Serum Vitamin D Level in Children with Type 1 diabetes mellitus in Duhok city, Iraq
Type 1 Diabetes Mellitus is an autoimmune disorder that occurs in the Β-cells of pancreatic islets. Vitamin D is essential in maintaining the bone health. It has proven that Vitamin D has an autoimmune disorders including T1DM. Hence, the aim is to detect the prevalence of vitamin D deficiency among children with T1DM. A case control study conducted in Duhok, North of Iraq between 15th of February and 15th of August 2016. 100 enrolled participants aged from 5 to 15 years of both genders were divided in to two groups. Fifty of them had T1DM and 50 children who were healthy and non-diabetic. All participants were studied in terms of age, gender, duration of diabetes, glycemic control (HbA1c) and Body Mass index .Samples of blood were taken to measure serum Vitamin D and HbA1c levels. Mean serum Vitamin D level in diabetic group was 6.068 ±2.45 ng/mL while in the control group it was 21.101 ±9.23 ng/mL. Vitamin D were lower in the diabetic patients than controls (P= 0.01). Vitamin D level was indirectly correlated with duration of diabetes (P=0.01).Level of Vitamin D was decreased with increasing HbA1C (P=0.01). Level of Vitamin D was not significantly related to body mass index. Vitamin D level is not significantly related to body mass index.
Allgrove, J., & Shaw, N. J. (2015). A practical approach to vitamin D deficiency and rickets Calcium and Bone Disorders in Children and Adolescents (Vol. 28, pp. 119-133): Karger Publishers.
Arnson, Y., Amital, H., & Shoenfeld, Y. (2007). Vitamin D and autoimmunity: new aetiological and therapeutic considerations. Annals of the rheumatic diseases, 66(9), 1137-1142.
Association, A. D. (2003). Standards of medical care for patients with diabetes mellitus. Diabetes Care, 26(suppl 1), s33-s50.
Bener, A., Alsaied, A., Al-Ali, M., Al-Kubaisi, A., Basha, B., Abraham, A., et al. (2009). High prevalence of vitamin D deficiency in type 1 diabetes mellitus and healthy children. Acta diabetologica, 46(3), 183.
Bierschenk, L., Alexander, J., Wasserfall, C., Haller, M., Schatz, D., & Atkinson, M. (2009). Vitamin D levels in subjects with and without type 1 diabetes residing in a solar rich environment. Diabetes Care, 32(11), 1977-1979.
Bluestone, J. A., Herold, K., & Eisenbarth, G. (2010). Genetics, pathogenesis and clinical interventions in type 1 diabetes. Nature, 464(7293), 1293.
Borkar, V. V., Devidayal, Verma, S., & Bhalla, A. (2010). Low levels of vitamin D in North Indian children with newly diagnosed type 1 diabetes. Pediatric diabetes, 11(5), 345-350.
Chakhtoura, M., & Azar, S. T. (2013). The role of vitamin d deficiency in the incidence, progression, and complications of type 1 diabetes mellitus. International Journal of Endocrinology, 2013.
Craig, M. E., Hattersley, A., & Donaghue, K. C. (2009). Definition, epidemiology and classification of diabetes in children and adolescents. Pediatric diabetes, 10, 3-12.
Cutolo, M., Pizzorni, C., & Sulli, A. (2011). Vitamin D endocrine system involvement in autoimmune rheumatic diseases. Autoimmunity reviews, 11(2), 84-87.
Dutta, D., Maisnam, I., Shrivastava, A., Sinha, A., Ghosh, S., Mukhopadhyay, P., et al. (2013). Serum vitamin-D predicts insulin resistance in individuals with prediabetes. The Indian journal of medical research, 138(6), 853.
El Baba, K., Zantout, M. S., Akel, R., & Azar, S. T. (2011). Seasonal variation of vitamin D and HbA1c levels in patients with type 1 diabetes mellitus in the Middle East. International journal of general medicine, 4, 635.
Elsayed, A. M., & Mohamed, G. A. (2016). Vitamin D deficiency and its correlation to hemoglobin A1C in adolescent and young adult type 1 diabetes mellitus patients. Al-Azhar Assiut Medical Journal, 14(2), 76.
Emamaullee, J. A., Davis, J., Merani, S., Toso, C., Elliott, J. F., Thiesen, A., et al. (2009). Inhibition of Th17 cells regulates autoimmune diabetes in NOD mice. Diabetes.
Forlenza, G. P., & Rewers, M. (2011). The epidemic of type 1 diabetes: what is it telling us? Current Opinion in Endocrinology, Diabetes and Obesity, 18(4), 248-251.
Greer, R. M., Portelli, S. L., Hung, B. S. M., Cleghorn, G. J., McMahon, S. K., Batch, J. A., et al. (2013). Serum vitamin D levels are lower in Australian children and adolescents with type 1 diabetes than in children without diabetes. Pediatric diabetes, 14(1), 31-41.
