Department of Women's and Children's Health, G. Salesi Hospital, 60123 Ancona, Italy.
Department of Pediatrics, Marche Polytechnic University, 60100 Ancona, Italy.
Nutrients. 2024 Mar 5;16(5):743. doi: 10.3390/nu16050743.
The aim of this work is to assess the vitamin D levels, evaluated as plasma 25-hydroxyvitamin D of children with a new diagnosis of celiac disease (CD), of children with a new onset of type 1 diabetes (T1D) and in children with CD at diagnosis of T1D (T1D&CD).
In this single-center observational study, we collected data for four groups of children and adolescents: T1D, CD, T1D&CD, and a control group (CG). The CG included schoolchildren who had negative results during a mass screening campaign for CD and were not diagnosed for T1D, according to RIDI Marche registry data, were considered for the purposes of this study. Plasma 25-hydroxyvitamin D, 25(OH)D, and 25(OH)D were considered as the parameters for evaluating vitamin D nutritional status, and the date of measurement was recorded to analyze vitamin D level seasonality. Vitamin D nutritional status was categorized as follows: severe deficiency (<10 ng/mL), deficiency (<20 ng/mL), insufficiency (20-29 ng/mL), or sufficiency/adequacy (≥30 ng/mL). The Kruskal-Wallis test was used to compare the groups. The association of 25(OH)D levels with health conditions and seasonal differences of 25(OH)D levels was analyzed using a multiple linear regression model.
The number of children enrolled for the present study was 393: 131 in the CG, 131 CD, 109 T1D, and 22 T1D&CD. Significantly lower levels of vitamin D were displayed for children with CD, T1D, or both the diseases. Interestingly, severe vitamin D deficiency was detected in no children with CD, 1.5% of children in the CG, in 24.4% with T1D, and 31.8% with T1D&CD ( < 0.001). As expected, the CG children vitamin D levels were significantly influenced by seasonality. Contrarily, no seasonal differences were reported in children with CD, T1D, and T1D&CD. Multiple regression analysis showed that children with T1D and T1D&CD had lower 25(OH)D levels of 9.9 ng/mL (95% CI: 5.4; 14.5) and 14.4 ng/mL (95% CI: 6.2-22.7) compared to CG children ( < 0.001).
Our results showed low levels of vitamin D diagnosis of T1D, CD, and T1D&CD; however, severe deficiency was only reported in children with T1D and T1D&CD. More studies are needed to better understand the role of this deficiency in children newly diagnosed with CD and T1D.
本研究旨在评估新诊断为乳糜泻（CD）、1 型糖尿病（T1D）和同时患有 CD 和 T1D（T1D&CD）的儿童的维生素 D 水平，以血浆 25-羟维生素 D 来评估。
在这项单中心观察性研究中，我们收集了四组儿童和青少年的数据：T1D、CD、T1D&CD 和对照组（CG）。CG 组包括在 CD 大规模筛查活动中结果为阴性且根据 RIDI 马尔凯登记数据未被诊断为 T1D 的学龄儿童，这些儿童被认为是本研究的目的。血浆 25-羟维生素 D、25（OH）D 和 25（OH）D 被视为评估维生素 D 营养状况的参数，并记录测量日期以分析维生素 D 水平的季节性。维生素 D 营养状况分为以下几类：严重缺乏（<10ng/ml）、缺乏（<20ng/ml）、不足（20-29ng/ml）或充足/适当（≥30ng/ml）。采用 Kruskal-Wallis 检验比较各组。采用多元线性回归模型分析 25（OH）D 水平与健康状况的关系以及 25（OH）D 水平的季节性差异。
本研究共纳入 393 名儿童：CG 组 131 名，CD 组 131 名，T1D 组 109 名，T1D&CD 组 22 名。与 CD、T1D 或两种疾病的儿童相比，维生素 D 水平显著较低。有趣的是，CD 组儿童没有严重维生素 D 缺乏，CG 组儿童为 1.5%，T1D 组儿童为 24.4%，T1D&CD 组儿童为 31.8%（<0.001）。正如预期的那样，CG 组儿童的维生素 D 水平受到季节性的显著影响。相反，CD、T1D 和 T1D&CD 组的儿童没有报告季节性差异。多元回归分析显示，与 CG 组儿童相比，T1D 和 T1D&CD 组儿童的 25（OH）D 水平分别低 9.9ng/ml（95%CI：5.4；14.5）和 14.4ng/ml（95%CI：6.2-22.7）（<0.001）。
我们的研究结果显示，新诊断为 T1D、CD 和 T1D&CD 的儿童维生素 D 水平较低；然而，只有 T1D 和 T1D&CD 组的儿童有严重缺乏。需要进一步研究以更好地了解这种缺乏在新诊断为 CD 和 T1D 的儿童中的作用。
