维生素D缺乏症在波兰新诊断的1型糖尿病儿童中很常见。

Karolina Maria Klenczar-Kciuk, Sebastian Seget, Piotr Adamczyk, Przemysława Jarosz-Chobot
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引用次数: 0

摘要

近年来,儿科人群中T1DM(1型糖尿病)和其他自身免疫性疾病的患病率不断上升。本研究的目的是评估新诊断的T1DM儿童的维生素D水平,同时考虑到最常见的自身免疫性疾病。材料与方法:数据库纳入2020 - 2021年诊断为T1DM的361例患者,平均年龄9.27±4.1岁,男童189例。回顾性分析常规检查的生理性数据和生化结果:入院时血pH值和碳酸氢盐(HCO3-)、糖化血红蛋白(HbA1c)、抗谷氨酸脱羧酶(GAD)抗体、抗酪氨酸磷酸酶(IA2)抗体、抗锌转运蛋白(ZnT8)抗体、25(OH)D抗体、抗IgA组织转谷氨酰胺酶抗体(TTG-IgA)、总IgA抗体、抗甲状腺过氧化物酶(TPOAb)抗体和抗甲状腺球蛋白(TgAb)抗体水平。结果:T1D患儿中35.5% (n = 128)存在25(OH)D缺乏症(< 20 ng/mL), 37% (n = 134)存在亚理想水平(20 ~ 30 ng/mL), 25% (n = 90)存在理想水平(30 ~ 50 ng/mL)。25(OH)D值与糖尿病酮症酸中毒严重程度成反比(p < 0.01),与HbA1c值呈负相关(p < 0.05)。25(OH)D水平也与儿童诊断年龄呈负相关(p < 0.001)。统计分析显示25(OH)D值与体重指数(BMI) Z-score或T1D典型抗体类型无相关性。在有其他自身免疫过程(甲状腺过氧化物酶抗体和/或甲状腺球蛋白抗体和组织转谷氨酰胺酶抗体)的患者中,维生素D水平也没有统计学上的显著差异。结论:波兰超过三分之一的新诊断T1D患儿存在25(OH)D缺乏症,尤其是糖尿病诊断时伴有糖尿病酮症酸中毒(DKA)的患者。维生素D水平的测定应作为新诊断T1DM儿童的常规程序。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Vitamin D deficiency is common among Polish children with newly diagnosed type 1 diabetes mellitus.

Introduction: In recent years, the prevalence of T1DM (type 1 diabetes mellitus) and other autoimmune diseases in the paediatric population has been increasing. The aim of this study was to evaluate vitamin D levels among children with newly diagnosed T1DM, taking into account the most common coexisting autoimmune conditions.

Material and methods: The database included 361 patients diagnosed with T1DM between 2020 and 2021, with a mean age of 9.27 ± 4.1 years, 189 boys. Auxological data and biochemical results of routinely performed tests were retrospectively analysed: blood pH and bicarbonate (HCO3-) on gasometry on admission, glycated haemoglobin (HbA1c), levels of antibodies against glutamic acid decarboxylase (GAD), antibodies against tyrosine phosphatase (IA2), antibodies against zinc transporters (ZnT8), 25-hydroxy vitamin D (25(OH)D), anti-IgA tissue transglutaminase antibodies (TTG-IgA), total IgA, levels of antibodies against thyroperoxidase (TPOAb), and antibodies against thyroglobulin (TgAb).

Results: 35.5% of children (n = 128) with T1D presented 25(OH)D deficiency (< 20 ng/mL), 37% (n = 134) had suboptimal levels (20-30 ng/mL), and 25% (n = 90) had optimal vitamin D levels (30-50 ng/mL). 25(OH)D values were inversely proportional to the severity of diabetic ketoacidosis (p < 0.01) and negatively correlated with HbA1c values (p < 0.05). 25(OH)D levels were also found to be negatively correlated with children's age at diagnosis (p < 0.001). Statistical analysis showed no association between 25(OH)D value and body mass index (BMI) Z-score or type of antibodies typical of T1D. There was also no statistically significant difference in vitamin D levels among patients with additional autoimmune processes (antibodies to thyroperoxidase and/or thyroglobulin and antibodies to tissue transglutaminase).

Conclusions: More than one-third of Polish children with newly diagnosed T1D have 25(OH)D deficiency, especially in patients with diabetic ketoacidosis (DKA) at the diagnosis of diabetes. Determination of vitamin D levels should be a routine procedure in children with newly diagnosed T1DM.

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