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Vitamin D deficiency linked to sex-specific hypoglycemia frequency, adverse cardiometabolic control
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In children and adolescents with type 1 diabetes, vitamin D deficiency is prevalent and may be linked to the frequency of hypoglycemic episodes and adverse cardiometabolic control in boys, according to study findings.
Adnan Al Shaikh, MD, and Abdullah M. Al Zahrani, both of King Saud bin Abdul Aziz University for Health in Saudi Arabia, evaluated data from 301 children (54% girls; mean age, 14 years; mean diabetes duration, 7.7 years; mean BMI, 21.1 kg/m2; mean HbA1c, 9.6%) who attended King Abdulaziz Medical City-Jeddah from 2010 to 2013 to determine the effect of vitamin D status on glycemic control and cardiometabolic complications.
Compared with boys, girls had a slightly higher BMI (P = .07). No significant differences were found between boys and girls for blood pressure, HbA1c and lipid profile.
Twenty-six percent of all participants had acceptable HbA1c values for glycemic control. Acceptable HbA1c levels were found in 28.6% of toddlers, 15.6% of children and 12.8% of adolescents when stratified by age. Mean 25-hydroxyvitamin D level was 35.1 nmol/L among the whole group but was higher in boys (36.93 nmol/L) vs. girls (33.37 nmol/L; P = .02).
Participants with 25-(OH)D levels up to 35.7 nmol/L had higher BMI (P = .019) and serum triglyceride level (P = .044) compared with participants with serum 25-(OH)D levels greater than 37.5 nmol/L. Sixty-four percent of boys and 68% of girls had vitamin D deficiency. BMI was higher in boys who were vitamin D deficient compared with those who were not (P < .01), and serum triglycerides were higher in girls with vitamin D deficiency compared with girls without vitamin D deficiency (P < .05).
In boys, researchers found an inverse relationship between vitamin D status and frequency of hypoglycemia (P < .01), BMI (P < .05), diastolic BP (P < .05) and triglyceride levels (P < .01) in boys. In girls, there was an inverse relationship between vitamin D status and age (P < .05), age at diabetes diagnosis (P < .01) and triglyceride level (P < .01). No link was found between circulating 25-(OH)D and HbA1c in the whole group (P = .6).
“Metabolic control among Saudi children with [type 1 diabetes] is less satisfactory compared to other countries,” the researchers wrote. “The high prevalence of vitamin D deficiency in this population and its inverse cardiometabolic associations support the recommendation of vitamin D status correction in [type 1 diabetes] subjects. Further studies in a large cohort are needed to confirm our findings.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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