Relationship between Vitamin D level and metabolic parameters in obese children and response to Vitamin D treatment.

OBJECTIVE: Vitamin D deficiency is common in children. The effects of Vitamin D on bone health are well-known. However, its effect on glucose and lipid metabolism in obese children remains controversial. This study projected to evaluate the association between Vitamin D level and glucose, lipid, and bone metabolism parameters in obese children. In addition, the objective of the study was to determine the change in insulin resistance after Vitamin D replacement therapy in obese children with Vitamin D deficiency. METHODS: Hundred fifty children with obesity were included in our retrospective cross-sectional study. The patients were separated into two groups as the study group (serum 25(OH)D level <20 ng/ml) and the control group (serum 25(OH)D level ≥20 ng/ml). Physical examination, body fat mass, and laboratory findings of the two groups were compared. Moreover, patients in the study group were supplemented with Vitamin D 2000 IU/d for 24 weeks. Glucose, insulin levels were analyzed before and after treatment. RESULTS: Body fat mass and percentage were evaluated as more raised in the study group than those in the control group. The study group had a higher level of insulin resistance. There was a significant loss in body weight of patients after treatment in the study group and insulin resistance of the study group decreased after Vitamin D3 treatment. CONCLUSION: Considering the low side effects and affordability of Vitamin D, it would be a reasonable approach to identify serum Vitamin D levels in obese children and to administer a treatment to those with Vitamin D deficiency.

Successful management with bisphosphonate treatment in a child with tuberculosis-associated hypercalcemia.

Hypercalcemia is a common metabolic abnormality in children and generally occurs due to hyperparathyroidism, vitamin D toxicity, some genetic disorders and malignant diseases. Granulomatous diseases are a rare cause of hypercalcemia in children, which are usually mild and asymptomatic. Severe hypercalcemia in granulomatous diseases has also been reported in the literature. Here, we report a child presenting with severe hypercalcemia secondary to miliary tuberculosis with successful management with bisphosphonate treatment. Increased 1,25(OH)2D3 synthesis by activated macrophages in the granuloma tissue is the major mechanism of hypercalcemia in tuberculosis.