Vitamin D insufficiency in infants with increased risk of developing type 1 diabetes: a secondary analysis of the POInT Study.

Autor:	Jacobs A; Department of Pediatric Endocrinology and Diabetes, KU Leuven University Hospitals Leuven, Leuven, Belgium an.k.jacobs@gmail.com., Warnants M; Katholieke Universiteit Leuven, Leuven, Belgium., Vollmuth V; Institute of Diabetes Research, Helmholtz Munich, German Center for Environmental Health, Munich, Germany., Winkler C; Institute of Diabetes Research, Helmholtz Munich, German Center for Environmental Health, Munich, Germany.; Forschergruppe Diabetes at Klinikum rechts der Isar, School of Medicine, Technical University Munich, Munich, Germany., Weiss A; Institute of Diabetes Research, Helmholtz Munich, German Center for Environmental Health, Munich, Germany., Ziegler AG; Institute of Diabetes Research, Helmholtz Munich, German Center for Environmental Health, Munich, Germany.; Forschergruppe Diabetes, Klinikum rechts der Isar, Technische Universität München, Munich, Germany., Lundgren M; Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.; Department of Pediatrics, Kristianstad Hospital, Kristianstad, Sweden., Elding Larsson H; Department of Pediatrics, Skåne University Hospital, Malmö, Sweden.; Department of Clinical Sciences Malmö, Lund University, Lund, Sweden., Kordonouri O; Auf der Bult Children's Hospital, Hannover, Germany., von dem Berge T; Auf der Bult Children's Hospital, Hannover, Germany., Zielmann ML; Department of Pediatrics, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany., Bonifacio E; Center for Regenerative Therapies, Technische Universität Dresden, Dresden, Germany., Hommel A; Center for Regenerative Therapies, Technische Universität Dresden, Dresden, Germany., Ołtarzewski M; Department of Screening and Metabolic Diagnostics, Institute of Mother and Child, Warsaw, Poland., Szypowska A; Department of Paediatrics, Medical University of Warsaw, Warsaw, Poland., Besser R; Department of Paediatrics, University of Oxford, Oxford, UK.; Wellcome Centre for Human Genetics, Nuffield Department of Medicine, NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK., Todd JA; Wellcome Centre for Human Genetics, Nuffield Department of Medicine, NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK., Casteels K; Department of Pediatric Endocrinology and Diabetes, KU Leuven University Hospitals Leuven, Leuven, Belgium.; Department of Development and Regeneration, KU Leuven, Leuven, Belgium.
Jazyk:	angličtina
Zdroj:	BMJ paediatrics open [BMJ Paediatr Open] 2024 Jan 12; Vol. 8 (1). Date of Electronic Publication: 2024 Jan 12.
DOI:	10.1136/bmjpo-2023-002212
Abstrakt:	Background: Vitamin D insufficiency (VDI) may be a factor in the development of type 1 diabetes (T1D). The aim of this study is to investigate the presence and persistence of VDI in a large cohort of infants with increased risk of developing T1D, in light of the differences in local supplementation guidelines. Methods: In the POInT Study, a multicentre primary prevention study between February 2018 and March 2021 in Germany, Poland, Belgium, England and Sweden, including infants aged 4-7 months at high genetic risk of developing β-cell autoantibodies, vitamin D levels were analysed at each study visit from inclusion (4-7 months) until 3 years, with an interval of 2 months (first three visits) or 4-6 months (visits 4-8). The protocol actively promotes vitamin D sufficiency to optimise immune tolerance. VDI was defined as a concentration below 30 ng/mL and was treated according to local guidelines of participating centres. Recovery from VDI was defined as a concentration above or equal to 30 ng/mL on the subsequent visit after VDI. Results: 1050 infants were included, of which 5937 vitamin D levels were available for analyses. VDI was observed in 1464 (24.7%) visits and 507 (46.1%) of these were not resolved at the next visit. The risk of having VDI was independently associated with season (higher in winter), weight (higher with increased weight), age (higher with increased age) and country (higher in England). The risk of not recovering from VDI was independently associated with the season of the previously determined VDI, which was higher if VDI was identified in winter. Conclusions: VDI is frequent in infants with increased risk of developing T1D. Treatment guidelines for VDI do not seem effective. Increasing supplementation dosages in this patient population seems warranted, especially during winter, and increasing dosages more aggressively after VDI should be considered. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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