The association between ketoacidosis and 25(OH)-vitamin D-3 levels at presentation in children with type 1 diabetes mellitus

Huynh, Tony, Greer, Ristan M., Nyunt, Ohn, Bowling, Francis, Cowley, David, Leong, Gary M., Cotterill, Andrew M. and Harris, Mark (2009) The association between ketoacidosis and 25(OH)-vitamin D-3 levels at presentation in children with type 1 diabetes mellitus. Pediatric Diabetes, 10 1: 38-43. doi:10.1111/j.1399-5448.2008.00439.x


Author Huynh, Tony
Greer, Ristan M.
Nyunt, Ohn
Bowling, Francis
Cowley, David
Leong, Gary M.
Cotterill, Andrew M.
Harris, Mark
Title The association between ketoacidosis and 25(OH)-vitamin D-3 levels at presentation in children with type 1 diabetes mellitus
Formatted title
 The association between ketoacidosis and 25(OH)-vitamin D3 levels at presentation in children with type 1 diabetes mellitus
Journal name Pediatric Diabetes   Check publisher's open access policy
ISSN 1399-5448
1399-5448
Publication date 2009
Year available 2009
Sub-type Article (original research)
DOI 10.1111/j.1399-5448.2008.00439.x
Volume 10
Issue 1
Start page 38
End page 43
Total pages 6
Editor M. Sperling
Place of publication Frederiksberg C, Denmark
Publisher Wiley-Blackwell Munksgaard
Collection year 2010
Language eng
Subject 110306 Endocrinology
Formatted abstract
 Background: There is considerable evidence supporting the role of vitamin D deficiency in the pathogenesis of type 1 diabetes mellitus (T1DM). Vitamin D deficiency is also associated with impairment of insulin synthesis and secretion. There have been no formal studies looking at the relationship between 25(OH)-vitamin D3 and the severity of diabetic ketoacidosis (DKA) in children at presentation with T1DM.

Objective: To determine the relationship between measured 25(OH)-vitamin D3 levels and the degree of acidosis in children at diagnosis with T1DM.

Subjects: Children presenting with new-onset T1DM at a tertiary children's hospital.

Methods: 25(OH)-vitamin D3 and bicarbonate levels were measured in children at presentation with newly diagnosed T1DM. Those with suboptimal 25(OH)-vitamin D3 levels (<50 nmol/L) had repeat measurements performed without interim vitamin D supplementation.

Results: Fourteen of the 64 children had low 25(OH)-vitamin D3 levels at presentation, and 12 of these had low bicarbonate levels (<18 mmol/L) (p = 0.001). Bicarbonate explained 20% of the variation in vitamin D level at presentation (partial r2 = 0.20, p < 0.001) and ethnic background a further 10% (partial r2 = 0.10, p = 0.002). The levels of 25(OH)-vitamin D3 increased in 10 of the 11 children with resolution of the acidosis.

Conclusions: Acid–base status should be considered when interpreting 25(OH)-vitamin D3 levels in patients with recently diagnosed T1DM. Acidosis may alter vitamin D metabolism, or alternatively, low vitamin D may contribute to a child's risk of presenting with DKA.

Keyword Acidosis
Diabetes mellitus
Autoimmunity
Vitamin D
Q-Index Code C1
Q-Index Status Provisional Code

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
 
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Created: Thu, 03 Sep 2009, 08:58:45 EST by Mr Andrew Martlew on behalf of Medicine - Princess Alexandra Hospital