Gomathy Srividya, V (2013) Prevalence and Risk Factors of Vitamin D Deficiency in Children with Cerebral Palsy: A Case Control study. Masters thesis, Kilpauk Medical College, Chennai.
|
Text
200700413gomathysrividya.pdf Download (1MB) | Preview |
Abstract
INTRODUCTION: Cerebral palsy (CP) is a disorder of aberrant control of movement and posture, appearing early in life secondary to a central nervous system (CNS) lesion or dysfunction that is not the result of recognized progressive or degenerative brain disease. Children with CP face myriad challenges to normal growth. Vitamin D deficiency, known to occur in children with cerebral palsy is one such challenge and if left untreated can cause osteopenia and fractures. The reasons attributed are multifactorial and include poor sunlight exposure due to their nonambulant nature, nutritional impairment due to feeding difficulties and use of long term anticonvulsants in these children. Vitamin D deficiency is common even amongst normal children in India despite plenty of sunshine. All Indian studies point to low 25 hydroxy vitamin D levels in the healthy normal pediatric population. The prevalence data of Vitamin D deficiency in healthy children from various studies in India and abroad ranged from 8% to 80% and the reason attributed is low intake of dietary calcium and phosphorus. AIM OF THE STUDY: 1. The aim of the study is to find the prevalence of vitamin D status –Vitamin D deficiency and insufficiency in children with Cerebral Palsy and to compare them with normal children. 2. To identify the risk factors associated with Vitamin D deficiency in these children. DISCUSSION: Vitamin D deficiency is a common association in children with Cerebral Palsy due to known reasons like poor sunlight exposure, nonambulatory nature, anticonvulsant use and feeding difficulties. Though the association is existent and well described in literature, the epidemiological data available regarding the same is less. This made us to do this study to highlight the proportion of children with cerebral palsy who have Vitamin D deficiency and to compare them with normal controls to find statistical significance and also to identify the possible risk factors causing it to enable early identification, periodic monitoring and supplementation with calcium and vitamin D to prevent the development of fractures and deformities. In this study, we have tried to correlate the vitamin D status in children with cerebral palsy in relation to the nutritional status, anticonvulsant use, feeding difficulty, poor sunlight exposure, and type of CP and functional grade of CP which have been implicated as possible causes for vitamin D deficiency in these children. VITAMIN D AND CP: It is a popular belief that rickets and vitamin D deficiency are not common in India, a tropical country, because of abundant sunlight exposure. But there is now increasing evidence that this statement is not correct. Vitamin D deficiency has been well documented among all age groups like neonates, toddlers, school children, pregnant women, and adult males and females residing in rural and urban India. There are studies from both north and south India. These studies clearly state the fact that approximately 75 to 85% of the groups studied have varying degrees of vitamin D deficiency or insufficiency (hypovitaminosis D). One more important data drawn out in these studies is the fact that dietary intake of vitamin D, nutrition and amount of sunlight exposure has a great impact on the vitamin D levels in the population. One of the studies has shown a big impact on dietary calcium supplementation to a group of children. The usage of different cut off points for vitamin D levels for insufficiency and deficiency by various authors has made it difficult to compare the results of published research by different authors and has complicated comparisons between different communities and populations. Also the latitude, solar zenith angle, uv radiation, amount of cloud cover, time duration of exposure to sunlight, body surface area exposed to sunlight is different among different parts of the world and also different in various areas of our own country and therefore comparisons between the different groups are not possible. CONCLUSION: The prevalence of vitamin D deficiency in children with CP was found to be 37.5% while insufficiency amounted to 56.3% and a total alteration in vitamin D status in CP children was 93.8%. The prevalence of vitamin D deficiency in age and sex matched controls was found to be 3.13% while insufficiency amounted to 37.5% and a total alteration in vitamin D status was 40.63%. The presence of feeding difficulties, poor sunlight exposure, poor nutritional status, and the use of antiepileptic drugs, type of CP and the functional grade of CP had statistically significant association with Vitamin D deficiency in these children. Periodic monitoring, early identification and appropriate calcium and vitamin D supplements may prevent complications like fractures, etc. Hypovitaminosis D is very common and represents latent stage of vitamin D deficiency. Appropriate treatment with vitamin D supplements and calcium is necessary for treatment of vitamin deficiency and replenishment of stores.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | Prevalence ; Risk Factors ; Vitamin D ; Children ; Cerebral Palsy ; Case Control study. |
| Subjects: | MEDICAL > Paediatrics |
| Depositing User: | Ravindran C |
| Date Deposited: | 09 Apr 2018 08:02 |
| Last Modified: | 11 Apr 2018 05:30 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/6914 |
Actions (login required)
 |
View Item |
