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. 2015:2015:896758.
doi: 10.1155/2015/896758. Epub 2015 Jan 20.

Determinants of vitamin d levels in children and adolescents with down syndrome

Stefano Stagi  1 , Elisabetta Lapi  2 , Silvia Romano  2 , Sara Bargiacchi  2 , Alice Brambilla  1 , Sabrina Giglio  2 , Salvatore Seminara  1 , Maurizio de Martino  1
Affiliations

Determinants of vitamin d levels in children and adolescents with down syndrome

Stefano Stagi et al. Int J Endocrinol. 2015.

Abstract

Background. Poor studies have evaluated 25-hydroxycholecalciferol (25(OH)D) levels in Down syndrome (DS). Objective. To assess in DS subjects serum 25(OH)D value, to identify risk factors for vitamin D deficiency, and to evaluate whether a normal 25(OH)D value can be restored with a 400 I.U. daily supplement of cholecalciferol in respect to controls. Methods. We have longitudinally evaluated 31 DS patients (aged 4.5-18.9 years old) and 99 age- and sex-matched healthy controls. In these subjects, we analysed calcium, phosphate, parathyroid hormone (PTH), 25(OH)D concentrations, and calcium and 25(OH)D dietary intakes, and we quantified outdoor exposure. After 12.3 months (range 8.1-14.7 months) of 25(OH)D supplementation, we reevaluated these subjects. Results. DS subjects showed reduced 25(OH)D levels compared to controls (P < 0.0001), in particular DS subjects with obesity (P < 0.05) and autoimmune diseases history (P < 0.005). PTH levels were significantly higher in DS subjects than controls (P < 0.0001). After cholecalciferol supplementation, 25(OH)D levels were significantly ameliorated (P < 0.05), even if reduced compared to controls (P < 0.0001), in particular in DS subjects with obesity (P < 0.05) and autoimmune diseases (P < 0.001). Conclusions. Hypovitaminosis D is very frequent in DS subjects, in particular in presence of obesity and autoimmune diseases. In these subjects, there could be a need for higher cholecalciferol supplementation.

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Figures

Figure 1
Figure 1
25(OH)D levels (ng/mL) at cross-sectional (a) and longitudinal (b) evaluation in patients with Down syndrome and controls. * P < 0.05; ** P < 0.005; *** P < 0.001.
Figure 2
Figure 2
25(OH)D levels (ng/mL) at cross-sectional (a) and longitudinal (b) evaluation in patients with Down syndrome and obesity and normal weight. * P < 0.05; ** P < 0.005; *** P < 0.001.
Figure 3
Figure 3
25(OH)D levels (ng/mL) at cross-sectional (a) and longitudinal (b) evaluation in patients with Down syndrome with and without autoimmune diseases. * P < 0.05; ** P < 0.005; *** P < 0.001.
Figure 4
Figure 4
25(OH)D levels (ng/mL) at cross-sectional evaluation in patients with Down syndrome and controls in different seasons. * P < 0.05; ** P < 0.005; *** P < 0.001.
Figure 5
Figure 5
Parathyroid hormone levels (ng/mL) at cross-sectional (a) and longitudinal (b) evaluation in patients with Down syndrome and controls. * P < 0.05; ** P < 0.005; *** P < 0.001.
See this image and copyright information in PMC

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