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. 2021 Oct 2;21(1):432.
doi: 10.1186/s12887-021-02906-7.

Hypovitaminosis D and risk factors in pediatric epilepsy children

Napakjira Likasitthananon  1 , Charcrin Nabangchang  1 , Thitiwan Simasathien  1 , Suchavadee Vichutavate  2 , Voraluck Phatarakijnirund  2 , Piradee Suwanpakdee  3
Affiliations

Hypovitaminosis D and risk factors in pediatric epilepsy children

Napakjira Likasitthananon et al. BMC Pediatr. .

Abstract

Background: Anti-seizure medication (ASM) treatment is one of the significant risk factors associated with abnormal vitamin D status in epilepsy patients. Multiple studies have shown that adult epilepsy patients can exhibit vitamin D deficiency. However, there are few reports investigating pediatric epilepsy patients. In this study, we aimed to identify risk factors related to hypovitaminosis D in pediatric epilepsy patients in Thailand.

Methods: A cross-sectional retrospective cohort study was conducted in 138 pediatric epilepsy patients who received anticonvulsants from April 2018 to January 2019. Demographic data, seizure types, puberty status, physical activity, duration, and types of anti-seizure medications were analyzed. Patients with abnormal liver function, abnormal renal function, and who received vitamin D supplements or ketogenic diet containing vitamin D were excluded. Levels of serum vitamin D (25(OH)D) were measured.

Results: All 138 subjects were enrolled, the age ranged from 1.04 - 19.96 years; (mean = 9.65 ± 5.09), the mean serum 25(OH) D level was 26.56 ± 9.67 ng/ml. The prevalence of vitamin D deficiency was 23.2% and insufficiency was 47.8% respectively. Two risk factors-puberty status (OR 5.43, 95% CI 1.879-15.67) and non-enzyme-inhibiting ASMs therapy (OR 3.58, 95% CI 1.117-11.46)-were significantly associated with hypovitaminosis D, as shown by multivariate analyses.

Conclusions: Our study reports the high prevalence of hypovitaminosis D in pediatric epilepsy patients in Thailand despite being located in the tropical zone. These findings can guide clinicians to measure vitamin D status in pediatric epilepsy patients particularly when they reach puberty and/or are using non-enzyme-inhibiting ASMs therapy. Early detection of vitamin D status and prompt vitamin D supplementation can prevent fractures and osteoporosis later in life.

Trial registration: TCTR20210215005 ( http://www.clinicaltrials.in.th/ ).

Keywords: Anti-seizure medications; Hypovitaminosis D; Pediatric epilepsy; vitamin D deficiency.

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Conflict of interest statement

The authors report no competing interests.

Figures

Fig. 1
Fig. 1
The data of age and serum vitamin D (25(OH)D) level showed almost the patients of all age were serum vitamin D less than 30 ng/ml, related with the prevalence of hypovitaminosis D 71%. The older age trend to decrease the level of serum vitamin D
Fig. 2
Fig. 2
Topiramate was compared between 2 groups, one was a low dose (< 5 mg/kg/day) in 17 patients and the other was a high dose (≥ 5 mg/kg/day) in 36 patients. The result was showed the high dose group was more hypovitaminosis D (25(OH) D < 30 ng/ml) than the low dose group, 80.6, and 58.8% respectively
See this image and copyright information in PMC

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