الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 134 |  |  |
| | | from | 134 | | |
Abstract
It has been established that Vitamin D hypovitaminosis can lead to
decreased bone mineral density, hyperparathyroidism, rickets,
osteoporosis, and increased risk of fracture.
It has recently been suggested that deficiency is also associated with
nonskeletal disorders such as hypertension, cardiovascular disease,
diabetes, asthma, and cancer.
It is possible that pediatric oncology patients are at risk for
developing vitamin D deficiency in their treatment course due to poor
nutrition, lack of sun exposure, and possible effects of treatment.
Therefore, one could suggest that these children would have a higher
prevalence of vitamin D hypovitaminosis than the general population.
Although several studies have been done internationally on this
topic none has been carried out thus far in an Egyptian population.
The aim of this study was to find the frequency of Vitamin D
insufficiency in children with cancer and once found to compare it with
the frequency of the same among the healthy children of the same
characteristics and explore any associations with age, sex, duration of
therapy, and type of cancer.
This cross-sectional, observational study included 28 patients who
attended the pediatric oncology unit at Zagazig University Hospital in the
period between January to September 2018.
To fulfill the aim of this study a control group of 28 healthy children
were recruited from schools and from the outpatient clinic presenting
with minimal medical or surgical disorders with distributional matching
to the patients on age and gender.
Summary and conclusion
91
The population characteristics
Children with different malignancies of both sexes aged below 15
years. Children are newly diagnosed cases with malignancy or on
treatment whose Vitamin D levels were measured at least once during
admission.
We excluded any child receiving supplementation of vitamin D or
those patients suffering from a disease that appeared due to Vitamin D
deficiency. Also , we excluded children received therapy for a period
longer than 2 years.
Methodology
Demographic data were collected from the subjects include age , sex,
place & socioeconomic level. Age were recorded and categorized into
two groups, those below 6 years and those above 6 years as seen in
healthy chidren populations.
Data concerning the tumor as type of cancer whether
Leukemia/lymphoma or solid tumors, time of diagnosis to laboratory
draw, , relapse status, and treatment status when the 25-OH D level was
drawn as well as the duration of therapy were recorded as well.
To fulfill the aim of this study a control group of 28 healthy children
will be recruited from schools and from the outpatient clinic presenting
with minimal medical or surgical disorders with distributional matching
to the patients on age and gender.
Approval for the study was obtained from our faculty Ethics
Committee.
Summary and conclusion
92
Assessment of Vitamin D levels
25-OH Vitamin D levels will be assessed by electro-chemiluminometric assay using Cobas 8000 (Roche).
The cut-off value to define Vitamin D insufficiency is <30 ng/ml as
decided by previous studies.
The results of this study showed that:
The prevalence of Vitamin D insufficiency in our study
group (89.3%) while in the control group was 57.1%
Vitamin D deficiency in the Leukemia and Lymphoma
patients was 80% while in the solid tumors was 20 % and the
percentage of normal vitamin D among Leukemia and
Lymphoma was 66.7% while 33.3 % in solid tumor but there
no significance correlation between solid and leukemia and
lymphoma tumors according to vitamin D level.
There was significance correlation between duration of
chemotherapy and vitamin D deficiency level as the more
duration of therapy the more increasing in vitamin D
deficiency levels .
The cut off value at which we can predict vitamin D level to
start to become deficient is 3 months duration of
chemotherapy.
Summary and conclusion
93
Conclusion:
This study provides preliminary evidence that the prevalence of
vitamin D deficiency in a diverse Egyptian pediatric cancer
population is higher than that of a comparable healthy population
Among cancerous patients, children with hematological
malignancies are more prone to Vit D deficiency than children
with solid tumors.
from our results it has been concluded that the more duration of
therapy the more increasing in vitamin D deficiency levels .
Vitamin D level start to becom