Monagel Dania A, Albaity Amal O, Asiri Fatimah M, Alghamdi Lama N, Alsufyani Raghad A, Alqarni Reem B, Bahatheq Shaden K, Ahmed Omaima, Elimam Naglla, Althubaiti Alaa
College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU.
Research and Development, King Abdullah International Medical Research Center, Jeddah, SAU.
Cureus. 2024 Feb 24;16(2):e54807. doi: 10.7759/cureus.54807. eCollection 2024 Feb.
Background There is a lack of local studies on vitamin D deficiency in children with cancer. This study aims to estimate the prevalence of vitamin D deficiency in the pediatric oncology population at King Abdul-Aziz Medical City (KAMC) in Jeddah, addressing knowledge gaps for improved clinical practice and future research. Methods This retrospective observational study was conducted from 2016 to 2021 at the pediatric oncology clinic in National Guard Hospital, Jeddah. The study focused on children aged 14 or younger at cancer diagnosis, data encompassed patient demographics, cancer details, and treatment information, including serum measurements of vitamin D (25(OH)D, calcium, phosphate, alkaline phosphatase). Vitamin D levels were categorized as deficient (<25 ng/ml), insufficient (25-49 ng/ml), sufficient (≥50- 125 ng/ml), or hypervitaminosis (>125 ng/ml), based on our center reference range and the validation of the assay. Results In this retrospective study of 155 pediatric oncology patients, the majority aged 0 to 10 years (78%), findings reveal a male preponderance (54.2%) and a more prevalent in patients with hematological malignancies (85%). Chemotherapy was administered to 98%, with 7% underwent radiotherapy, and 89% received steroids. Analysis of serum 25-OH vitamin D levels indicated an overall deficiency and insufficiency at diagnosis (63%) and post-therapy (43%). Age and gender had a significant influence on vitamin D levels at diagnosis, with older children and females exhibiting lower concentrations. However, these differences diminished by the end of therapy. Notably, hematological malignancy patients often presented insufficient vitamin D levels, while solid tumor patients frequently had sufficient levels. Clinical outcomes showed a high survival rate (90.7%), limited bone density assessments (18.1%), and a 14.2% prevalence of hypervitaminosis. Conclusion In summary, our study reveals that over two-thirds of pediatric oncology patients experience vitamin D deficiency and insufficiency at the time of diagnosis, particularly notable in females and older children. Notably, those with solid tumors exhibit higher baseline 25-OH vitamin D concentrations compared to counterparts with hematological malignancies. The findings underscore the importance of educating both patients and caregivers on supplementation and sun exposure to mitigate the prevalence of deficient and insufficient vitamin D levels in pediatric oncology cases.
目前缺乏关于癌症患儿维生素D缺乏症的本地研究。本研究旨在估计吉达阿卜杜勒-阿齐兹国王医疗城（KAMC）儿科肿瘤患者中维生素D缺乏症的患病率，填补知识空白，以改善临床实践和未来研究。方法：本回顾性观察研究于2016年至2021年在吉达国民警卫队医院的儿科肿瘤诊所进行。该研究聚焦于癌症诊断时14岁及以下的儿童，数据包括患者人口统计学信息、癌症详情和治疗信息，包括维生素D（25(OH)D）、钙、磷、碱性磷酸酶的血清测量值。根据我们中心的参考范围和检测方法的验证，维生素D水平分为缺乏（<25 ng/ml）、不足（25 - 49 ng/ml）、充足（≥50 - 125 ng/ml）或维生素D过多（>125 ng/ml）。结果：在这项对155名儿科肿瘤患者的回顾性研究中，大多数患者年龄在0至10岁（78%），结果显示男性占优势（54.2%），血液系统恶性肿瘤患者更为常见（85%）。98%的患者接受了化疗，7%的患者接受了放疗，89%的患者接受了类固醇治疗。血清25-OH维生素D水平分析表明，诊断时和治疗后总体存在缺乏和不足（诊断时63%，治疗后43%）。年龄和性别对诊断时的维生素D水平有显著影响，年龄较大的儿童和女性维生素D浓度较低。然而，这些差异在治疗结束时减小。值得注意的是，血液系统恶性肿瘤患者的维生素D水平往往不足，而实体瘤患者的维生素D水平通常充足。临床结果显示生存率较高（90.7%），骨密度评估有限（18.1%），维生素D过多的患病率为14.2%。结论：总之，我们的研究表明，超过三分之二的儿科肿瘤患者在诊断时存在维生素D缺乏和不足，在女性和年龄较大的儿童中尤为明显。值得注意的是，与血液系统恶性肿瘤患者相比，实体瘤患者的基线25-OH维生素D浓度较高。这些发现强调了对患者和护理人员进行补充剂和阳光照射教育的重要性，以降低儿科肿瘤病例中维生素D缺乏和不足的患病率。
