Vitamin D Levels in Children and Adolescents with Cerebral Palsy: Cross-sectional Study / Níveis de Vitamina D em Crianças e Adolescentes com Paralisia Cerebral: Estudo Transversal

Marcela Almeida Linden, Elizete Aparecida Lomazi, Gabriel Hessel, Maria Ângela Bellomo-Brandão

Abstract


Aim: Tetraparetic Cerebral Palsy (TCP) patients may present risks factors for Vitamin D deficiency such as increased risk of malnutrition and possibly infrequent sun exposure. The present study aimed to compare the vitamin D status in this population of TCP pediatric patients (Case Group) and compare them with healthy children and adolescents (Control Group). Methods: The clinical data obtained were: gender, age, weight, height, nutritional status, consumption of vitamin D food sources, sun exposure and serum levels of vitamin D. Vitamin D deficiency was defined as 20 ng/mL or less of 25(OH)D; “insufficiency” was defined as between 21-29 ng/mL; “sufficiency” was defined as between 30-100 ng/mL.1 Results: Sixty patients aged 3 to 20 years old were divided into two groups: the Control Group (n=30) and the Case Group (n=30) composed of individuals with TCP. Vitamin D levels did not differ between groups; the mean levels were 26.65 ng/mL (SD: 10.51) in the Case Group and, 28.93 ng/mL (SD: 9.26) in the Control Group. Conclusion: There was no difference identified between vitamin D levels among TCP and control patients, and no relationship between risk factors and serum 25(OH)D levels was observed. Even though Brazil is a tropical country with abundant sunshine during most of the year, there is still a considerable number of individuals with vitamin D classifications of insufficiency and deficiency in our study (N= 34/60). This should be alarming for healthcare professionals who work with the pediatric population, which is a population at risk for the development of disability.


Keywords


Cholecalciferol, Neurological Disorders, Pediatric, Deficiency.

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References


Bischoff-ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-hughes B. Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes 1 – 3. 2006;25:18-28.

Hossein-nezhad A, Holick MF. Vitamin D for health: a global perspective. Mayo Clin Proc. 2013;88(7):720-755. doi:10.1016/j.mayocp.2013.05.011

Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357(3):266-281. doi:10.1056/NEJMra070553

Holick MF, Chen TC. Vitamin D deficiency: a worldwide problem with health consequences. Am J Clin Nutr. 2008;87(4):1080S-6S. https://www.ncbi.nlm.nih.gov/pubmed/18400738.

Cesari M, Incalzi RA, Zamboni V, Pahor M. Vitamin D hormone: A multitude of actions potentially influencing the physical function decline in older persons. Geriatr Gerontol Int. 2011;11(2):133-142. doi:10.1111/j.1447-0594.2010.00668.x

Seth A, Aneja S, Singh R, Majumdar R, Sharma N, Gopinath M. Effect of impaired ambulation and anti-epileptic drug intake on vitamin D status of children with cerebral palsy. Paediatr Int Child Health. 2017;37(3):193-198. doi:10.1080/20469047.2016.1266116

Kilpinen-Loisa P, Nenonen H, Pihko H, Mäkitie O. High-dose vitamin D supplementation in children with cerebral palsy or neuromuscular disorder. Neuropediatrics. 2007;38(4):167-172. doi:10.1055/s-2007-990266

Emi K, Souza S De, Marcos S, Carvalho R De. Motor E Do Índice De Massa Corpórea Em Crianças Com Paralisia Cerebral. Rev Bras Crescimento Desenvolv Hum. 2011;21(1):11-20.

Caramico-Favero DCO, Guedes ZCF, de MORAIS MB. Food intake, nutritional status and gastrointestinal symptoms in children with cerebral palsy. Arq Gastroenterol. 2018;55(4):352-357. doi:10.1590/s0004-2803.201800000-78

Johnson A, Gambrah-Sampaney C, Khurana E, et al. Risk Factors for Malnutrition Among Children With Cerebral Palsy in Botswana. Pediatr Neurol. 2017;70:50-55. doi:10.1016/j.pediatrneurol.2017.02.003

