Research Article
Volume 11 Issue 8 - 2022
Estimation and Comparison of Vitamin D Levels and its Interactions in Children with and without Cerebral Palsy
Akshay Jadhav1*, Sajitha Nair2, Sasidharan Ponthenkandath3 and R Sundaram4
1Consultant Pediatrician and Pediatric Emergency, Belenus Champion Hospital, Bengaluru, KA, IN [Formerly Fellow Paediatric Critical Care Medicine, (Fellow Paediatric Emergency Care, ECMS), Rainbow Children’s Hospital, Marathahalli, Bangalore, India]
2Professor, Department of Paediatrics, AIMS, Kochi, India
3Chair, Paediatrics and Neonatalogy, and Head, Neonatalogy, Dept of Paediatrics, AIMS, Kochi, India (during this Study), [presently Professor of Pediatrics and Founding Chair, SOM Pediatrics, UC Riverside, CA, US]
4Professor and Chair, Department of Biostatistics, AIMS, Kochi, India
*Corresponding Author: Akshay Jadhav, Consultant Pediatrician and Pediatric Emergency, Belenus Champion Hospital, Bengaluru, KA, IN [Formerly Fellow Paediatric Critical Care Medicine, (Fellow Paediatric Emergency Care, ECMS), Rainbow Children’s Hospital, Marathahalli, Bangalore, India].
Received: July 23, 2019; Published: July 29, 2022




Abstract

Background: Cerebral palsy (CP) is a diagnostic term used to describe a group of permanent disorders of movement and posture causing activity limitation that are attributed to non-progressive disturbances in the developing foetal or infant brain. This study was done to assess the levels of vitamin D in children with CP and compare with normal healthy children. We also aimed to describe the risk factors for vitamin D deficiency among children with CP.

Methods: This prospective cross sectional observational study included 50 children with CP in the age group of 2 to 15 years subjecting them for assessment of 25 OH vitamin D levels by CLEA method.

Results: Of total of 50 children with CP, 40 children (80%) had vitamin D levels < 20 ng/ml (deficiency). 10 (20%) children with CP had vitamin D levels between 21-29ng/ml (insufficiency) and none of them had vitamin D levels ≥ 30 ng/ml (sufficiency). A significant co relation was found between monotherapy and polytherapy, presence of dental caries and in children with moderate to severe CP. The levels of vitamin D decreased as the duration of antiepileptic drug (AEDs) usage increased. Severe Vitamin D deficiency was also significantly more in CP children (p-0.042).

Conclusion: A majority (80%) of the children with CP were vitamin D deficient. The use of more than one antiepileptic drugs for seizure control, moderate to severe CP (based on GMFCS), presence of dental caries were found to be significant risk factors for low Vitamin D levels. Vitamin D deficiency was significantly higher in children with CP when compared to that of age matched healthy children.

Keywords: Vitamin D Deficiency; Cerebral Palsy; Epilepsy; Anti-Epileptic Drugs; Hypovitaminosis D; Dental Caries

References

  1. Rosen MG and Dickinson JC. “The incidence of cerebral palsy”. American Journal of Obstetrics and Gynecology 2 (1992): 417-423.
  2. Gladstone M. “A review of the incidence and prevalence, types and aetiology of childhood cerebral palsy in resource-poor settings”. Annals of Tropical Paediatrics 3 (2010): 181-196.
  3. Harinarayanan CV and Joshi SR. “Vitamin D status in India - Its implications and remedial measures”. Journal of the Association of Physicians of India 57 (2009): 40-48.
  4. Henderson RC., et al. “Bone density and metabolism in children and adolescents with moderate to severe cerebral palsy”. Pediatrics 1 (2002): e5.
  5. “The definition and classification of cerebral palsy”. Developmental Medicine and Child Neurology 49 (2007): 1-44.
  6. Richard C Henderson. “Vitamin D Levels in Non-Institutionalized Children with Cerebral Palsy”. Journal of Child Neurology7 (1997): 443-447.
  7. Ross AC., et al. “The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know”. The Journal of Clinical Endocrinology and Metabolism 1 (2011): 53-58.
  8. Holick MF., et al. “Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline”. The Journal of Clinical Endocrinology and Metabolism7 (2011): 1911-1930.
  9. Finbråten AK., et al. “Bone mineral density and vitamin D status in ambulatory and non-ambulatory children with cerebral palsy”. Osteoporosis International1 (2015): 141-150.
  10. Ware T., et al. “Vitamin d status in tasmanian children with cerebral palsy”. Journal of Paediatrics and Child Health4 (2013): E349-E350.
  11. Ramya S., et al. “A study of vitamin-D status in epileptic children in age group of 2-15 years”. International Journal of Advances in Medicine 2 (2016): 319-323.
  12. Morijiri YU and Sato TA. “Factors causing rickets in institutionalized handicapped children on anticonvulsant therapy”. Archives of Disease in Childhood6 (1981): 446-449.
  13. Shaw NJ., et al. “Osteopenia in cerebral palsy”. Archives of Disease in Childhood3 (1994): 235-238.
  14. Nettekoven S., et al. “Effects of antiepileptic drug therapy on vitamin D status and biochemical markers of bone turnover in children with epilepsy”. European Journal of Pediatrics12 (2008): 1369-1377.
  15. Fong CY and Riney CJ. “Vitamin D deficiency among children with epilepsy in South Queensland”. Journal of Child Neurology 3 (2013): 368-373.
  16. Yousafzai AK., et al. “Feeding difficulties in disabled children leads to malnutrition: experience in an Indian slum”. British Journal of Nutrition6 (2003): 1097-1106.
  17. DE Camargo MA and Antunes JL. “Untreated dental caries in children with cerebral palsy in the Brazilian context”. International Journal of Paediatric Dentistry2 (2008): 131-138.
  18. S Bhatnagar and N Purohit. “Rickets in Cerebral Palsy children”. IJPMR 22 (2011): 17-20.
Citation: Akshay Jadhav., et al. “Estimation and Comparison of Vitamin D Levels and its Interactions in Children with and without Cerebral Palsy”. EC Paediatrics 11.8 (2022): 780-789.

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