Evaluation of vitamin D status in children with refractory epilepsy

OBJECTIVE: Vitamin D deficiency has been implicated in children using antiepileptic drugs. Multiple antiepileptic drugs may increase the risk of vitamin D deficiency. The aim of this study is to evaluate the vitamin D status and risk factors for vitamin D deficiency in children with refractory epilepsy. METHODS: Forty children with refractory epilepsy seen in our tertiary pediatric neurology outpatient clinic were included and serum 25-hydroxy vitamin D, parathyroid hormone, calcium, phosphate and alkaline phosphatase were measured. Vitamin D deficiency was defined as 25-hydroxy vitamin D levels <20 ng/mL, and insufficiency between 21 and 29 ng/mL. Correlation between vitamin D levels and type of epilepsy (generalized or localization related), etiology of epilepsy (symptomatic vs idiopathic), body mass index, seizure frequency, number of antiepileptic drugs, type of antiepileptic drugs (old or new; enzyme inducing or not), presence of intellectual disability, ambulatory status and gross motor function classification scores were evaluated. RESULTS: The study group consisted of 17 boys and 23 girls with a mean age of 6.65 ± 5.29 years. Vitamin D deficiency was identified in 25 (62.5%) and insufficiency in 6 (15%) of the patients. There was no correlation between vitamin D levels and type of epilepsy, etiology of epilepsy, body mass index, seizure frequency, number of antiepileptic drugs, type of antiepileptic drugs, presence of intellectual disability, ambulatory status and gross motor function classification scores. CONCLUSION: We found that vitamin D deficiency was high in this cohort of children with refractory epilepsy. Vitamin D level should be monitored in patients with refractory epilepsy irrespective of the potential risk factors.

Download Full-text

Prevalence of Vitamin-D Deficiency in Patients with Acute Coronary Syndrome in Syria

International Journal of Pharmaceutical Sciences and Nanotechnology ◽

10.37285/ijpsn.2016.9.6.5 ◽

2016 ◽

Vol 9 (6) ◽

pp. 3544-3548

Author(s):

Aya Hallak ◽

Malhis Mahmoud ◽

Yaser Abajy Mohammad

Keyword(s):

Vitamin D ◽

Acute Coronary Syndrome ◽

Vitamin D Deficiency ◽

Hypovitaminosis D ◽

Control Group ◽

Coronary Syndrome ◽

Normal Individuals ◽

Vitamin D Levels ◽

25 Hydroxy Vitamin D ◽

Coronary Syndromes

The objectives of this study were to estimate the prevalence of vitamin D deficiency in patients with acute coronary syndrome in comparison with normal individuals and study the correlation between these two conditions. We measured the plasma 25-hydroxy vitamin D (25-OH-D) levels in 60 patients with acute coronary syndromes (ACS) of both gender and in 30 age matched control individuals of both gender without any known cardiovascular or systemic diseases. The levels of 25-OH-D were measured by ELISA method and the results were statically analyzed to find out any possible correlation. We classified the cases according to their plasma 25(OH)D levels. 25(OH)D levels of ≥ 30 ng/ml were considered normal, levels < 30 and > 20 ng/ml were classified as insufficient, while levels of ≤ 20 ng/ml were classified as deficient. In the current study the prevalence of hypovitaminosis D in the patients group was much higher than it was in the control group. Vitamin D deficiency was observed in 80% and insufficiency in 13% of total patients of ACS, there by bringing the total count to 93%. Whereas only 7% of the patients had adequate vitamin D levels. Thus, these results indicate the existence of a significant correlation between the vitamin D deficiency and ACS in comparison to healthy controls

Download Full-text

Vitamin D status in pregnant women and their newborns in a tertiary care hospital

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20184969 ◽

2018 ◽

Vol 7 (12) ◽

pp. 5071

Author(s):

Harleen Kour ◽

Shashi Gupta ◽

Swarn K. Gupta ◽

Bawa Ram Bhagat ◽

Gagan Singh

Keyword(s):

