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乳糜泻和 1 型糖尿病诊断时血浆 25-羟维生素 D 水平的差异。

Differences in Plasma 25-Hydroxyvitamin D Levels at Diagnosis of Celiac Disease and Type 1 Diabetes.

机构信息

Department of Women's and Children's Health, G. Salesi Hospital, 60123 Ancona, Italy.

Department of Pediatrics, Marche Polytechnic University, 60100 Ancona, Italy.

出版信息

Nutrients. 2024 Mar 5;16(5):743. doi: 10.3390/nu16050743.

Abstract

AIM

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).

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.

摘要

目的

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。

方法

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。

结果

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)。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cce/10934773/77abdcb55954/nutrients-16-00743-g001.jpg

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