ABSTRACT
Down syndrome (DS), caused by trisomy of human chromosome 21, is one of the most common chromosomal abnormalities in live born infants with a prevalence rate of 1 in 700 live births. Individuals with DS usually have comorbid conditions such as thyroid dysfunction, growth retardation, diabetes mellitus and obesity. The most frequent among these are the thyroid abnormalities which range from subclinical to overt hypothyroidism, and rarely hyperthyroidism.1-3 Individuals with DS are more susceptible to thyroid disorders compared to the general population. Primary hypothyroidism, referred to as elevated TSH, is the most common thyroid abnormality in DS; secondary hypothyroidism indicated by normal/reduced TSH is extremely rare. The prevalence of hypothyroidism varies between 3-54% in adults with DS.4 The aim of this study was to examine the incidence of thyroid abnormalities among children with DS registered in a tertiary referral center for neurodevelopmental disorders and non-communicable neurological disorders in Kerala, a south Indian state. 100 children with DS in the age range of 4 months-15 years, registered at Institute for Communicative and Cognitive Neurosciences (ICCONS), Shoranur, Kerala during the period of 2012-2016, were recruited for the study. The mean age of the participants (57 males, 43 females) was 5.4'3.8 years. The diagnosis of DS was confirmed by karyotyping. All the participants were drug-naive at the time of blood collection. 500 'l of serum samples was used for thyroid function test (TFT) which measured the levels of TSH, triiodothyronine (T3) and thyroxine (T4) by chemiluminescence immunoassay (CLIA). The reference range for TSH, T3 and T4 were as follows, TSH: 0.4-4mIU/ml, T3: 70-170ng/dl, T4: 4.5-12.5mg/dl.
ABSTRACT
Background: Authors examined serum vitamin D status among the healthy school children belonging to the south Indian state of Kerala.Methods: A cross-sectional study, participants were recruited through medical camps organized in Thrissur and Palakkad districts of central Kerala during the months of March and April 2017. A 174 healthy school children (98 males and 76 females) aged 5-13 years were recruited for the study. The children were found to be healthy on the basis of physical examination by a Paediatrician. None of the children had any symptoms of skeletal deformities. All the children were drug-naive. Data on height, weight, skin color, food habits, physical activities and socio-economic status were recorded. A 2ml of peripheral blood samples were collected from the participants. Total vitamin D in the serum was estimated by chemiluminescence immunoassay (CLIA).Results: VDD was observed in 60.92% and insufficiency in 30.46% of the participants. Only 8.62% of the participants had normal vitamin D levels. The mean vitamin D level was 19.93 ng/ml. Males had significantly higher vitamin D levels compared to females. Factors such as age, height, weight, diet, skin color and socio-economic status did not influence vitamin D levels.Conclusions: This is the first study of vitamin D status among the school-age children of Kerala. This paper adds further evidence to the reports indicating high prevalence of subclinical VDD among children across India and calls for action.