Brooks J, Day S, Shavelle R, Strauss D. Low Weight, Morbidity, and Mortality in Children With Cerebral Palsy: New Clinical Growth Charts. Pediatrics. 2011;128(2):e299-e307. doi:10.1542/peds.2010-2801

Leite J, Prado G. Paralisia Cerebral — Aspectos Fisioterapêuticos e Clínicos. Rev Neurociências. 2004;12(01):41-45. doi:10.4181/RNC.2004.12.41

Samaniego EA, Sheth RD. Bone Consequences of Epilepsy and Antiepileptic Medications. Semin Pediatr Neurol. 2007;14(4):196-200. doi:10.1016/j.spen.2007.08.006

Linden MA, De Freitas RGBON, Hessel G, Marmo DB, Bellomo-Brandão MÂ. Definition of vitamin D deficiency in schoolchildren: Systematic review with meta-analysis. Arq Gastroenterol. 2019;56(4):425-430. doi:10.1590/s0004-2803.201900000-64

Ribeiro HPB, Souza Bessa C, Amaral HA de A, et al. Os efeitos da colecalciferol (vitamina D) no sistema nervoso central em modelos experimentais. Brazilian J Heal Rev. 2019;2(5):4199-4208. doi:10.34119/bjhrv2n5-025

Braegger C, Campoy C, Colomb V, et al. Vitamin D in the healthy European paediatric population. J Pediatr Gastroenterol Nutr. 2013;56(6):692-701. doi:10.1097/MPG.0b013e31828f3c05

Jekovec-Vrhovzek M, Kocijanziz A. Effect of vitamin D and calcium on bone mass in children with cerebral paresis and epilepsy. Monatsschr Kinderheilkd. 1999;147(9):900. http://onlinelibrary.wiley.com/o/cochrane/clcentral/articles/160/CN-00337160/frame.html.

Cargnin APM, Mazzitelli C. Proposta de Tratamento Fisioterapêutico para Crianças Portadoras de Paralisia Cerebral Espástica , com Ênfase nas Alterações Musculoesqueléticas. Neurociência. 2003;11(1):34-39.

Pereira RA, Koifman S. Uso do questionário de freqüência na avaliação do consumo alimentar pregresso. Rev Saúde Pública. 1999;33(6):610-621.

Onis M de, Onyango A, Borghi E, Siyam A, Pinol A. The new WHO child growth standards. Paediatr Croat Suppl. 2008;52(SUPP.1):13-17. doi:10.4067/S0370-41062009000400012

Al-Ghannami SS, Sedlak E, Hussein IS, et al. Lipid-soluble nutrient status of healthy Omani school children before and after intervention with oily fish meal or re-esterified triacylglycerol fish oil. Nutrition. 2016;32(1):73-78. doi:10.1016/j.nut.2015.07.014

Perenc L, Trzeciak J. Cerebral Palsy in Children as a Risk Factor for Malnutrition. Ann Nutr Metab. 2015;66:224-232. doi:10.1159/000431330

Melunovic M, Hadzagic-catibusic F, Bilalovic V. Anthropometric Parameters of Nutritional Status in Children with Cerebral Palsy. 2017;29(March):68-72. doi:10.5455/msm.2017.29.68-72

Neyestani TR, Hajifaraji M, Omidvar N, et al. Calcium-vitamin D-fortified milk is as effective on circulating bone biomarkers as fortified juice and supplement but has less acceptance: a randomised controlled school-based trial. J Hum Nutr Diet. 2014;27(6):606-616. doi:10.1111/jhn.12191

Roy C Le, Barja S, Sepúlvedac C, et al. Vitamin D and iron deficiencies in children and adolescents with cerebral palsy. Neurología. 2019:1-7.

Ware T, Whitelaw C, Flett P, Parameswaran V. Vitamin D Status in Tasmanian Children With Cerebral Palsy. J Paediatr Child Health. 2013;49:349-350.

Soininen S, Eloranta AM, Lindi V, et al. Determinants of serum 25-hydroxyvitamin D concentration in Finnish children: the Physical Activity and Nutrition in Children (PANIC) study. Br J Nutr. 2016;115(6):1080-1091. doi:10.1017/S0007114515005292




DOI: https://doi.org/10.34119/bjhrv4n3-177

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