Setty-Shah Nithya, Maranda Louise, Nwosu Benjamin Udoka
Department of Pediatrics, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.
Department of Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.
Gastroenterol Res Pract. 2014;2014:561351. doi: 10.1155/2014/561351. Epub 2014 Dec 4.
Background. It is unknown whether the coexistence of type 1 diabetes (T1D) and celiac disease (CD) increases the risk for vitamin D deficiency. Aims. To determine the vitamin D status and the risk for vitamin D deficiency in prepubertal children with both T1D and CD compared to controls, TID, and CD. Subjects and Methods. Characteristics of 62 prepubertal children of age 2-13 y with either CD + T1D (n = 22, 9.9 ± 3.1 y), CD only (n = 18, 8.9 ± 3.3 y), or T1D only (n = 22, 10.1 ± 2.8 y) were compared to 49 controls of the age of 8.0 ± 2.6 years. Vitamin D deficiency was defined as 25(OH)D < 50 nmol/L, overweight as BMI of >85th but <95th percentile, and obesity as BMI > 95th percentile. Results. The 4 groups had no difference in 25(OH)D (ANOVA P = 0.123) before stratification into normal-weight versus overweight/obese subtypes. Following stratification, 25(OH)D differed significantly between the subgroups (F (3,98) = 10.109, ANOVA P < 0.001). Post-hoc analysis showed a significantly lower 25(OH)D in the overweight/obese CD + T1D compared to the overweight/obese controls (P = 0.039) and the overweight/obese CD (P = 0.003). Subjects with CD + T1D were 3 times more likely to be vitamin D deficient (OR = 3.1 [0.8-11.9], P = 0.098), compared to controls. Conclusions. The coexistence of T1D and CD in overweight/obese prepubertal children may be associated with lower vitamin D concentration.
背景。1型糖尿病（T1D）与乳糜泻（CD）并存是否会增加维生素D缺乏风险尚不清楚。目的。确定与对照组、单纯T1D和单纯CD相比，同时患有T1D和CD的青春期前儿童的维生素D状况及维生素D缺乏风险。对象与方法。将62名2至13岁青春期前儿童的特征进行比较，这些儿童分别患有CD + T1D（n = 22，9.9 ± 3.1岁）、单纯CD（n = 18，8.9 ± 3.3岁）或单纯T1D（n = 22，10.1 ± 2.8岁），对照组为49名8.0 ± 2.6岁的儿童。维生素D缺乏定义为25（OH）D < 50 nmol/L，超重定义为BMI处于第85至第95百分位数之间，肥胖定义为BMI > 95百分位数。结果。在按正常体重与超重/肥胖亚型分层之前，4组儿童的25（OH）D无差异（方差分析P = 0.123）。分层后，各亚组之间的25（OH）D有显著差异（F（3,98）= 10.109，方差分析P < 0.001）。事后分析显示，超重/肥胖的CD + T1D儿童的25（OH）D显著低于超重/肥胖对照组（P = 0.039）和超重/肥胖的CD儿童（P = 0.003）。与对照组相比，患有CD + T1D的儿童维生素D缺乏的可能性高出3倍（OR = 3.1 [0.8 - 11.9]，P = 0.098）。结论。超重/肥胖的青春期前儿童中T1D与CD并存可能与较低的维生素D浓度有关。
