Incidence of vitamin D deficiency in pediatric neurology outpatient department of a tertiary care hospital

Authors

  • Purva Keni Karnavat Department of Pediatrics, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India
  • Anaita Udwadia Hegde Department of Pediatrics, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India
  • Fazal Nabi Department of Pediatrics, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20181209

Keywords:

Pediatric neurology, Vitamin D deficiency

Abstract

Background: Pediatric neurology outpatient populations are a vulnerable subgroup for vitamin D deficiency. The aim was to study the incidence of vitamin D deficiency in pediatric neurology patients by studying relevant biochemical profile and to assess the contributory factors for the same.

Methods: A hospital based cross sectional study was conducted at a tertiary care setup in Mumbai between 2011 and 2012. A total of 284 children aged 0.5-18 years, attending pediatric neurology OPD were enrolled. Statistical analysis was carried out with SPSS version 17.0 and included descriptive statistics; Chi squared and unpaired t-tests to investigate significance of proposed predictors for vitamin D status.

Results: 89.1% of the children were deficient in vitamin D levels (≤30 ng/ml); out of these 11% were severely deficient. Factors significantly associated with vitamin D deficiency were increasing age (p=0.034), absence of intake of calcium supplements (p=0.00) and upper socio-economic class (p=0.001). Low serum calcium levels (p=0.01) and high PTH levels (p=0.00) were associated significantly. Prevalence was similar in children with higher BMI as compared to lower BMI. Duration of AEDs rather than number of drugs was more associated with deficiency.

Conclusions: A high prevalence of vitamin D inadequacy in noted in pediatric neurology patients.

Author Biographies

Anaita Udwadia Hegde, Department of Pediatrics, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India

Consultant Pediatric Neurologist

Fazal Nabi, Department of Pediatrics, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India

Consultant Pediatrician and Intensivist

References

Harinarayan CV, Joshi SR. Vitamin D status in India-Its implications and Remedial Measures. J Assoc Physicians India 2009;57:40-8.

Dietary guidelines for Indian a manual drafted by NIN 2011.

Hollick MF. Vitamin D deficiency. N Engl J Med 2007; 357:266-81.

Borkar VV, Devidayal, Verma S, Bhalla AK. Low levels of vitamin D in North Indian children with newly diagnosed type 1 diabetes. Pediatr Diabetes. 2010;11(5):345-50.

Shellhas RA, Joshi SM. Vitamin D and bone health among children with epilepsy. Paediatric neurology 2010;42(6):385-9.

Harinarayan. Prevalence of VDD in children - Tirupati, South India. IJMR. 2008.

Sahu M, Bhatia V, Aggarwal A, Rawat V, Saxena P, Pandey A, et al. Vitamin D deficiency in rural girls and pregnant women despite abundant sunshine in northern India. Clin Endocrinol (Oxf) 2009;70(5):680–4.

Marwaha RK, Tandon N, Reddy DR, Aggarwal R, Singh R, Sawhney RC, et al. Vitamin D and bone mineral density status of healthy schoolchildren in northern India. Am J Clin Nutr. 2005;82(2);477-82.

Absoud M, Cummins C, Lim MJ, Wassmer E, Shaw N. Prevalence and Predictors of Vitamin D Insufficiency in Children: A Great Britain Population Based Study. PLoS ONE. 2011;6(7):e22179.

Calvo MS. Vitamin D Intake: A Global Perspective of Current Status. J Nutr. 2005;135:310–6.

Goswami R, Kochupillai N, Gupta N, Goswami D, Singh N, Dudha A. Presence of 25(OH) D deficiency in a rural North Indian village despite abundant sunshine. J Assoc Physicians India. 2008;56:755-7.

Arya V, Bhambri R, Godbole MM, Mithal A. Vitamin D status and its relationship with bone mineral density in healthy Asian Indians. Osteoporos Int. 2004;15:56-61.

Gilbert-Diamond D, Baylin A, Mora-Plazas M, Marin C, Arsenault JE, Hughes MD, et al. Vitamin D deficiency and anthropometric indicators of adiposity in school-age children: A prospective study. Am J Clin Nutr. 2010;92:1446.

