1- Serviço de Pediatria, Hospital Distrital de Santarém, EPE, Santarém; 2- Unidade de Endocrinologia Pediátrica, Área Departamental de Pediatria Médica, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Lisboa
Reunião internacional – 9th Joint Meeting of Paediatric Endocrinology. Milão – Itália. 19-22.09.2013
Background: Recent studies from Europe and America, suggest that low plasma vitamin D may be involved in the pathogenesis of type 1 diabetes (T1D). Vitamin D is thought to have both direct and indirect effects on various mechanisms related to pathophysiology of diabetes, including pancreatic cell dysfunction, impaired insulin action and systemic inflammation.
Objective: To assess 25OHD status in a group of patients with newly-onset T1D, comparing it to a group of healthy controls; to evaluate the influence of 25OHD levels on disease presentation.
Methods: Longitudinal retrospective case-control study. Clinical and laboratorial characterization of 34 T1D patients at disease onset. Determination of 25OHD levels in 34 T1D and 14 healthy controls from the same area.
Results: Patients were predominantly male (21/34); median age was 8 years. The majority of patients had inadequate 25OHD levels: insufficiency (21-29ng/ml) (48,5%) and deficiency (≤20ng/ml) (12,1%). Although 25OHD levels were lower in males, as previously reported, the difference was not significant. There was no correlation between 25OHD levels and patient characteristics (age, body mass index), disease presentation (form of presentation, season of the year, HbA1C, C-peptide). Mean levels of 25OHD were lower in patients comparatively to controls (29,9ng/ml vs 44,59ng/ml), but the difference was not statistically significant.
Conclusions: The fact that the majority of patients had inadequate 25OHD levels, even though not significantly different from controls, reinforces that awareness to 25OHD status in T1D patients is essential. We believe that screening for 25OHD insufficiency is mandatory at disease onset, and supplementation is to be considered.