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Kronik Hastalığı Olan Çocuk ve Adölesanlarda Vitamin D Eksiklik/Yetersizliği

Year 2016, Volume: 10 Issue: 4, 259 - 264, 01.12.2016

Abstract

Amaç: D vitamininin kemik metabolizması üzerindeki etkisi iyi bilinmektedir. Son dönemlerde D vitaminin kardiyovasküler hastalıklar, obezite, enfeksiyonlar, otoimmünite ve kanser gelişimi ile de ilişkisi olduğu gösterilmeye başlanmıştır. Bu çalışmada, çocukluk çağındaki kronik hastalıklarda D vitamini eksikliğinin değerlendirilmesi amaçlandı.Gereç ve Yöntemler: 2005-2011 yılları arasında kliniğimizde D vitamini eksiklik/yetersizliği (25OHD < 30 ng/ml) nedeniyle takip edilen ve ek kronik hastalığı olan 438 olgu geriye dönük olarak değerlendirildi.Bulgular: Olguların yaş ortalaması 12.8±4.6 yıl ve kız/erkek oranı:1.29 olarak bulundu. Eşlik eden hastalıklar arasında diyabetes mellitus, obezite, Turner Sendromu, konjenital adrenal hiperplazi, miyopati, otoimmün ve romatolojik hastalıklar, santral sinir sistemi hastalıkları ve maligniteler yer almaktaydı. Kronik hastalığı olan çocuk/adölesanlarda D vitamini eksiklik/yetersizliği sıklığı 62.5-% 95 arasında değişmekteydi. Olguların ortalama 25OHD düzeyi 17±6.6 ng/ml’di. Hiç bir grupta hipokalsemi ve benzeri iyon dengesizliği saptanmadı.Sonuç: D vitaminin multisistemik etkileri dikkate alındığında, çocukluk çağındaki kronik hastalıklarda 25OHD düzeyi takip edilmeli ve gereğinde replasman yapılmalıdır. Böylece altta yatan hastalığın seyrinde de düzelme gözlenebilir.

References

  • Shin YH, Shin HJ, Lee YJ. Vitamin D status and childhood health. Korean J Pediatr 2013;56:417-23.
  • Romagnoli E, Pepe J, Piemonte S, Cipriani C, Minisola S. Management of endocrine disease: Value and limitations of assessing vitamin D nutritional status and advised levels of vitamin D supplementation. Eur J Endocrinol 2013;169:59-69.
  • Hatun S, Islam O, Cizmecioglu F, Kara B, Babaoglu K, Berk F, et al. Subclinical vitamin D deficiency is increased in adolescent girls who wear concealing clothing. J Nutr 2005;135:218-22.
  • Olmez D, Bober E, Buyukgebiz A, Cimrin D. The frequency of vitamin D insufficiency in healthy female adolescents. Acta Paediatr 2006;95:1266-99.
  • Wactawski-Wende J, Kotchen JM, Anderson GL, Assaf AR, Brunner RL, O’Sullivan MJ, et al. Calcium plus vitamin D supplementation and the risk of colorectal cancer. N Engl J Med 2006;354:684-96.
  • Rabelink NM, Westgeest HM, Bravenboer N, Jacobs MA, Lips P. Bone pain and extremely low bone mineral density due to severe vitamin D deficiency in celiac disease. Arch Osteoporos 2011;6:209-13.
  • Zaniew M, Jarmolinski T. Vitamin D status and bone density in steroid-treated children with glomerulopathies: Effect of cholecalciferol and calcium supplementation. Adv Med Sci 2012;3:1-6.
  • Söderpalm AC, Magnusson P, Ahlander AC, Karlsson J, Kroksmark AK, Tulinius M, et al. Low bone density and decreased bone turnover in Duchenne muscular dystrophy. Neuromuscul Disord 2007;17:919-28.
  • Wang Z, Lin YS, Zheng XE. An inducible cytochrome P450 3A4-dependent vitamin D catabolic pathway. Mol Pharmacol 2012;81:498-509.

