Hypovitaminosis D and risk factors in pediatric epilepsy children

Abstract

Background Anti-seizure medication (ASM) treatment is one of the significant risk factors associated with abnormal vitamin D status in epilepsy patients. Multiple studies have shown that adult epilepsy patients can exhibit vitamin D deficiency. However, there are few reports investigating pediatric epilepsy patients. In this study, we aimed to identify risk factors related to hypovitaminosis D in pediatric epilepsy patients in Thailand. Methods A cross-sectional retrospective cohort study was conducted in 138 pediatric epilepsy patients who received anticonvulsants from April 2018 to January 2019. Demographic data, seizure types, puberty status, physical activity, duration, and types of anti-seizure medications were analyzed. Patients with abnormal liver function, abnormal renal function, and who received vitamin D supplements or ketogenic diet containing vitamin D were excluded. Levels of serum vitamin D (25(OH)D) were measured. Results All 138 subjects were enrolled, the age ranged from 1.04 – 19.96 years; (mean = 9.65 ± 5.09), the mean serum 25(OH) D level was 26.56 ± 9.67 ng/ml. The prevalence of vitamin D deficiency was 23.2% and insufficiency was 47.8% respectively. Two risk factors—puberty status (OR 5.43, 95% CI 1.879-15.67) and non-enzyme-inhibiting ASMs therapy (OR 3.58, 95% CI 1.117-11.46)—were significantly associated with hypovitaminosis D, as shown by multivariate analyses. Conclusions Our study reports the high prevalence of hypovitaminosis D in pediatric epilepsy patients in Thailand despite being located in the tropical zone. These findings can guide clinicians to measure vitamin D status in pediatric epilepsy patients particularly when they reach puberty and/or are using non-enzyme-inhibiting ASMs therapy. Early detection of vitamin D status and prompt vitamin D supplementation can prevent fractures and osteoporosis later in life. Trial registration TCTR20210215005 (http://www.clinicaltrials.in.th/).

Association between serum vitamin D status and the anti-seizure treatment in Chinese children with epilepsy

“…In this retrospective study, age, sex, BW, and seasonality became the various determinants. There was an obvious negative association between the serum 25-OH-VitD levels and age in both case and cohort groups ( Supplementary Figure 1 ), which was in line with results from previous reports ( 31 , 33 , 34 ). Of note, significant decline in serum 25-OH-VitD levels was observed in adolescents among both groups of study subjects.…”

“…For healthy controls, geographical location and socio-economic status of Nanjing might play potential roles in the sufficient serum 25-OH-VitD levels ( Figure 2A , 83%). To our knowledge, this is the largest study to date assessing VitD status in children with epilepsy ( n = 648) on long-term ASMs therapy ( 18 , 31 , 32 ). Even more rarely, this is also a comparative study that simultaneously enrolled the largest number of healthy children ( n = 6,338) ( 15 , 29 ).…”

Prevalence and Related Risk Factors of Vitamin D Deficiency in Saudi Children with Epilepsy

“…Our cohort’s vitamin D deficiency status is relatively higher than what has been reported in other studies [ 12 , 23 , 24 , 25 ]. The prevalence of vitamin D deficiency among adults with epilepsy was 67.3% in a previous study [ 26 ].…”

Updates on Sturge-Weber Syndrome

“…Vitamin D deficiency and insufficiency is common in pediatric epilepsy patients taking seizure medications. 72,73 However, as Vitamin D deficiency has also been associated with endothelial dysfunction, 74 regulation of inflammatory processes, and nerve health, 75 vitamin D has been suggested to be a useful therapeutic method for patients with SWS. 71 Further in vivo and in vitro studies are needed to establish causal relationship.…”