title: Autonomic cardiovascular dysfunction and vitamin D deficiency in pediatric spinal cord injury.
abstract: OBJECTIVE
  The purpose of this manuscript is to present a general overview and preliminary results of pilot projects of two complications in pediatric spinal cord injury (SCI): autonomic cardiovascular dysfunction and vitamin D deficiency.
  
  
  METHODS
  Retrospective cross-sectional investigations of blood pressures (BP), heart rates (HR), and vitamin D levels were performed.
  
  
  RESULTS
  Among 279 children with SCI, it was observed that baseline BP increases and HR decreases with increasing age. Boys had higher systolic BP and girls had higher HR, but a gender difference in diastolic BP did not emerge. There were no significant associations of baseline BP or HR as a function of injury level, severity, or duration. Among 82 youth with SCI, 79% had vitamin D deficiency or insufficiency. There were no differences in vitamin D status as a function of gender or level of injury. Adolescents, however, were more likely to exhibit deficiency compared to children.
  
  
  CONCLUSIONS
  Because of the clinical significance of autonomic dysreflexia and orthostatic hypotension, baseline BP and HR need to be routinely assessed in youth with SCI. In view of the high prevalence of vitamin D insufficiency in youth with SCI and the risk of complications such as pathological fractures, serum 25-hydroxycholecalciferol levels should be routinely monitored.
authors.affiliation: Shriners Hospitals for Children, Chicago, IL 60707, USA. kzebracki@shrinenet.org
authors.forename: Kathy
authors.initials: K
authors.lastname: Zebracki
authors.forename: Miriam
authors.initials: M
authors.lastname: Hwang
authors.forename: Pamela L
authors.initials: PL
authors.lastname: Patt
authors.forename: Lawrence C
authors.initials: LC
authors.lastname: Vogel
mesh_terms: D000293:Adolescent; D000367:Age Factors; D020211:Autonomic Dysreflexia / Q000453:epidemiology; D001794:Blood Pressure / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000097:blood / Q000453:epidemiology*; D014808:Vitamin D Deficiency / Q000453:epidemiology*