Low serum vitamin-D status is associated with high prevalence and early onset of type-1 diabetes mellitus in Kuwaiti children.

Majedah A Rasoul,Maria Al-Mahdi,Gursev S Dhaunsi,Hessa Al-Kandari,Mohammad Z Haider

doi:10.1186/s12887-016-0629-3

Abstract

BackgroundType 1 diabetes mellitus (T1DM) is highly prevalent in Kuwait with incidence of around 40.1/100,000 individuals. Evidence indicate that vitamin D plays an important role in modulating the immune system and could thus impact the onset and high prevalence of T1DM. We report serum vitamin D levels in Kuwaiti children with T1DM and non-diabetic controls to explore its relationship with prevalence and onset of the disease.MethodsThis study included 216 Kuwaiti Arab children with T1DM. The diagnosis of T1DM was based on the ISPAD criteria. The control subjects (204 Kuwaitis) were age and gender matched, healthy, non-diabetic, and had no close relative with T1DM. Vitamin D levels were determined in serum using an enzyme immunoassay (EIA) method.ResultsThe age of onset of T1DM was <4y in 20 % of the T1DM cases, between 4 and 6y in 28 % cases and >6y in 52 % patients. In T1DM patient group, 84 % subjects were found to be deficient in serum vitamin D level compared to 77 % of the controls (p = 0.046). Collectively, the deficient and insufficient vitamin D status was detected in 99 % of the T1DM patients compared to 92 % of the controls (p = 0.027). The mean serum vitamin D levels were found to be significantly different in early onset cases (age <4y) compared to the late onset sub-group (p = 0.001). A significant correlation was found between some elements of socioeconomic status, SES (i.e. parent’s profession and family’s income) and lower vitamin D levels in Kuwaiti T1DM children. There was no significant difference between mean serum vitamin D levels during winter and summer months in the T1DM patients.ConclusionsThe proportion of cases with a deficient vitamin D status was significantly high in Kuwaiti T1DM children compared to the controls. The serum vitamin D levels were found to be significantly different in early onset and late onset T1DM patients. Therefore, serum vitamin D status can be considered an important contributor in high prevalence of T1DM in Kuwaiti children.

Highlights

Type 1 diabetes mellitus (T1DM) is highly prevalent in Kuwait with incidence of around 40.1/100,000 individuals
Shaltout et al [2] reported a four-fold increase in the incidence of T1DM (15.4/100,000) in the 0–14y agegroup compared to 3.96/100,000 individuals reported from Kuwait in 1980s [3]
We report serum vitamin-D levels in Kuwaiti children with T1DM and healthy controls to explore its relationship with the disease

Summary

Introduction

Type 1 diabetes mellitus (T1DM) is highly prevalent in Kuwait with incidence of around 40.1/100,000 individuals. The incidence of type-1 Diabetes Mellitus (T1DM) has been increasing in Kuwait over the past three decades [1]. Later in 2002, Shaltout et al [1] reported an incidence of 20.1/ 100,000 Kuwaiti children in the age range 0–14 y These authors reported that in the 1980s, the incidence of T1DM in Kuwait was in the same range as ‘low incidence’ countries (3.96/100,000), during the subsequent 10 years period, in the 1992–93, it increased almost four times to 15.4/100,000 children [3] and was similar to that reported from ‘high incidence’ European countries [4, 5]. The most recent incidence data of T1DM in Kuwait comes from the Rasoul et al BMC Pediatrics (2016) 16:95

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