Ann Pediatr Endocrinol Metab.  2015 Dec;20(4):198-205. 10.6065/apem.2015.20.4.198.

Risk factors of vitamin D deficiency in children with epilepsy taking anticonvulsants at initial and during follow-up

• Lee SH
• Yu J

• KMID: 2354696
• DOI: http://doi.org/10.6065/apem.2015.20.4.198

Abstract

PURPOSE
Vitamin D status was evaluated in children with epilepsy taking anticonvulsants to determine the prevalence and risk factors of vitamin D deficiency.
METHODS
This study was designed as both a cross-sectional and a retrospective cohort study. A sum of 198 children who were diagnosed with epilepsy at the Department of Pediatrics in Dankook University Hospital was included. Their serum vitamin D levels were reviewed based on clinical information, and analyzed using IBM SPSS ver. 20.0.
RESULTS
One hundred twenty-four children (62.6%) had vitamin D deficiency. Two risk factors were associated: winter to spring season (odds ratio [OR], 3.71; 95% confidence interval [CI], 1.835-7.492) and age more than 12 years (OR, 3.22; 95% CI, 1.377-7.542). Out of the 57 patients who were not vitamin D deficient at the time of initial assay, 47 patients (82.5%) became vitamin D deficient during followup. The change of serum 25-hydroxy vitamin D3 (25(OH)D) levels during follow up showed a weak negative correlation with the duration of medication (r=-0.283, P=0.033). Medication duration was longer and brain magnetic resonance imaging (MRI) abnormality, abnormal underlying conditions, and nonambulatory status were more frequently present in twenty-five patients (44%) who showed a decline of more than 15 ng/mL during follow-up (P<0.05).
CONCLUSION
Vitamin D deficiency is common in children with epilepsy taking anticonvulsants, especially in adolescents more than 12 years of age. This study emphasizes the regular monitoring of vitamin D level, especially in the presence of longer duration of medication, brain MRI abnormality, abnormal underlying conditions, and nonambulatory status.

Keyword

Vitamin D deficiency; Child; Epilepsy; Anticonvulsants

MeSH Terms

Adolescent
Anticonvulsants*
Brain
Child*
Cholecalciferol
Cohort Studies
Epilepsy*
Follow-Up Studies*
Humans
Magnetic Resonance Imaging
Pediatrics
Prevalence
Retrospective Studies
Risk Factors*
Seasons
Vitamin D Deficiency*
Vitamin D*
Vitamins*
Anticonvulsants
Cholecalciferol
Vitamin D
Vitamins

Figure

• 

  Fig. 1 The mean serum 25(OH)D level in patients of the non-deficiency group at the time of initial assay and last assay (P<0.001). 25(OH)D, 25-hydroxy vitamin D3.

• 

  Fig. 2 Vitamin D status from nondeficiency to deficiency during follow-up.

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  Fig. 3 Correlation between the change of serum 25(OH)D levels during follow-up and the duration of medication (r=-0.283, P=0.033). 25(OH)D, 25-hydroxy vitamin D3.

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  Fig. 4 Correlation between serum 25(OH)D levels and serum phosphorus levels at the time of last assay (r=0.356, P=0.016). 25(OH)D, 25-hydroxy vitamin D3.

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