Title Vitamins in health and disease in children Title (croatian) Vitamini u zdravlju i bolestima djece Author Nina Sepideh Tighnavard Mollasarai Mentor Mario Ćuk (mentor)Committee member Mario Ćuk (predsjednik povjerenstva)Committee member Danko Milošević (član povjerenstva)Committee member Marija Jelušić (član povjerenstva)Granter University of Zagreb Defense date and country 2017-07-14, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract This review will discuss vitamin D, B6 and B12, with focus on their source, metabolic pathway, physiology and deficiency. What they have in common is their essential function in normal child development, growth and health. Vitamin D deficiency is an increasing public health problem in infants and children worldwide, causing rickets and growth failure. Vitamin D deficiency can be of various causes, but the number one factor responsible for this increase is most probably insufficient sun exposure and the excessive use of sunscreen. Exclusively breastfed infants and infants born to vitamin D deficient mothers are at high risk of developing nutritional vitamin D deficiency. Vitamin B6 is essential for normal brain function and development. Unlike vitamin D, nutritional vitamin B6 deficiency is rare, due to its availability in various food products. Deficiency states are most commonly seen in children with malabsorption diseases, in severe malnutrition due to poverty and in inborn errors of vitamin B6 metabolism. Although the inborn errors of metabolism are extremely rare one such error will be highlighted here, pyridoxine dependent epilepsy. It is an autosomal recessive disease where defective lysine catabolism causes decreased levels of vitamin B6 in the brain, resulting in seizures and other neurological manifestations. Vitamin B12 is involved in the metabolism of every cell in the human body, most importantly in DNA synthesis. As a consequence, vitamin B12 deficiency mostly affects tissues of high metabolic activity, i.e epithelial, nervous and hematopoietic systems. The clinical manifestations of vitamin B12 deficiency has a wide spectrum and are usually non specific, thus there is a need for high index of suspicion to find the correlation. Vitamin B12 is exclusively found in food of animal origin, putting infants of vegan or vegetarian mothers at the highest risk of developing a deficiency. As vegan or vegetarian diets are trending, women planning to get pregnant need to be informed about the crucial function of vitamin B12 and the need for supplementation during pregnancy and lactation. Although some deficiencies are rare and some are common, they are all clinically preventable diseases by implementing prevention and screening programs (especially in high risk groups), supplementation and food fortification. Early diagnosis and treatment are of utmost importance in all vitamin deficiencies since it prevents devastating irreversible consequences and significantly improves outcome in severely deficient children.
Abstract (croatian) Ovaj pregled će se osvrnuti na vitamine D, B6 i B12, s fokusom na njihov izvor, metabolički proces, fiziologiju te nedostatak. Ono što imaju zajedničko je njihova esencijalna funkcija u normalnom rastu, razvoju i zdravlju djeteta. Nedostatak vitamina D je rastući problem javnog zdravstva kod dojenčadi i djece diljem svijeta, uzrokujući rahitis i zastoj u rastu. Nedostatak vitamina D može biti uzrokovan različitim čimbenicima, ali je glavni uzrok odgovoran za taj porast najvjerojatnije neadekvatna izloženost suncu te pretjerano korištenje krema za sunce. Isključivo dojenčad i novorođenčad čije su majke u nedostatku vitamina D su u visokom riziku razvoja prehrambenog nedostatka vitamina D. Vitamin B6 je esencijalan u normalnom razvoju i funkciji mozga. Za razliku od vitamina D, nutritivni manjak vitamina B6 je rijedak radi njegovog prisustva u različitim hranidbenim proizvodima. Stadiji nedostatka su najčešće viđeni u djece s bolestima malabsorpcije, u teškoj pothranjenosti radi siromaštva te u urođenim greškama metabolizma B6. Makar su urođene greške metabolizma rijetke, jednu od njih ćemo naglasiti ovdje, epilepsiju ovisnu o piridoksinu. To je autosomalna recesivna bolest gdje neispravan katabolizam lizina uzrokuje snižene nivoe vitamina B6 u mozgu te prouzrokuje napadaje i ostale neurološke manifestacije. Vitamin B12 je umiješan u metabolizam svake stanice u ljudskom tijelu, najvažnije u sintezu DNK. Kao posljedica, nedostatak vitamina B12 najviše utječe na tkiva visoke metaboličke aktivnosti, npr. epitela, živaca i hematopoetskih sustava. Kliničke manifestacije nedostatka vitamina B12 imaju širok spektar i obično su nespecifične, dakle postoji potreba za visokim indeksom sumnje kako bi se našla korelacija. Vitamin B12 isključivo postoji u hrani životinjskog porijekla pa čini dojenčad veganskih ili vegetarijanskih majki najrizičnijom skupinom razvoja nedostatka. Kako su veganski i vegetarijanski tipovi prehrane u trendu, žene koje planiraju trudnoću trebaju biti informirane o presudnoj funkciji vitamina B12 te o potrebi za dopunom tijekom trudnoće i dojenja. Makar su neki nedostaci rijetki, a neki učestali, to su klinički sprječive bolesti ako se implementiraju programi prevencije i probira (pogotovo u visoko rizičnim skupinama), suplementacije i fortifikacije hrane. Rana dijagnoza i liječenje su iznimno važni u svim nedostacima vitamina jer sprječavaju razarajuće nepovratne posljedice i značajno poboljšavaju ishod u djece sa velikim deficitom.
Keywords
vitamin D deficiency
rickets
vitamin B6 deficiency
pyridoxine dependent epilepsy
vitamin B12 deficiency
megaloblastic anemia
pernicious anemia
Keywords (croatian)
nedostatak vitamina D
rahitis
nedostatak vitamina B6
piridoksin ovisna epilepsija
nedostatak vitamina B12
megaloblastična anemija
pernicijozna anemija
Language english URN:NBN urn:nbn:hr:105:166257 Study programme Title: Medicine (in English language) Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2018-04-18 07:12:32