Vitamin D ◽

Pregnant Women ◽

Vitamin D Deficiency ◽

Tertiary Care ◽

North India ◽

Care Hospital ◽

Vitamin D Status ◽

Pregnant Females ◽

Vitamin D Levels ◽

Maternal And Newborn

Background: In the recent years there has been an increased understanding of the role that vitamin D plays in regulation of cell growth, calcium absorption and immunity and its impact on the developing fetus and maternal health is of significant concern. This study aims at evaluating the Vitamin D status in pregnant women and their newborns.Methods: A cross sectional study was done on 100 pregnant females according to inclusion and exclusion criteria. At the time of delivery, maternal blood was collected, and newborn samples were taken from newborn side of umbilical cord and sent for analysis.Results: The prevalence of Vitamin D deficiency has been found to be 85% of pregnant females and 91% of the newborns. Only 5% of pregnant females and 1% of the newborns showed Vitamin D sufficiency. Maternal and newborn vitamin D levels show a positive correlation. Mean maternal and newborn Vitamin D levels were found to be 16.78±7.04 ng/mL and 11.29±5.75 ng/ml.Conclusions: Vitamin D deficiency is highly prevalent among pregnant women in north India. Low maternal vitamin D levels lead to vitamin D deficiency in the newborns also.

Download Full-text

Levels of vitamin D among overweight and obese adolescents: an observational study

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20174136 ◽

2017 ◽

Vol 4 (6) ◽

pp. 1934

Author(s):

T. Prashanth Reddy ◽

Kishore Reddy ◽

Madhu Sudhan Reddy ◽

Manjunath G. A.

Keyword(s):

Vitamin D ◽

Observational Study ◽

Vitamin D Deficiency ◽

Overweight And Obesity ◽

Dietary Factors ◽

Vitamin D Status ◽

Obese Adolescents ◽

Vitamin D Levels ◽

Study Results ◽

Wide Range

Background: Normal growth and development requires vitamin D, and its deficiency compromises long term health and increases the risk of chronic disease. Severe vitamin D deficiency include rickets, osteomalacia, osteoporosis, increased risk of fracture, tooth loss. Studies indicate that vitamin D insufficiency (less severe than deficiency) is associated with a wide range of illnesses and chronic conditions, including type 1 diabetes, hypertension, multiple sclerosis and many types of cancer. Currently world is facing an unrecognized and untreated pandemic of vitamin D deficiency. This study aims at showing the relation between Vitamin D status and obesity in adolescent children and to know the dietary factors, life style factors like physical activity contributing to overweight and obesity in adolescents.Methods: Study design: This is an observational study of 30 overweight and obese adolescents based on BMI were studied and their Vitamin D levels were assessed.Results: A total of 14(46.7%) overweight and 16(53.3%) obese adolescents Vitamin D levels were assessed. 20(66.7%) had vitamin D levels <20ng/ml that is in the deficiency range.4(13.3%) had in the insufficiency range (21-30ng/ml), 6(20%) had in the sufficient range. Results shows vitamin D levels were significantly less in obese and overweight adolescents.Conclusions: Study results confirm that Vitamin D deficiency or insufficiency is common to obese and overweight adolescents, this may help to explain the relationship between obesity and several chronic diseases that are associated with poor Vitamin D status.

Download Full-text

Correlation Between 25-hydroxy-Vitamin D and Parkinson's Disease:A Case-Control study

10.21203/rs.3.rs-38762/v1 ◽

2020 ◽

Author(s):

ming xia ◽

wenjuan Xiu ◽

Xuliang Wang ◽

Tingting Wu ◽

Yingying Zheng ◽

...

