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

Abstract

Background: Vitamin D has a role in the pathogenesis of many medical disorders, especially those of the central nervous system. It is essential in maintaining the bone health of children. However, patients with epilepsy are at high risk of developing vitamin D deficiency due to antiseizure medications (ASMs). Therefore, we aimed to assess the prevalence of vitamin D deficiency and related risk factors in children with epilepsy. Methods: This is the baseline report of a pragmatic, randomized, controlled, open-label trial that assessed the impact of vitamin D supplementation in preventing vitamin D deficiency (NCT03536845). We included children with epilepsy aged 2–16 years who were treated with ASMs from December 2017 to March 2021. Children with preexisting vitamin D metabolism problems, vitamin-D-dependent rickets, malabsorption syndromes, renal disease, and hepatic disease were excluded. The baseline demographic data, anthropometric measurements, seizure types, epilepsy syndromes, ASMs, and seizure control measures were recorded. Blood tests for vitamin D (25-hydroxyvitamin D [25(OH)D), serum calcium, serum phosphorus, and parathyroid hormone levels were performed. Based on vitamin D concentration, patients were categorized as deficient (<50 nmol/L), insufficient (74.9–50 nmol/L), or normal (>75 nmol/L). Results: Of 159 recruited children, 108 (67.92%) had generalized seizures, 44 (27.67%) had focal seizures, and 7 (4.4%) had unknown onset seizures. The number of children receiving monotherapy was 128 (79.0%) and 31 (19.1%) children were receiving polytherapy. The mean vitamin D concentration was 60.24 ± 32.36 nmol/L; 72 patients (45.28%) had vitamin D deficiency and 45 (28.3%) had vitamin D insufficiency. No significant difference in vitamin D concentration was observed between children receiving monotherapy and those receiving polytherapy. The main risk factors of vitamin D deficiency were obesity and receiving enzyme-inducer ASMs. Conclusions: The prevalence of vitamin D deficiency was high among children with epilepsy. Obese children with epilepsy and those on enzyme-inducer ASMs were at increased risk for vitamin D deficiency. Further studies are needed to establish strategies to prevent vitamin D deficiency.

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“…One of the most common diseases associated with vitamin D is bone diseases such as rickets in children and osteoporosis in adults [12]. Vitamin D deficiency has spread widely in many countries and it is considered a common epidemic because it affects about one billion people in the world [13], and for this reason, it is a source of concern for health and international organizations, especially through early stages of human growth of including infancy stage, followed by the childhood, and finally the stage adolescence [14,15]. Despite Saudi Arabia being one of the countries that enjoy exposure to the sunshine most days of the year, as exposure to sunlight is an essential source for obtaining vitamin D [16], it was found the prevalence of vitamin D deficiency among the population was more than 80%, this result, according to a recent study conducted In Saudi Arabia [17,18].…”

Comparison of 25-hydroxy vitamin D serum levels among children with epilepsy in therapy with single versus multiple antiseizure medications

“…Epilepsy is a major paediatric neurological health problem in Indonesia, with 103 new cases at Dr Soetomo General Academic Hospital in 2013 [1] , [2] , [3] , [4] . The long-term administration of antiseizure medications (ASMs) requires monitoring their side effects, one of which is a decreased serum vitamin D level [5] , [6] , [7] . Some children with epilepsy have been administered multiple ASMs to reduce the frequency of convulsions.…”