Gregori, S., Giarratana, N., Smiroldo, S., Uskokovic, M., & Adorini, L. (2002). A 1α, 25-dihydroxyvitamin D3 analog enhances regulatory T-cells and arrests autoimmune diabetes in NOD mice. Diabetes, 51(5), 1367-1374.
Hamed, E. A., Abu Faddan, N. H., Adb Elhafeez, H. A., & Sayed, D. (2011). Parathormone–25 (OH)‐vitamin D axis and bone status in children and adolescents with type 1 diabetes mellitus. Pediatric diabetes, 12(6), 536-546.
Harinarayan, C. V. (2014). Vitamin D and diabetes mellitus. Hormones, 13(2), 163-181.
Hewison, M. (2011). Vitamin D and innate and adaptive immunity Vitamins & hormones (Vol. 86, pp. 23-62): Elsevier.
Janner, M., Ballinari, P., Mullis, P.-E., & Flück, C. (2010). High prevalence of vitamin D deficiency in children and adolescents with type 1 diabetes. Swiss medical weekly, 140, w13091.
Khoo, A. L., Joosten, I., Michels, M., Woestenenk, R., Preijers, F., He, X. H., et al. (2011). 1, 25‐Dihydroxyvitamin D3 inhibits proliferation but not the suppressive function of regulatory T cells in the absence of antigen‐presenting cells. Immunology, 134(4), 459-468.
Lammi, N., Taskinen, O., Moltchanova, E., Notkola, I., Eriksson, J., Tuomilehto, J., et al. (2007). A high incidence of type 1 diabetes and an alarming increase in the incidence of type 2 diabetes among young adults in Finland between 1992 and 1996. Diabetologia, 50(7), 1393-1400.
Mohammadian, S., Fatahi, N., Zaeri, H., & Vakili, M. A. (2015). Effect of vitamin d3 supplement in glycemic control of pediatrics with type 1 diabetes mellitus and vitamin d deficiency. Journal of clinical and diagnostic research: JCDR, 9(3), SC05.
Nagpal, S., Na, S., & Rathnachalam, R. (2005). Noncalcemic actions of vitamin D receptor ligands. Endocrine reviews, 26(5), 662-687.
Norman, A. W. (2008). From vitamin D to hormone D: fundamentals of the vitamin D endocrine system essential for good health–. The American journal of clinical nutrition, 88(2), 491S-499S.
Pozzilli, P., Manfrini, S., Crinò, A., Picardi, A., Leomanni, C., Cherubini, V., et al. (2005). Low levels of 25-hydroxyvitamin D3 and 1, 25-dihydroxyvitamin D3 in patients with newly diagnosed type 1 diabetes. Hormone and Metabolic Research, 37(11), 680-683.
Riachy, R., Vandewalle, B., Belaich, S., Kerr-Conte, J., Gmyr, V., Zerimech, F., et al. (2001). Beneficial effect of 1, 25 dihydroxyvitamin D3 on cytokine-treated human pancreatic islets. Journal of endocrinology, 169(1), 161-168.
Riachy, R., Vandewalle, B., Kerr Conte, J., Moerman, E., Sacchetti, P., Lukowiak, B., et al. (2002). 1, 25-dihydroxyvitamin D3 protects RINm5F and human islet cells against cytokine-induced apoptosis: implication of the antiapoptotic protein A20. Endocrinology, 143(12), 4809-4819.
Riachy, R., Vandewalle, B., Moerman, E., Belaich, S., Lukowiak, B., Gmyr, V., et al. (2006). 1, 25-Dihydroxyvitamin D3 protects human pancreatic islets against cytokine-induced apoptosis via down-regulation of the Fas receptor. Apoptosis, 11(2), 151-159.
Sonia, H.-L., Ali, M., Yousr, D., Wiem, B., Anies, H., Kamel, H., et al. (2016). Serum Vitamin D Level in Children with and without Type 1 Diabetes Mellitus. J Diabetes Metab, 7(655), 2.
Thrailkill, K. M., Jo, C.-H., Cockrell, G. E., Moreau, C. S., & Fowlkes, J. L. (2011). Enhanced excretion of vitamin D binding protein in type 1 diabetes: a role in vitamin D deficiency? The Journal of Clinical Endocrinology & Metabolism, 96(1), 142-149.
Tunc, O., Cetinkaya, S., & Kizilgun, M. (2010). Evaluation of the relation between vitamin D and insulin requirements and frequency of osteopenia/osteoporosis in childhood with type 1 diabetes. Paper presented at the 49th Annual Meeting of the ESPE September.
Wulandari, D., Cahyono, H. A., Widjajanto, E., & Puryatni, A. (2014). Low levels of vitamin D correlate with hemoglobin A1c and interleukin-10 levels in pediatric type 1 diabetes mellitus patients. Journal of Tropical Life Science, 4(3), 182-186.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License [CC BY-NC-SA 4.0] that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work, with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online.