Vitamin D supplementation in children with epilepsy and intellectual disability

Area of Science:

• Pediatric Neurology
• Endocrinology
• Clinical Nutrition

Background:

• Children with epilepsy and intellectual disability face a heightened risk of vitamin D deficiency.
• Factors influencing 25-hydroxyvitamin D levels and treatment outcomes in this population remain unclear.
• Current Dutch guidelines for vitamin D supplementation may not be sufficient for all high-risk children.

Purpose of the Study:

• To investigate factors associated with baseline 25-hydroxyvitamin D levels in children with epilepsy and intellectual disability.
• To evaluate the therapeutic effectiveness of cholecalciferol supplementation according to Dutch guidelines in this cohort.
• To determine the proportion of patients achieving sufficient vitamin D status after supplementation.

Main Methods:

• Retrospective study of 30 pediatric residents at a tertiary epilepsy center.
• Administration of cholecalciferol supplementation meeting or exceeding Dutch guidelines from November 2012.
• Measurement of serum 25-hydroxyvitamin D at baseline, 6 months, and 15 months.

Main Results:

• Baseline vitamin D status: 36.7% deficient, 33.3% insufficient, 30.0% sufficient.
• Significant associations found between baseline 25-hydroxyvitamin D and supplementation dose, diet, BMI, intellectual disability, and mobility.
• Mean 25-hydroxyvitamin D increased from 57.40 ± 22.00 to 89.47 ± 26.77 nmol/L after 15 months (P < 0.001).
• Despite supplementation, 64% of deficient and 30% of insufficient patients did not reach sufficiency after 15 months.

Conclusions:

• Supplementation adhering to Dutch guidelines did not ensure sufficient vitamin D status in all high-risk children.
• Continuous monitoring of 25-hydroxyvitamin D levels is recommended for this population.
• Individualized supplementation adjustments and patient follow-up are crucial to achieve vitamin D sufficiency.