Hypovitaminosis D: How Common is it, and what are its Predictors among Children with Congenital Heart Disease Attending the Lagos State University Teaching Hospital?

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Abstract Malnutrition is a deficiency of both macro- and micro-nutrients. Malnutrition is common in children with congenital heart defects due to reduced intake, poor gastrointestinal absorption resulting from gut hypo-perfusion and increased metabolism. The present study aimed to determine the prevalence and predictors of hypovitaminosis D in children with congenital heart defects aged 1 to 12 years compared with apparently healthy controls. Methods A comparative cross-sectional study conducted from July to November 2020 involving 115 children with congenital heart disease and 115 apparently healthy controls matched for age, sex and socio-economic class. A self-designed proforma was used to collect information on subjects’ bio-data, socio-economic class, health information, morbidity pattern, frequency and duration of sunlight exposure and 48 hours’ dietary recall of vitamin D containing foods. Weight, height, waist and hip circumference were measured, BMI was calculated, waist hip ratio, weight-for-age, height-for-age and BMI-for-age Z scores were obtained. Blood samples were collected for measurement of serum 25-hydroxyvitamin D levels. Hypovitaminosis D was taken as both vitamin D deficiency and insufficiency with serum 25(OH)D levels of less than 20ng/ml and 20.1-29.9ng/ml respectively. Descriptive and inferential analysis was carried out using SPSS version 27. Result The prevalence of hypovitaminosis D in subjects was 59.1% with median (interquartile range) of 28.13ng/ml (21.2-42.3ng/ml) while the prevalence in healthy controls was 41.7%. The difference was statistically significant (p= 0.008). There was no statistically significant difference in the prevalence of hypovitaminosis D between the acyanotic and cyanotic subjects. The age groups greater than 3 years, female sex and duration of diagnosis greater than 48 months were independent predictors of hypovitaminosis D in subjects. Conclusion children with congenital heart defect should have their serum 25-hydroxyvitamin D measured at intervals and may benefit from treatment if found to have vitamin D deficiency.

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