Prevalence of vitamin D insufficiency and deficiency among children with epilepsy

Abstract

Background and aim The relation between vitamin D, the use of antiepileptic drugs (AEDs), and bone integrity has been found in patients with epilepsy. The aim of the work was to study the prevalence of vitamin D insufficiency and deficiency among children with epilepsy, and to identify some possible risk factors. Patients and methods A comparative cross-sectional study was done on randomly chosen 60 children with epilepsy aged 3–15 years attending the neurology out-patient clinic and 20 healthy age-matched and sex-matched children, attending the pediatric outpatient clinic at Alexandria University Children’s Hospital from September 2014 to March 2015. They were divided into three groups: group I included 40 children receiving AED monotherapy for more than 1 year; group II included newly diagnosed epileptic children before receiving medications; group III included 20 healthy children as controls. History taking included patients’ age, sex, seizure history, nutritional history, sunlight exposure, associated illness or drug intake and history of vitamin D or calcium supplementation. Clinical examinations were done (systematic and neurological examination, weight and BMI). Laboratory investigations [liver and kidney function tests, serum calcium, phosphorus, alkaline phosphatase, and serum 25-hydroxyvitamin D (25(OH)D) levels] were done. Electroencephalogram was done for groups I and II. Results There was no significant difference between all groups regarding age and sex. The BMI was significantly different between groups II and III. Laboratory tests (alanine aminotransferase, aspartate aminotransferase, urea, creatinine, serum calcium, phosphorus, and alkaline phosphatase levels) showed no significant differences between the three studied groups. The mean of 25(OH)D among children in group I was significantly lower compared with children in group III. Females were associated with insufficient and deficient levels of vitamin D. There were statistically significant relations between 25(OH)D levels and BMI and the duration of AED treatment in group I. Conclusion The present study provides evidence of the increased prevalence of vitamin D insufficiency and deficiency among newly diagnosed children with epilepsy and in those on treatment with AEDs. In addition, the study has indicated that female sex, high BMI, AED use (carbamazepine, Na valproate) and prolonged duration of treatment are risk factors for vitamin D insufficiency and deficiency.