow’s milk protein allergy (CMPA). We aimed to determine differences in vitamin D and bone metabolism markers between infants with CMPA and healthy infants and explore relationships between these in a cross-sectional study. Methods In total, we included 41 children diagnosed with CMPA and under systematic medical and nutritional care at our center, and 50 healthy children as a control group. We reviewed demographic and clinical characteristics and measured serum biomarkers. Results We found that serum 25-hydroxyvitamin D (25(OH)D) levels among infants in the CMPA group were significantly lower than those in the control group, and levels of bone-specific alkaline phosphatase (BALP), serum phosphorus, and serum calcitonin were reduced. Pearson correlation analysis showed that serum 25(OH)D concentrations in the CMPA group were negatively correlated with parathyroid hormone but not significantly correlated with calcitonin and BALP. Logistic regression showed that CMPA was a risk factor for vitamin D deficiency. Conclusions Our study indicated that CMPA was associated with disturbances in bone metabolism. Levels of vitamin D in children with CMPA were lower than those in healthy children. CMPA was a risk factor for vitamin D deficiency.


2017 ◽  
Vol 43 (1) ◽  
pp. 49-56 ◽  
Author(s):  
Murat Elevli ◽  
Ayşe Ergül Bozacı ◽  
Kamil Şahin ◽  
Hatice Nilgün Duru ◽  
Mahmut Çivilibal ◽  
...  

AbstractIntroduction:We aimed to investigate the impact of serum zinc, and vitamin D levels on the development of asthma, and its clinical characteristics.Methods:In our cross-sectional study; 50 patients who were diagnosed as atopic asthma and 70 healthy children consisted the control group. In both groups levels of vitamin D, and zinc were analyzed.Results:A statistically significant intergroup difference was not detected as for age, gender, body height (percentile), and weight (percentile) of the patients (p>0.05). Mean vitamin D levels in the asthmatic patient, and control groups were 32.61±9.48 nmol/L, and 42.55±15.42 nmol/L, respectively. Between two groups a statistically significant difference was found (p=0.001). Zinc levels were higher in the control group without any statistically significant difference between groups (p=0.25). A statistically significant negative correlation (−0.635) was found between vitamin D levels, and severity of asthma in the patient group. As the level of vitamin D increased, a decrease in severity of asthma was seen (p=0.04).Conclusion:Though larger series are needed to arrive at definitive conclusions, we think that vitamin D deficiency rather than zinc deficiency, might convey importance in the emergence, and exacerbation of asthma.


2010 ◽  
Vol 163 (5) ◽  
pp. 825-831 ◽  
Author(s):  
Ayse Kubat Uzum ◽  
Serpil Salman ◽  
Aysegul Telci ◽  
Harika Boztepe ◽  
Refik Tanakol ◽  
...  

ObjectiveFibroblast growth factor 23 (FGF23), a phosphatonin, inhibits renal phosphate reabsorption and suppresses 1-α hydroxylase activity. Calcitriol stimulates FGF23 synthesis in bone. We aimed to determine the effect of vitamin D replacement therapy on serum FGF23 concentrations in vitamin D-deficient women and to compare the FGF23 concentrations of vitamin D-deficient patients with healthy subjects and patients with genetically determined hypophosphatemic rachitis.Design and methodsThe study group was composed of vitamin D-deficient females (n=18, mean age 29.1±9.9 years), vitamin D-sufficient healthy females (control group;n=19, mean age 28.5±5.2 years), and patients with genetically determined hypophosphatemic rachitis (n=13, mean age 26.5±15.1 years). The groups were compared for serum FGF23, 1,25-dihydroxyvitamin D3 (1,25(OH)2D), calcium, phosphate, bone turnover markers, intact parathyroid hormone (PTH), and urinary excretion of calcium and phosphate. The vitamin D-deficient group was re-evaluated after a standard treatment regimen.ResultsSerum FGF23 concentrations were significantly lower in vitamin D-deficient patients than in vitamin D-sufficient women and hypophosphatemic rachitis group. Serum FGF23 and phosphate concentrations further decreased significantly during replacement of vitamin D (P<0.05). A significant negative correlation was evident between FGF23 and PTH before vitamin D replacement in the patients (r=−0.469,P<0.05).ConclusionDecreased FGF23 concentrations, which further decline during vitamin D replacement therapy, may have favorable action on bone mineralization by counterregulatory effect on phosphate homeostasis. Lower 1,25(OH)2D concentrations at baseline and hypophosphatemia during treatment may have dominating effects on FGF23 concentrations in vitamin D deficiency, leading to decreased FGF23 concentrations at baseline and during replacement therapy.


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