Keyword(s):

Parkinson’S Disease ◽

Vitamin D ◽

Parkinson's Disease ◽

Vitamin D Deficiency ◽

Case Control Study ◽

Case Control ◽

Lower Serum ◽

Vitamin D Levels ◽

25 Hydroxy Vitamin D ◽

Control Study

Abstract Background: Previous cross-sectional studies have shown that Parkinson’s disease (PD) patients have lower serum 25- hydroxy vitamin D (25(OH)D) concentrations than controls. whether the research in other regions findings are generalizable to China populations remains untested in other studies. In this case-control study we examined the Correlation between 25-hydroxy-vitamin D and Parkinson's disease.Methods:We establish an association between deficiency of 25-hydroxy-vitamin D and PD in a case-control study of 100 PD patients and 100 control subjects free of neurologic disease in the First Affliated Hospital of Xinjiang Medical University.Results:Total 25-hydroxy-vitamin D levels, were deficient in 21% of patients with PD compared with 4% of controls. In univariate analyses Plasma levels of 25-hydroxy-vitamin D were associated with PD(p<0.001), respectively. In multivariate analyses, Vitamin D deficiency(25(OH)D <20 ng/mL) were significant associated with PD (p=0.008,OR=17.13,95% CI, 2.082-141.075). Individuals with levels in the lowest quartile of 25(OH)D values had the highest prevalence of PD(p =0.026,OR=11.786,95%CI,1.342-103.51)compared with individuals with values in the highest quartile.Conclusions:Our study reveals an association between 25-hydroxy-vitamin D and PD.Patients with incident PD had significantly lower serum 25(OH)D concentrations than age-matched controls, High-risk PD patients with vitamin D deficiency who have not yet developed exercise impairment, these populations should undergo vitamin D measurement and vitamin D treatment as soon as possible.

Download Full-text

Vitamin D levels in pregnant women in Uttarakhand, India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20175840 ◽

2017 ◽

Vol 7 (1) ◽

pp. 169

Author(s):

Nikita Pahuja ◽

Nidhi Chauhan ◽

Vinita Kalra

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Bone Growth ◽

Innate Immune ◽

Vitamin D Status ◽

Medical Sciences ◽

Healthy Pregnancy ◽

Vitamin D Levels ◽

Increase Risk ◽

Sufficient Vitamin

Background: A balanced, nutritious diet is an important aspect of a healthy pregnancy and its outcome. Vitamin D plays an important role in regular bone growth and in adequate function of innate immune system, including barrier function of mucous membrane. Vitamin D deficiency in adult females may increase risk of pre-eclampsia, gestational diabetes, bacterial vaginosis. The present study was undertaken to find the prevalence of Vitamin D deficiency in the women of Uttarakhand, India.Methods: The study was conducted in the Department of Obstetrics and Gynecology, Himalayan Institute of Medical Sciences (HIMS), Swami Ram Nagar, Dehradun, India over a period of 12 months. Sample size was 100 pregnant females attending antenatal clinic.Results: Out of 100 subjects, 21 (21%) had deficient, 69 (69%) had insufficient and 10 (10%) had sufficient vitamin D status. Out of 21 deficient subjects, 18 (85.71%) were Hindus, 2 (9.52%) were Muslims, 1 (4.76%) was Sikh and no deficiency was seen in Christian. In the present study, deficient vitamin D status was seen in 1 (4.76%) in lower, 16 (76.19%) in middle and 4 (19.04%) subjects in upper socioeconomic status.Conclusions: It is concluded from our study that there is serious vitamin D deficiency and insufficiency in the women of Uttarakhand, India.

Download Full-text

Vitamin D Status of Epileptic Children in India: A Prospective Cross-Sectional Study from a Tertiary Care Centre

Journal of Child Science ◽

10.1055/s-0040-1715860 ◽

2020 ◽

Vol 10 (01) ◽

pp. e87-e92

Author(s):

Chandrika Azad ◽

Vishal Guglani ◽

Jasbinder Kaur ◽

Roosy Aulakh ◽

Sukhvinder Singh ◽

...

