Meng Lin

Objective: The vitamin D–type 1 diabetes (T1D) association has been debated in public health. The purpose of this study was to develop a vitamin D deficiency prediction model and investigate vitamin D deficiency risk factors in children and adolescents with new-onset T1D.Methods: A single-centre, retrospective analysis of paediatric patients (1–18 years) with new-onset T1D and initial 25-hydroxyvitamin D assessments was performed at a tertiary hospital in China between January 2020 and July 2024 (n = 353). The patients were divided into two groups according to whether their vitamin D deficiency exceeded 12 ng/ml. After identifying vitamin D deficiency risk factors in children/adolescents with new-onset T1D, a receiver operating characteristic (ROC) curve model was developed to predict the probability of vitamin D deficiency in these individuals. That model was represented with a nomogram. Calibration and clinical decision analysis curves were used to evaluate the model's effectiveness after internal validation via bootstrapping.Results: The prevalence rate of serum vitamin D deficiency among patients with new-onset T1D was 26.35% (93/353). Multivariate logistic regression analysis revealed that minority status (X1), weight (X2), diabetic ketoacidosis severity (X3), serum vitamin D testing season (X4), free triiodothyronine (X5), and high-density lipoprotein (X6) were closely associated with serum vitamin D deficiency development in children/adolescents with new-onset T1D (P < 0.05). The model was logit (P) =e^x/(1 + e^x), X = 4.626−1.878*X1−0.038*X2−0.821*X3−0.88*X4 + 0.351*X5 + 0.532*X6. The area under the curve (AUC) of the serum vitamin D deficiency predictive model among patients with new-onset T1D was 0.769 (95% CI = 0.711–0.826). The predicted probability's best cut-off value was 0.671.Conclusions: The established risk prediction model has good efficacy, providing a reference for screening high-risk vitamin D deficiency groups among children/adolescents with new-onset T1D and taking preventive and protective measures. The nomogram was developed based on a single-center cohort in China, and its generalizability needs further validation in more extensive populations.

Objective: Difficulties in emotion regulation (DERs) can contribute to disordered eating behavior in children and adolescents with type 1 diabetes (T1D), although it is unknown how DERs may affect eating behavior in these children and adolescents. This study examined the relationship between disordered eating behaviors and emotion regulation in children and adolescents with T1D.Methods: For this cross-sectional study, 128 patients (aged 8–16 years) were recruited to complete the Diabetes Eating Problem Survey-Revised (DEPS-R) and Difficulties in Emotion Regulation Scale (DERs).Results: The mean age of the 128 patients (99 females) who completed the DEPS-R was 11.63 ± 2.27 years. The participants' mean DEPS-R score was 17.78 ± 8.56 points. Of the total sample, 61 participants' scores surpassed the established threshold, resulting in a DEPS-R positivity rate of 47.66%. The participants' mean total DERS score was 72.3 ± 21.15 points, and it was found that children and adolescents with T1D who had a positive DEPS-R screening result had significant differences in emotional regulation and that eating behavior disorders were positively correlated with emotional regulation and all dimensions scores.Conclusions: The prevalence of disordered eating behavior is high among children and adolescents with T1D. DERs are related to disordered eating behavior in children and adolescents with T1D. The novel finding that DERs may be a predictor of eating problems lends preliminary support for the inclusion of DERs in future risk models and as a potential target for intervention.

Background: The impact of vitamin D on type 1 diabetes has been a controversial topic in public health. Furthermore, significant differences in the proportion of vitamin D have been noted. The purpose of this systematic review was to determine the overall proportion of vitamin D deficiency in children/adolescents with type 1 diabetes (T1D). Methods: Based on six electronic databases (PubMed, Web of Science, Embase, Ovid Medline, ProQuest, and Cochrane Library), eligible studies since the databases’ inception up to April 2022 were searched. Reference lists were also manually searched to identify additional studies. Overall, studies with statistical information on vitamin D deficiency in children and adolescents with T1D were included, and a random effects model was applied for the meta-analysis. In addition, subgroup and sensitivity analyses were carried out to evaluate heterogeneity, and publication bias was evaluated by using Egger’s test. Results: A total of 45 studies involving 6,995 participants met the inclusion criteria; these included 25 countries covering Africa, Oceania, Europe, North America and Asia. The proportion of vitamin D deficiency in children/adolescents with T1D was 45% (95% confidence interval [CI] 37–54%, I² = 97.94%). Subgroup analysis further revealed that the publication year, study design, vitamin D classification, season and geographical region significantly contributed to the variation in the reported incidence of vitamin D deficiency. Conclusions: The results of the meta-analysis showed that the proportion of vitamin D deficiency among T1D children/adolescents was 45%. In addition, the proportion remains higher, which has important implications for adapting health and social care systems.

Background: The impact of vitamin D on type 1 diabetes has been a controversial topic in public health. Furthermore, significant differences in the proportion of vitamin D have been noted. The purpose of this systematic review was to determine the overall proportion of vitamin D deficiency in children/adolescents with type 1 diabetes (T1D). Methods: Based on six electronic databases (PubMed, Web of Science, Embase, Ovid Medline, ProQuest, and Cochrane Library), eligible studies since the databases’ inception up to April 2022 were searched. Reference lists were also manually searched to identify additional studies. Overall, studies with statistical information on vitamin D deficiency in children and adolescents with T1D were included, and a random effects model was applied for the meta-analysis. In addition, subgroup and sensitivity analyses were carried out to evaluate heterogeneity, and publication bias was evaluated by using Egger’s test. Results: A total of 45 studies involving 6,995 participants were selected for the meta-analysis. The proportion of vitamin D deficiency in children/adolescents with T1D was found to be 45% (95% confidence interval [CI] 37-54%, I² = 97.94%). Subgroup analysis further showed that the publication year, study design, classification of vitamin D, different seasons and geographical region could significantly contribute to variations in the reported proportion of vitamin D deficiency. Conclusions: This systematic review analyzed the available literature and revealed that the proportion of vitamin D deficiency among T1D children/adolescents was 45%. In addition, the proportion remains higher, which has important implications for adapting health and social care systems.