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Vitamin D at the onset of type 1 diabetes in Italian children

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Abstract

Low vitamin D levels have been reported in multiple immune disorders such as type 1 diabetes mellitus (T1DM). The purpose of our study was to determine vitamin D levels in children at the onset of T1DM compared with children with other diseases and to test the hypothesis that low vitamin D may increase the odds for developing diabetes. All the children (n = 58) that were consecutively admitted to our clinic at T1DM onset between May 2010 and July 2012 were compared with a control group of children (n = 166) hospitalized for other diseases, matched for sex, season of visit, and age. For each subject, we considered clinical and anthropometric data, the season at time of hospitalization, and serum 25-hydroxyvitamin D (25(OH)D), which were analyzed and compared using multivariable conditional logistic regression. Median 25(OH)D was significantly lower in the diabetic patients (36.2 nmol/l, range = 7.5–121.0 nmol/l) than in controls (48.7 nmol/l, range = 7.5–190.2 nmol/l), p = 0.010. Low 25(OH)D levels seem to increase the odds for developing T1DM (odds ratio (OR) = 3.45 for 25(OH)D 51–74 nmol/l, OR = 5.56 for 25(OH)D ≤ 50 nmol/l). There was no seasonal effect on the risk of developing T1DM. Median 25(OH)D level was significantly lower in patients admitted with diabetic ketoacidosis (30.2 nmol/l, range = 7.5–101.8 nmol/l) than in patients without ketoacidosis (40.7 nmol/l, range = 15.2–121.1 nmol/l), p = 0.019; but when adjusted for season, the p value was 0.116. Conclusions: Children at onset of T1DM have lower vitamin D serum levels than those with other diseases. Further longitudinal studies on children before the onset of T1DM will allow clinicians to explore the causal relationship between vitamin D and T1DM.

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Abbreviations

25(OH)D:

25-hydroxyvitamin D levels

BMI:

body mass index

CI:

confidence interval

GADA:

autoantibodies to glutamic acid decarboxylase

IA-2A:

autoantibodies to tyrosine phosphatase related islet antigen 2

IAA:

autoantibodies to native insulin

ORs:

odds ratios

T1DM:

type 1 diabetes mellitus

ZnT8A:

autoantibodies to zinc transporter 8

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Acknowledgments

We are grateful to Ms Judyth Dillon, a native English-speaking copy editor, for checking the manuscript for the correct language.

Competing interests

The authors declare that they have no conflict of interest and that they have no financial relationships with any organizations that might have an interest in the submitted work.

No external funding has been secured for this study.

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Correspondence to Attilio Loris Boner.

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Franchi, B., Piazza, M., Sandri, M. et al. Vitamin D at the onset of type 1 diabetes in Italian children. Eur J Pediatr 173, 477–482 (2014). https://doi.org/10.1007/s00431-013-2204-3

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