TRAJECTORIES OF SERUM 25(OH)D IN CHILDREN WITH PARALYTIC SYNDROMES WHEN USING VITAMIN D FROM DIFFERENT MANUFACTURERS AND IN DIFFERENT DOSES

O. Riga, O. Mikhaylova
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Abstract

The prevalence of vitamin D deficiency and insufficiency varies significantly in different subpopulations of children depending on age and diseases, and recommendations for their correction in children with paralytic syndromes are limited.Aim. Empirical determination of blood 25(OH)D trajectory in children with paralytic syndromes when using vitamin D from different manufacturers and in different doses.Material and methods. The 25(OH)D (ng/ml) of blood serum was analyzed by immune-enzymatic method "Labline-90" (Austria) with the test system "Monobind Inc." (ELISA, USA) in 77 children with paralytic syndromes aged 1-18 years, a repeat study after vitamin D3 supplementation was conducted in 36 children. The rate of increase in 25(OH)D concentration per month was calculated. Methods of descriptive statistics, non-parametric correlation analysis and Kaplan-Meier survival analysis were used with MedCalc Statistical Software (Belgium).This study was approved by the Ethics Committee (protocol No. 5, October 2021), which was conducted with the involvement of minor patients and did not contain measures that could harm their health.The research was carried out within the framework of the Department of Pediatrics of Kharkiv National Medical University "Medical and social aspects of adaptation of children with somatic pathology in modern conditions" (state registration number 0120U102471, 2020).Results. Vitamin D insufficiency was diagnosed in 17% of children with paralytic syndromes, and vitamin D deficiency in 73%, so daily doses of 2000-4000 IU of vitamin D3 from different manufacturers were recommended at the discretion of the parents for 6 months. In reality, children received doses from 500 to 5000 IU randomly, from 2 to 7 months. Doses were stratified as greater than 2000 IU and less than 2000 IU. If the child received a dose of 2000 IU or more, the rate of increase of 25(OH)D in the blood in children was 3.6 ng/ml per month, if the dose was less than 2000 IU - 1.6 ng/ml per month.Conclusions. Children with paralytic syndromes should be screened and monitored for serum 25(OH)D levels. With a serum 25(OH)D level of less than 20 ng/ml, daily administration of vitamin D3 in a dose of at least 2000 IU for at least 6 months allows reaching a 25(OH)D level of 30 ng/ml in most of them. Further large-scale studies are needed to supplement current recommendations for vitamin D3 supplementation in children with paralytic syndromes.
使用不同厂家和不同剂量的维生素d对麻痹综合征儿童血清25(oh) d的影响轨迹
维生素D缺乏和不足的患病率在不同的儿童亚群中因年龄和疾病而有显著差异,对麻痹综合征儿童的纠正建议是有限的。不同厂家不同剂量维生素D对麻痹综合征患儿血25(OH)D轨迹的影响材料和方法。血清25(OH)D (ng/ml)采用奥地利Labline-90免疫酶法,检测系统为“Monobind Inc.”。(ELISA, USA)对77例1-18岁麻痹综合征患儿,在补充维生素D3后对36例患儿进行重复研究。计算每月25(OH)D浓度的增加速率。采用比利时MedCalc统计软件进行描述性统计、非参数相关分析和Kaplan-Meier生存分析。这项研究得到了伦理委员会的批准(2021年10月第5号议定书),该研究是在未成年患者参与的情况下进行的,不包含可能损害其健康的措施。该研究是在哈尔科夫国立医科大学儿科学系“现代条件下躯体病理儿童适应的医学和社会方面”(国家登记号码0120U102471, 2020)的框架内进行的。患有麻痹综合征的儿童中有17%被诊断为维生素D不足,73%被诊断为维生素D缺乏症,因此,根据父母的判断,建议在6个月内每天服用2000-4000国际单位的不同制造商的维生素D3。实际上,儿童在2到7个月期间随机接受500到5000国际单位的剂量。剂量分为大于2000 IU和小于2000 IU。如果儿童接受2000国际单位或更高的剂量,儿童血液中25(OH)D的增加速率为每月3.6纳克/毫升,如果剂量低于2000国际单位- 1.6纳克/毫升。小儿麻痹综合征应筛选和监测血清25(OH)D水平。在血清25(OH)D水平低于20 ng/ml的情况下,每天服用至少2000 IU的维生素D3至少6个月,大多数患者的25(OH)D水平可以达到30 ng/ml。需要进一步的大规模研究来补充目前对麻痹综合征儿童补充维生素D3的建议。
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