title: Low vitamin D level in pediatric patients with new onset type 1 diabetes is common, especially if in ketoacidosis.
abstract: Vitamin D deficiency (VDD) adversely affects bone health. US data on prevalence of VDD or vitamin D insufficiency (VDI) at diagnosis of type 1 diabetes (T1D) is lacking. Low serum 25-hydroxyvitamin D (25OHD) is speculated to increase the risk of developing T1D.
  
  
  
  Assess the prevalence of pediatric VDD and VDI at diagnosis of T1D, and investigate correlations with demographic and clinical parameters.
  
  
  
  We performed a retrospective Institutional Review Board (IRB)-approved chart review of all T1D cases diagnosed from January 2011 to August 2012, all having the same 25OHD assay performed at Quest Diagnostics. Definitions for VDD, VDI, and vitamin D sufficiency (VDS) were 25OHD levels (ng/mL) ≤ 20, 21-29, and ≥ 30, respectively. We termed 25OHD <30 ng/mL as Low-D.
  
  
  
  We identified 185 autoantibody positive T1D subjects (51% female) with 25OHD measured, 51% Caucasian, 25% Hispanic, 4% mixed-Hispanic, 4% African American, and 16% other/mixed race. Mean age 9.8 yr (0.9-18.6). Most had Low-D (58%), 40% VDI, 18% VDD, and 42% VDS. No gender or age differences among the 25OHD groups. Low-D was more common (p < 0.0001) in Hispanics (81%) vs Caucasians (44%), but VDD rates were similar. Low-D subjects were heavier than VDS (p = 0.018). All four with elevated celiac titers were VDS. Diabetic ketoacidosis was present in 33%, but more common (44%) in Low-D vs. VDS (18%) (p < 0.0001), and trended higher in VDD (61%) vs. VDI (36%). Seventy-seven percentage with DKA had Low-D.
  
  
  
  VDD and insufficiency are common, even in Caucasians, at onset of T1D in pediatrics, worse in those with DKA.
authors.affiliation: Le Bonheur Children's Hospital, Pediatrics, Division of Pediatric Endocrinology, Memphis, TN, USA.|University of Tennessee Health Science Center, Pediatrics Memphis, TN, USA.
authors.forename: Hiba
authors.initials: H
authors.lastname: Al-Zubeidi
authors.affiliation: University of California San Diego, Pediatrics San Diego, CA, USA.
authors.forename: Lucero
authors.initials: L
authors.lastname: Leon-Chi
authors.affiliation: University of California San Diego, Pediatrics San Diego, CA, USA. rnewfield@ucsd.edu.|Rady Children's Hospital San Diego, Pediatrics, Division of Pediatric Endocrinology, San Diego, CA, USA. rnewfield@ucsd.edu.
authors.forename: Ron S
authors.initials: RS
authors.lastname: Newfield
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D016883:Diabetic Ketoacidosis / Q000097:blood / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D014807:Vitamin D / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000453:epidemiology*
chemical_list: D014807:Vitamin D
keywords: diabetic ketoacidosis; pediatric; type 1 diabetes; vitamin D deficiency