title: Vitamin D deficiency in patients with intellectual disabilities: prevalence, risk factors and management strategies.
abstract: BACKGROUND
  People with intellectual disabilities have a high risk of osteoporosis and fractures, which could partly be as a result of vitamin D deficiency.
  
  
  OBJECTIVE
  To compare the serum vitamin D (25(OH)D) levels of 155 patients with intellectual disabilities under psychiatric care and 192 controls, investigate potential risk factors for vitamin D deficiency in people with intellectual disabilities and assess available treatments.
  
  
  METHODS
  Cross-sectional observational study followed by treatment evaluation. Results Almost twice as many patients with intellectual disabilities had vitamin D deficiency (25(OH)D <50 nmol/l) compared with controls (77.3% v. 39.6%, P<0.0001). In the intellectual disabilities group, winter season (P<0.0001), dark skin pigmentation (P<0.0001), impaired mobility (P = 0.002) and obesity (P = 0.001) were independently associated with lower serum 25(OH)D. In most patients, 800 IU colecalciferol daily normalised 25(OH)D levels.
  
  
  CONCLUSIONS
  Vitamin D deficiency is highly prevalent in people with intellectual disabilities, partly because of insufficient exposure to sunlight. Screening and treatment strategies, aiming to reduce these patients' high fracture risk, should be introduced. Similar strategies may be required in other psychiatric populations at risk for fractures and with a tendency to spend excessive time indoors.
authors.affiliation: Valeria Frighi, MD, Department of Psychiatry, University of Oxford and Oxfordshire Learning Disability NHS Trust (now Southern Health NHS Foundation Trust), Oxford; Alireza Morovat, PhD, FRCPath, Department of Clinical Biochemistry, Oxford University Hospitals NHS Trust, Oxford; Matthew T. Stephenson, FRCPsych, MSysPsych, Oxfordshire Learning Disability NHS Trust (now Southern Health NHS Foundation Trust), Oxford; Sarah J. White, RGN, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford; Christina V. Hammond, BSc, Guy M. Goodwin, Dphil, FRCPsych, FMedSci, Department of Psychiatry, University of Oxford, Oxford, UK.
authors.forename: Valeria
authors.initials: V
authors.lastname: Frighi
authors.affiliation: Valeria Frighi, MD, Department of Psychiatry, University of Oxford and Oxfordshire Learning Disability NHS Trust (now Southern Health NHS Foundation Trust), Oxford; Alireza Morovat, PhD, FRCPath, Department of Clinical Biochemistry, Oxford University Hospitals NHS Trust, Oxford; Matthew T. Stephenson, FRCPsych, MSysPsych, Oxfordshire Learning Disability NHS Trust (now Southern Health NHS Foundation Trust), Oxford; Sarah J. White, RGN, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford; Christina V. Hammond, BSc, Guy M. Goodwin, Dphil, FRCPsych, FMedSci, Department of Psychiatry, University of Oxford, Oxford, UK.
authors.forename: Alireza
authors.initials: A
authors.lastname: Morovat
authors.affiliation: Valeria Frighi, MD, Department of Psychiatry, University of Oxford and Oxfordshire Learning Disability NHS Trust (now Southern Health NHS Foundation Trust), Oxford; Alireza Morovat, PhD, FRCPath, Department of Clinical Biochemistry, Oxford University Hospitals NHS Trust, Oxford; Matthew T. Stephenson, FRCPsych, MSysPsych, Oxfordshire Learning Disability NHS Trust (now Southern Health NHS Foundation Trust), Oxford; Sarah J. White, RGN, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford; Christina V. Hammond, BSc, Guy M. Goodwin, Dphil, FRCPsych, FMedSci, Department of Psychiatry, University of Oxford, Oxford, UK.
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Stephenson
authors.affiliation: Valeria Frighi, MD, Department of Psychiatry, University of Oxford and Oxfordshire Learning Disability NHS Trust (now Southern Health NHS Foundation Trust), Oxford; Alireza Morovat, PhD, FRCPath, Department of Clinical Biochemistry, Oxford University Hospitals NHS Trust, Oxford; Matthew T. Stephenson, FRCPsych, MSysPsych, Oxfordshire Learning Disability NHS Trust (now Southern Health NHS Foundation Trust), Oxford; Sarah J. White, RGN, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford; Christina V. Hammond, BSc, Guy M. Goodwin, Dphil, FRCPsych, FMedSci, Department of Psychiatry, University of Oxford, Oxford, UK.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: White
authors.affiliation: Valeria Frighi, MD, Department of Psychiatry, University of Oxford and Oxfordshire Learning Disability NHS Trust (now Southern Health NHS Foundation Trust), Oxford; Alireza Morovat, PhD, FRCPath, Department of Clinical Biochemistry, Oxford University Hospitals NHS Trust, Oxford; Matthew T. Stephenson, FRCPsych, MSysPsych, Oxfordshire Learning Disability NHS Trust (now Southern Health NHS Foundation Trust), Oxford; Sarah J. White, RGN, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford; Christina V. Hammond, BSc, Guy M. Goodwin, Dphil, FRCPsych, FMedSci, Department of Psychiatry, University of Oxford, Oxford, UK.
authors.forename: Christina V
authors.initials: CV
authors.lastname: Hammond
authors.affiliation: Valeria Frighi, MD, Department of Psychiatry, University of Oxford and Oxfordshire Learning Disability NHS Trust (now Southern Health NHS Foundation Trust), Oxford; Alireza Morovat, PhD, FRCPath, Department of Clinical Biochemistry, Oxford University Hospitals NHS Trust, Oxford; Matthew T. Stephenson, FRCPsych, MSysPsych, Oxfordshire Learning Disability NHS Trust (now Southern Health NHS Foundation Trust), Oxford; Sarah J. White, RGN, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford; Christina V. Hammond, BSc, Guy M. Goodwin, Dphil, FRCPsych, FMedSci, Department of Psychiatry, University of Oxford, Oxford, UK.
authors.forename: Guy M
authors.initials: GM
authors.lastname: Goodwin
mesh_terms: D000328:Adult; D050071:Bone Density Conservation Agents / Q000008:administration & dosage; D002762:Cholecalciferol / Q000008:administration & dosage*; D003430:Cross-Sectional Studies; D004334:Drug Administration Schedule; D005260:Female; D050723:Fractures, Bone / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008607:Intellectual Disability / Q000097:blood / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D009765:Obesity / Q000150:complications; D010024:Osteoporosis / Q000209:etiology / Q000517:prevention & control; D012307:Risk Factors; D013472:Sunlight; D016896:Treatment Outcome; D014807:Vitamin D / Q000097:blood*; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications / Q000188:drug therapy*
chemical_list: D050071:Bone Density Conservation Agents; D014807:Vitamin D; D002762:Cholecalciferol