Vitamin D deficiency in children with congenital adrenal hyperplasia (CAH): a cross-sectional study from tertiary health care center of Pakistan.

Vitamin D deficiency in children with congenital adrenal hyperplasia (CAH)

Abstract

INTRODUCTION: Children with congenital adrenal hyperplasia (CAH) receive glucocorticoids from the time of diagnosis. Recent studies show that steroids enhance the inactivation of 25(OH)D by up-regulating 24-hydroxylase activity. We conducted this study to find out vitamin D deficiency (VDD) in children with CAH who were receiving steroids.

MATERIAL AND METHODS: Prospective descriptive cross-sectional study, conducted at the outpatient department of pediatric endocrinology at National Institute of Child Health (NICH) Karachi during 2017-2018. The sampling technique was non-probability consecutive sampling and the sample size was n= 150 CAH patients. All CAH patients meeting the inclusion criteria were enrolled in the study.

RESULTS: Fifty-four per cent of patients with CAH had VDD and 46% had a sufficient level of vitamin D. The mean age of our patients was 11.85±3.32 years. The mean duration of CAH and vitamin D levels were 11.85±3.32 years and 14.6±5.65 ng/dl, respectively. Forty-eight per cent of VDD patients were from low socioeconomic status and 68.67% of patients from the urban area were deficient in vitamin D status. VDD was found more in children with inadequate sun-exposure i.e. 65.62% of patients with inadequate sun exposure were VDD. More females with CAH were VDD as compared to males with a male to female ratio of 1:1.2.

CONCLUSION: The frequency of VDD in children with CAH is comparable to our general population. Adolescent girls, patients from lower socioeconomic status, patients from the urban areas and patients with inadequate sun exposure are more prone to VDD.