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Tertiary Care ◽

Cross Sectional Study ◽

Vitamin D Status ◽

Sectional Study ◽

Cross Sectional ◽

Vitamin D Levels ◽

Epileptic Children ◽

25 Oh Vitamin D

AbstractVitamin D deficiency is prevalent all over the world, especially in tropical countries. In epileptics, antiepileptic drugs (AED) and associated comorbidities further impact vitamin D status. The aim of this study is to estimate the prevalence of 25(OH) vitamin D deficiency in epileptic children and evaluate probable risk factors. A cross-sectional study of 200 children between 1 and 18 years of age on AED was undertaken in the pediatric neurology clinic of a tertiary care center of Northern India. In all children, serum 25(OH) vitamin D levels, calcium, phosphorus, and alkaline phosphatase were estimated. The deficiency levels of vitamin D were categorized as: deficiency <20 ng/mL, insufficiency 20 to 30 ng/mL, and sufficiency >30 ng/mL. The potential risk factors for hypovitaminosis D, including type of epilepsy, AED regimen (specific medications, polytherapy vs. monotherapy), cerebral palsy, ambulatory status, intellectual disability, body mass index, gender, and vegetarianism were examined. Among the 200 enrolled children (60% boys), 106/200 (53%) were vitamin D deficient. There was no significant relation of vitamin D levels with gender, type of epilepsy, neurological deficit, and type of AED. An inverse relationship of higher phenytoin doses during monotherapy associated with lower vitamin D levels in monotherapy was found, thereby suggesting adverse effect of high doses of phenytoin on vitamin D levels. VDD is common among epileptic children on AED therapy. Vitamin D deficiency is common prevalent among epileptic children on AED therapy, and its detection and treatment correction should be an integral part of epilepsy management.

Download Full-text

Role of pregnancy and obesity on vitamin D status, transport, and metabolism in baboons

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.00208.2018 ◽

2019 ◽

Vol 316 (1) ◽

pp. E63-E72

Author(s):

Eugenia Mata-Greenwood ◽

Hillary F. Huber ◽

Cun Li ◽

Peter W. Nathanielsz

Keyword(s):

Vitamin D ◽

Maternal Obesity ◽

Subcutaneous Fat ◽

Placental Tissue ◽

Vitamin D Insufficiency ◽

Primate Species ◽

Vitamin D Status ◽

Vitamin D Levels ◽

25 Hydroxy Vitamin D ◽

Kidney Liver

Human studies show that obesity is associated with vitamin D insufficiency, which contributes to obesity-related disorders. Our aim was to elucidate the regulation of vitamin D during pregnancy and obesity in a nonhuman primate species. We studied lean and obese nonpregnant and pregnant baboons. Plasma 25-hydroxy vitamin D (25-OH-D) and 1α,25-(OH)2-D metabolites were analyzed using ELISA. Vitamin D-related gene expression was studied in maternal kidney, liver, subcutaneous fat, and placental tissue using real-time PCR and immunoblotting. Pregnancy was associated with an increase in plasma bioactive vitamin D levels compared with nonpregnant baboons in both lean and obese groups. Pregnant baboons had lower renal 24-hydroxylase CYP24A1 protein and chromatin-bound vitamin D receptor (VDR) than nonpregnant baboons. In contrast, pregnancy upregulated the expression of CYP24A1 and VDR in subcutaneous adipose tissue. Obesity decreased vitamin D status in pregnant baboons (162 ± 17 vs. 235 ± 28 nM for 25-OH-D, 671 ± 12 vs. 710 ± 10 pM for 1α,25-(OH)2-D; obese vs. lean pregnant baboons, P < 0.05). Lower vitamin D status correlated with decreased maternal renal expression of the vitamin D transporter cubulin and the 1α-hydroxylase CYP27B1. Maternal obesity also induced placental downregulation of the transporter megalin (LRP2), CYP27B1, the 25-hydroxylase CYP2J2, and VDR. We conclude that baboons represent a novel species to evaluate vitamin D regulation. Both pregnancy and obesity altered vitamin D status. Obesity-induced downregulation of vitamin D transport and bioactivation genes are novel mechanisms of obesity-induced vitamin D regulation.

