ESPE Abstracts (2015) 84 P-3-660

Bone

4 Years Follow-Up for 25OHD and iPTH in Vitamin D Substituted Patients with Diabetes Mellitus 1: An Unicentric Prospective Study

Claudia Weissenbacher, Julia Roeb, Carmen Sydlik, Susanne Bechtold Dalla Pozza, Michael Marx & Heinrich Schmidt

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University Childrens Hospital, Munich, Germany


Background: Vitamin D deficiency/insufficiency seems to occur frequently in children and teenagers but it is a matter of debate if limits (<20 ng/ml; <30 ng/ml) are correct. Besides its effect in bone metabolism Vit-D is also supposed to have a positive influence in diabetes mellitus 1 (DM1).

Objective and hypotheses: To study 25OHD and iPTH values in a group of patients (pts) (n=57) with DM1 without Vit-D substitution (2011), with 1000 I.E./d (2012 and 2013) and 2000 I.E./d (2014).

Method: n=57 pts (age: 7–17) followed for 4 years; 2011 no Vit-D, 2012, 2013, 2014 from October–March on Vit-D; one blood sample each year (January–March: iPTH and 25OHD). Pts and parents were asked about compliance. Subgroups due to 25OHD: i) <10 ng/ml (I.a. patients who refused to take Vit-D and I.b. Vit-D was taken.); ii) 10–20 ng/ml (II.a and II.b like before), iii) 20–30 ng/ml (III.a, III.b) and iv) >30 ng/ml (IVa, IVb.).

Results: 2011 (no Vit-D): I: 19% of pts, iPTH: 51 pg/ml (30–99.5), II: 64% of pts, iPTH: 47.8 pg/ml (29.4–58.8), (83% of pts had 25OHD <20 ng/ml), III: 14.2% of pts, iPTH: 31.1 pg/ml (21.2–40.9), IV: 2% of pts, iPTH: 23.6. 2012: (1000 I.E./d): I.b.: 1.7% of pts, iPTH: 38.9 pg/ml; II.a+II.b: 29.3% of pts, II.a, iPTH: 45.7 (27.7–62.6) pg/ml, II.b. iPTH: 51.2 (38.9–59.7) pg/ml, III.a+IIIb: 32.7% of pts, III.a.: 40.08 (34–55.6) pg/ml, III.b.: 40.8 (22.1–62.3) pg/ml, IV.a.+IV.b.:29.3% of pts, IV.a.: 42.4 (42.3–42.7) pg/ml, IV.b.: 39.1 (22.0–55.3) pg/ml. 2013 (1000 I.E./d): data similar to 2012, 2014 (2000 I.E./d): I.a.+I.b.: 4% of pts, I.a.: 35.7 (23.2–48.3) pg/ml, I.b.:none, II.a.+II.b.: 22% of pts, II.a.: 51.4 (42.4–56.2) pg/ml, II.b.: 69.6 (59.9–86.2) pg/ml, III.a+III.b: 47% of pts, III.a.: 40.1 (22.6–56.9) pg/ml, III.b.:43.5 (21.1–75.4) pg/ml, IV.a.+IV.b.: 28% of pts, IV.a.: 41.6 (28.7–61.8) pg/ml, IV.b.: 39.7 (23.6–69.9) pg/ml. Individual correlation between iPTH and Vit-D as well as changes during treatment will be shown.

Conclusion: Due to actual limits of 25OHD, 83% of non-substituted DM1 patients had Vit-D deficiency (<20 ng/ml) and 97% had levels <30 ng/ml. Under 2000 I.E/d Vit-D during the autumn/winter period: 26% of patients had values below 20 ng/ml, 47% of patients below 30 ng/ml, and 28% of patients>30 ng/ml (max: 63), thus substitution with 2000 I.E/d significantly improved Vit-D status.

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