Vitamin D Deficiency in Preschool Children with Down Syndrome

Abstract

Vitamin D is a fat-soluble secosteroid prohormone that is produced on the skin by contact with sunlight. Through various metabolic changes in the body, it transforms into a hormone known as calcitriol, with a key role in the calcium and phosphate metabolism (1). Vitamin D serves plenty of functions in the body. Therefore, its deficiency may cause musculoskeletal symptoms such as bone pain, muscle weakness, gait difficulty, skeletal deformity, in addition to extraskeletal symptoms such as autoimmune diseases, cardiovascular diseases, and neuropsychiatric diseases (2). Down Syndrome occurs as a result of trisomy, which occurs due to an extra copy of the whole or part of the long arm of chromosome 21 and is the most commonly known cause of delay in development. DS affects 1 in every 787 liveborn babies (3). DS is often accompanied by distinctive craniofacial features, congenital heart disease and immune, musculoskeletal and endocrine system abnormalities (4,5). In patients with this syndrome, various environmental and hormonal factors such as hypotonia, low physical activity, poor calcium and vitamin D intake, intrauterine growth restriction, hypogonadism and thyroid dysfunction may contribute to bone mass and quality (6,7). Among all the others, vitamin D may have a crucial role in the health of these people. Vitamin D levels differ with many factors, including exposure to sunlight, dietary intake, and supplement use (8,9). There is a lack of scientific evidence on the prevalence and severity of vitamin D deficiency in children with DS. Hence, this study aimed to determine vitamin D deficiency in children with DS, from infancy to toddler and particularly during the preschool period, and to raise awareness on the matter.

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“…According to the preliminary results of our VD study, the DS group had a higher level of VD insufficient amounts compared to the controls. This result is consistent with a prior investigation that revealed a substantial prevalence of VD deficiency in Down syndrome children [16,17,19,20]. According to study by Stagi et al, there is a very high frequency of VD insufficiency in DS children, with a mean VD level of 14.34 ± 8.31 [21].…”

“…This study demonstrated a significant difference in age, BMI, milk intake, sun exposure, and meat consumption between the DS and control groups stratified by VD categories. A study in Turkey demonstrated that the VD levels significantly down from infancy until preschool in DS children [19]. Meat consumption status in children with Down syndrome is also linked to numerous nutritional issues.…”

“…Meanwhile, the differences in sun exposure between the groups are contrary to those in another study [25] that demonstrated no differences in the DS than control groups. The low sun exposure in DS children could be due to hypotonia and developmental delay [19].…”