Download Full-text

Vitamin D assessment in perioperative medicine and critical care

Wiener klinische Wochenschrift ◽

10.1007/s00508-019-01584-x ◽

2019 ◽

Cited By ~ 1

Author(s):

Paul Zajic ◽

Stefan Heschl ◽

Michael Schörghuber ◽

Petra Srekl-Filzmaier ◽

Tatjana Stojakovic ◽

...

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

False Positive Rate ◽

Fluid Loading ◽

Vitamin D Levels ◽

Positive Rate ◽

25 Hydroxy Vitamin D ◽

The Mean ◽

Clinical Trials Registry ◽

The Impact

Summary Background There is controversy about the impact of acute illness on vitamin D levels. This study was carried out to assess the influence of perioperative fluid loading on 25-hydroxy-vitamin D [25(OH)D] levels. The study evaluated the clinical utility of a commonly available chemiluminescence assay (ECLIA, IDS-iSYS) and liquid chromatography/mass spectrometry (LC-MS/MS) in the diagnosis of vitamin D deficiency in this setting. Methods In this prospective observational pilot study in adult patients undergoing cardiovascular surgery on cardiopulmonary bypass (CPB), blood samples drawn at preoperative baseline (t1), after weaning from CPB (t2), on intensive care unit (ICU) admission (t3) and on the first (t4) and second (t5) postoperative days were analyzed. Results A total of 26 patients (130 samples) were included in this study. Fluid loading by CPB led to a median reduction of 25(OH)D by −22.6% (range −54.5% to −19.5%) between t1 and t2. Cohen’s kappa (κ) for method agreement for vitamin D deficiency (tested cut-off values 20 ng/ml and 12 ng/ml), was κ = 0.291 (p < 0.001) and κ = 0.469 (p < 0.001), respectively. The mean difference between measurements by ECLIA and LC-MS/MS was 4.8 ng/ml (±5.7), Pearson’s r for correlation was 0.73 (p < 0.001). The biologically inactive C3-epimer did not contribute to 25(OH)D levels assessed by LC-MS/MS. Conclusion The 25(OH)D measurements by chemiluminescence assays can noticeably deviate from those measured by LC-MS/MS, which can be considered the unequivocal gold standard. These assays may still be acceptably reliable in the screening for vitamin D deficiency, especially in the setting of low vitamin D levels. Stricter definitions, e.g. serum 25(OH)D levels lower than 12 ng/ml, may be used to diagnose deficiency with low false positive rate. Trial Registration DRKS00009216, German Clinical Trials Registry (www.drks.de)

Download Full-text

Demographic Characteristics, Risk Factors, and Presenting Features of Children with Symptomatic Nutritional Rickets: A French Series

Hormone Research in Paediatrics ◽

10.1159/000511419 ◽

2020 ◽

Vol 93 (5) ◽

pp. 304-312

Author(s):

Claire Flot ◽

Valérie Porquet-Bordes ◽

Justine Bacchetta ◽

Anya Rothenbuhler ◽

Anne Lienhardt-Roussie ◽

...

Keyword(s):

