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Vitamin D Status Among Children With Juvenile Idiopathic Arthritis: A Multicenter Prospective, Non-randomized,
Elena I Kondratyeva1,2, Nuriniso D Odinaeva2, Leonid Ya Klimov3
1Research Centre for Medical Genetics, Moscow, Russia.
Insights
Children with juvenile idiopathic arthritis (JIA) frequently have low vitamin D levels, with insufficient intake and standard supplementation failing to correct deficiencies. Season and cholecalciferol dosage significantly impact vitamin D status in JIA patients.
Area of Science:
- Pediatric Rheumatology
- Endocrinology
- Nutritional Science
Background:
- Juvenile idiopathic arthritis (JIA) is a chronic autoimmune joint disease.
- Vitamin D deficiency is a concern in pediatric autoimmune conditions.
- This study investigates vitamin D levels in children with JIA compared to healthy peers.
Purpose of the Study:
- To compare vitamin D levels in children and adolescents with JIA versus a healthy control group.
- To examine the influence of endogenous, exogenous, and genetic factors on vitamin D levels in JIA.
- To assess the adequacy of current vitamin D supplementation protocols for JIA patients.
Main Methods:
- A cohort of 150 JIA patients and 277 healthy children were studied.
- Serum 25(OH)D (calcidiol) levels were measured.
- Factors analyzed included age, sex, geographic insolation, dietary intake, cholecalciferol dosage, and VDR gene polymorphisms (TaqI, FokI, BsmI).
Main Results:
- 66% of JIA patients exhibited low vitamin D levels, with median levels considered insufficient.
- Dietary vitamin D intake was significantly below norms in JIA patients.
- Standard prophylactic vitamin D (cholecalciferol) doses (500-2,000 IU/day) were inadequate for JIA patients.
- Vitamin D levels were not influenced by JIA clinical therapies or VDR genetic variants.
Conclusions:
- Low vitamin D is prevalent in children with JIA.
- Current prophylactic cholecalciferol doses are insufficient to address vitamin D needs in JIA.
- Seasonal variations and cholecalciferol administration critically affect vitamin D status in JIA.
Background:
Juvenile idiopathic arthritis (JIA) is a chronic autoimmune disease characterized by destructive and inflammatory damage to the joints. The aim in this study was to compare vitamin D levels between children and adolescents, 1-18 years of age, with juvenile idiopathic arthritis (JIA) and a health control group of peers. We considered effects of endogenous, exogenous, and genetic factors on measured differences in vitamin D levels among children with JIA.
Methods:
Our findings are based on a study sample of 150 patients with various variants of JIA and 277 healthy children. The blood level of vitamin D was assessed by calcidiol level. The following factors were included in our analysis: age and sex; level of insolation in three regions of country (center, south, north); assessment of dietary intake of vitamin D; effect of prophylactic doses of cholecalciferol; a relationship between the TaqI, FokI, and BsmI polymorphisms of the VDR gene and serum 25(OH)D concentration.
Results:
We identified a high frequency of low vitamin D among children with JIA, prevalence of 66%, with the medial level of vitamin D being within the range of "insufficient" vitamin D. We also show that the dietary intake of vitamin D by children with JIA is well below expected norms, and that prophylactic doses of vitamin D supplementation (cholecalciferol) at a dose of 500-1,000 IU/day and 1,500-2,000 IU/day do not meet the vitamin D needs of children with JIA. Of importance, we show that vitamin D levels among children with JIA are not affected by clinical therapies to manage the disease nor by the present of VDR genetic variants.
Conclusion:
Prophylactic administration of cholecalciferol and season of year play a determining role in the development of vitamin D deficiency and insufficiency.
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