Vitamin D Deficiency/Insufficiency in Children and Adolescents with Chronic Disease

Year 2016, Volume: 10 Issue: 4, 259 - 264, 01.12.2016

Abstract

Objective: The effect of vitamin D on bone metabolism is well known. It has recently been shown to be also associated with cardiovascular diseases, obesity, infections, autoimmunity, and cancer. The aim of our study was to evaluate vitamin D deficiency in childhood chronic diseases.Material and Methods: A total of 438 cases followed-up for vitamin D deficiency/insufficiency (25 OHD level < 30 ng/mL) in our clinic between 2005 and 2011 and who had an additional chronic disorder were evaluated retrospectively. Results: The mean age of the cases was 12.8±4.6 years and the female/male ratio 1.29 Accompanying disorders included diabetes mellitus, obesity, Turner syndrome, congenital adrenal hyperplasia, myopathy, autoimmune and rheumatic diseases, central nervous system diseases and malignancies. The vitamin D deficiency/insufficiency incidence ranged between 62.5 and 95.0% in the children/adolescents with chronic disease. The mean 25 OHD level was 17±6.6 ng/ml. Hypocalcemia or a similar ion imbalance was not found in any group. Conclusion: Considering the multisystemic effects of vitamin D, 25 OHD levels should be monitored in chronic diseases in childhood and supplementation provided if necessary. This may lead to an improvement in the course of the underlying disease as well

References

  • Shin YH, Shin HJ, Lee YJ. Vitamin D status and childhood health. Korean J Pediatr 2013;56:417-23.
  • Romagnoli E, Pepe J, Piemonte S, Cipriani C, Minisola S. Management of endocrine disease: Value and limitations of assessing vitamin D nutritional status and advised levels of vitamin D supplementation. Eur J Endocrinol 2013;169:59-69.
  • Hatun S, Islam O, Cizmecioglu F, Kara B, Babaoglu K, Berk F, et al. Subclinical vitamin D deficiency is increased in adolescent girls who wear concealing clothing. J Nutr 2005;135:218-22.
  • Olmez D, Bober E, Buyukgebiz A, Cimrin D. The frequency of vitamin D insufficiency in healthy female adolescents. Acta Paediatr 2006;95:1266-99.
  • Wactawski-Wende J, Kotchen JM, Anderson GL, Assaf AR, Brunner RL, O’Sullivan MJ, et al. Calcium plus vitamin D supplementation and the risk of colorectal cancer. N Engl J Med 2006;354:684-96.
  • Rabelink NM, Westgeest HM, Bravenboer N, Jacobs MA, Lips P. Bone pain and extremely low bone mineral density due to severe vitamin D deficiency in celiac disease. Arch Osteoporos 2011;6:209-13.
  • Zaniew M, Jarmolinski T. Vitamin D status and bone density in steroid-treated children with glomerulopathies: Effect of cholecalciferol and calcium supplementation. Adv Med Sci 2012;3:1-6.
  • Söderpalm AC, Magnusson P, Ahlander AC, Karlsson J, Kroksmark AK, Tulinius M, et al. Low bone density and decreased bone turnover in Duchenne muscular dystrophy. Neuromuscul Disord 2007;17:919-28.
  • Wang Z, Lin YS, Zheng XE. An inducible cytochrome P450 3A4-dependent vitamin D catabolic pathway. Mol Pharmacol 2012;81:498-509.
There are 9 citations in total.

Details

Other ID JA23VE39MT
Journal Section Research Article
Authors

Meryem Karaca This is me

Semra Çetinkaya This is me

Melikşah Keskin This is me

Aşan Önder This is me

Zehra Aycan This is me

Publication Date December 1, 2016
Submission Date December 1, 2016
Published in Issue Year 2016 Volume: 10 Issue: 4

Cite

Vancouver Karaca M, Çetinkaya S, Keskin M, Önder A, Aycan Z. Vitamin D Deficiency/Insufficiency in Children and Adolescents with Chronic Disease. Türkiye Çocuk Hast Derg. 2016;10(4):259-64.


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