Risk Factors ◽

Vitamin D ◽

Pediatric Population ◽

Vitamin D Supplementation ◽

Demographic Characteristics ◽

Total Serum ◽

Nutritional Rickets ◽

Total Serum Calcium ◽

Vitamin D Levels ◽

25 Hydroxy Vitamin D

Aim: To describe the demographic characteristics, risk factors, and presenting features of children with symptomatic nutritional rickets in France. Methods: This is a retrospective study of 38 children diagnosed with nutritional rickets from 1998 to 2019. Results: We observed a higher frequency of rickets in males (74 vs. 26%), in young children (median age at diagnosis: 23 months; 82% were younger than 5 years), and in children with a non-Caucasian ethnic background (89%). Most children were exclusively breastfed (78%) without adequate vitamin D supplementation (89%). The most common presentations were bowed legs (63%), hypocalcemic seizures (21%), and growth retardation (11%). Approximately half (62%) of the children were hypocalcemic. The children presenting with hypocalcemic seizures were significantly younger (0.8 vs. 2.2 years; p = 0.041) and had lower total serum calcium levels (1.44 vs. 2.17 mmol/L; p < 0.0001), higher phosphatemia (1.43 vs. 1.23 mmol/L; p = 0.020), and lower 25-hydroxy vitamin D levels (3 vs. 7 ng/mL; p = 0.020) but similar parathyroid hormone levels (357 vs. 289 ng/mL; p = 0.940) compared to rickets cases who did not experience hypocalcemic seizures. A dilated cardiomyopathy was detected in 14% of the children who had undergone echocardiography. Conclusion: Nutritional rickets remains endemic in the pediatric population and its most severe forms can have life-threatening sequelae. Health practitioners need to be cognizant of these facts to raise awareness and screen high-risk populations.

Download Full-text

Assessment of risk factors associated with vitamin D status among children of an urban and a rural areas of Bangladesh

Bangladesh Medical Research Council Bulletin ◽

10.3329/bmrcb.v46i2.49024 ◽

2020 ◽

Vol 46 (2) ◽

pp. 134-141

Author(s):

Anamika Saha ◽

Md Salim Shakur ◽

Runa Laila ◽

Salomee Shakur ◽

Md Sohel Shomik ◽

...

Keyword(s):

Risk Factors ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Hypovitaminosis D ◽

Urban Children ◽

Outpatient Department ◽

P Value ◽

Rural Children ◽

Vitamin D Status ◽

Factors Associated

Background: Vitamin D deficiency is one of the most common micronutrient deficiency in children worldwide, even in Bangladesh. However, to date, the prevalence of vitamin D deficiency among children of different region of Bangladesh is less reported. Objective: This study was conducted to assess vitamin D status of urban and rural Bangladeshi children including the risk factors associated with vitamin D deficiency are also evaluated. Methods: A multi-centre (urban and rural based), cross sectional study was done from July 2016 to June 2017, using serum 25(OH) vitamin D3 as a marker of nutritional vitamin D status. Urban and rural children were taken from Paediatric Outpatient Department, United Hospital Limited. Dhaka and Medical Outpatient Department, Upazila Health Complex, Ghatail, Tangail respectively. Children of 1-10 years age attending OPD with mild undernutrition (<–1 SD z score) and/or clinical features suggestive of vitamin D deficiency were included in the study. Results: A total 150 children were studied with 102 (68.0%) urban and 48 (32.0%) rural children. Hypovitaminosis D (25-OHD <30ng/ml) was found in 75.0% of children. Hypovitaminosis D was found significantly more in urban children (81.0%) compared to rural (62.0%) children (OR=0.382, 95% CI: 0.177-0.822, p value <0.05). Inadequate exposure to sunlight was significantly associated with hypovitaminosis D compared to adequate sun exposure and it was about 2.5 times higher (OR=2.475, 95% CI: 1.139-5.380, p value <0.05). No significant associations of vitamin D deficiency were detected with skin color of children, covering clothes of mother, exclusive breast feeding, limb pain and anthropometric status. Children of higher educated mother (above Secondary School Certificate) (OR=0.412, 95% CI: 0.189-0.900) were more associated with vitamin D deficiency. Conclusion: Vitamin D deficiency (VDD) is prevalent among Bangladeshi children, urban children being more vulnerable to VDD. Adoption of a screening programme for children of all age group and implementation of preventive strategies for VDD through public health policies are strongly recommended. Bangladesh Med Res Counc Bull 2020; 46(2): 134-141

Download Full-text