ESPE Abstracts

Several observational studies have reported vitamin D deficiency (VDD) in children with type 1 diabetes mellitus (T1DM). The investigation of VDD in children with new onset T1DM in China is lacking. The current study aimed to assess vitamin D status and examine the factors that influence VDD in children with new onset T1DM in Henan Province, China. Children with new onset T1DM (n=280) and healthy controls (n=710) were enrolled in Henan Province. Demographic and clinical data were collected from medical records. Children in the T1DM group and controls were divided into two groups according to 25-hydroxyvitamin D [25(OH)D] levels: the VDD group [25(OH)D < 20 ng/mL] and the vitamin D sufficient (VDS) group [25(OH)D ≥ 20 ng/mL]. The serum 25(OH)D level of children with new onset T1DM [17.8(12.1, 27.3) ng/mL] was significantly lower than that of healthy children [23.7(17.4, 32.4) ng/mL] with comparable age, gender, body mass index, and season (P<0.001). More children with T1DM had VDD than controls (56.8% vs. 36.3%, P<0.001). In the control group, the age and rate of males were lower in the VDS group than in the VDD group (P<0.001, P<0.001). The body max index was higher in the VDS group than in the VDD group (P=0.006). Seasonal distribution of VDD was also found in healthy children(P<0.001). In the T1DM group, the age and hemoglobin A1c level were lower in the VDS group than in the VDD group (P<0.001, P=0.002). Calcium levels were higher in the VDS group than in the VDD group (P<0.001). Moreover, there were significant differences in the prevalence of VDD among different age groups (P<0.001) and seasons (P=0.028) in T1DM group. The prevalence of VDD for children with T1DM was 50.5% in the non-DKA group and 48.4%, 67.2%, and 63.3% in the mild, moderate, and severe diabetic ketoacidosis (DKA) groups, respectively. There were no significant differences between different degrees of DKA (P=0.065). According to logistic regression analysis, According to logistic regression analysis, healthy children were 3.03 (95%CI: 1.90-4.84) (P<0.001) times more likely to be VDD in winter. The healthy children with 6-10 years age (OR: 5.50; 95%CI: 3.66-8.27) (P<0.001) and 10-14 years age (OR: 17.83; 95%CI: 10.01-31.5)(P<0.001) had the highest odds for VDD. For children with new onset T1DM, besides moderate DKA (OR: 2.94; 95%CI: 1.31-6.60) (P=0.009) and severe DKA (OR: 2.57; 95%CI: 1.12-5.91) (P=0.026), children with 6-10 years age (OR: 6.85; 95%CI: 3.45-13.57) (P<0.001) and 10-14 years age (OR: 17.07; 95%CI: 6.32-46.08) (P<0.001) had the highest odds for VDD. In conclusion, the prevalence of VDD among children with new onset T1DM was high in Henan Province, China. Besides DKA, increased age (6-14 years old) was the main risk factor for children with new onset T1DM. We recommend testing for 25(OH)D and supplementation in children with new onset T1DM, especially in 6-14 years old children with DKA.