Khor GL, Chee WS, Shariff ZM, Poh BK, Arumugam M, Rahman JA, et al. High prevalence of vitamin D insufficiency and its association with BMI-for-age among primary school children in Kuala Lumpur, Malaysia. BMC Public Health. 2011;11:95.

Gordon CM, DePeter KC, Feldman HA, Grace E, Emans SJ. Prevalence of vitamin D deficiency among healthy adolescents. Arch Pediatr Adolesc Med. 2004;158:531-7.

Rockell JE, Green TJ, Skeaff CM, Whiting SJ, Taylor RW, Williams SM, et al. Season and ethnicity are determinants of serum 25-hydroxyvitamin D concentrations in New Zealand children aged 5-14 y. J Nutr. 2005;135:2602-8.

Holick, Michael F. Vitamin D deficiency in obesity and health consequences Current Opinion in Endocrinology & Diabetes. 2006;13(5):412-8.

Kumar N, Gupta N, Kishore J. Kuppuswamy's socioeconomic scale: Updating income ranges for the year 2012. Indian J Public Health. 2012;56:103-4.

Chittari HV, Joshi S. Vitamin D Status of Upper Socioeconomic Status Subjects of South Indians Living in High Altitude (Bengaluru) Endocr Rev, 2012.

Spinks A, Macpherson A, Bain C, McClure R. Determinants of sufficient daily activity in Australian primary school children. J Paediatr Child Health. 2006;42:674–9.

Salmon J, Timperio A, Cleland V, Venn A. Trend’s in children’s physical activity and weight status in high and low socio-economic status areas of Melbourne, Victoria, 1985–2001. Australian New Zealand J Public Health. 2005;29(4):337–42.

Greenway A, Zacharin M. Vitamin D status of chronically ill or disabled children in Victoria. J Paediatr Child Health. 2003;39(7):543-7.

Sullivan PB, Lambert B, Rose M, Ford-Adams M, Johnson A, Griffiths P. Prevalence and severity of feeding and nutritional problems in children with neurological impairment: Oxford feeding study. Dev Med Child Neurol. 2000;42:674-80.

Nicolaidou P, Georgouli H, Kotsalis H, Matsinos Y, Papadopoulou A, Fretzayas A, et al. Effects of Anticonvulsant Therapy on Vitamin D Status in Children: Prospective Monitoring Study J Child Neurol. 2006;21:205-10.

Alison M. Pack. The Association Between Antiepilepticc Drugs and Bone Disease Epilepsy Curr. 2003;3(3):91–5.

Aggarwal V, Seth A, Marwaha RK, Sharma B, Sonkar P, Singh S, et al. Management of Nutritional Rickets in Indian Children: A Randomized Controlled Trial. J Trop Pediatr. 2013;59(2):127-33.

Murthy J. Antiepileptic drugs and bone health: Dietary calcium and vitamin D-the confounding factors. Neurol India. 2010;58:175-6.

Steven A. Abrams, Ian J. Griffin, Keli M. Hawthorne, Sheila K. Gunn, Caren M. Gundberg, Thomas O. Carpenter Relationships among Vitamin D Levels, Parathyroid Hormone, and Calcium Absorption in Young Adolescents J Clin Endocrinol Metab. 2005;90(10):5576–81.

Ghada El-Hajj Fuleihan, Mona Nabulsi, Mahmoud Choucair,Mariana Salamoun, Carmen Hajj Shahine, Aline Kizirian, and Raja Tannous Hypovitaminosis D in Healthy Schoolchildren Pediatrics. 2001;107:4-53.

Shaheen S, Noor SS, Barakzai Q. Serum alkaline phosphatase screening for vitamin D deficiency states. J Coll Physicians Surg Pak. 2012;22(7):424-7.

Downloads

Published

2018-03-23

How to Cite

Karnavat, P. K., Hegde, A. U., & Nabi, F. (2018). Incidence of vitamin D deficiency in pediatric neurology outpatient department of a tertiary care hospital. International Journal Of Community Medicine And Public Health, 5(4), 1414–1418. https://doi.org/10.18203/2394-6040.ijcmph20181209

Issue

Section

Original Research Articles