Vitamin D status and measurements of markers of bone metabolism in patients with small intestinal resection

Haderslev, Kent V.; Jeppesen, Palle Bekker; Sørensen, Helle; Mortensen, Per Brøbech; Staun, Michael

doi:10.1136/gut.52.5.653

Cited by 62 publications

(70 citation statements)

References 41 publications

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“…Data in the literature do not agree on the relationship between the ileal involvement in CD and deficiency of vitamin D. Some authors report an association between hypovitaminosis and ileal disease [21,29], while others did not find such correlation [19,25,30]. Our data are consistent with recent studies of Crohn's disease, demonstrating on the contrary a positive trend between hypovitaminosis and the extent of disease in ulcerative colitis.…”

Section: International Journal Of Digestive Diseasessupporting

confidence: 72%

Hypovitaminosis D and Low Bone Mineral Density in Inflammatory Bowel Disease Patients

Tapete¹,

Almerigogna²,

Cozzi³

et al. 2016

Int J Dig Dis

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Section: International Journal Of Digestive Diseasessupporting

confidence: 72%

Hypovitaminosis D and Low Bone Mineral Density in Inflammatory Bowel Disease Patients

Tapete¹,

Almerigogna²,

Cozzi³

et al. 2016

Int J Dig Dis

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“…Serum 25OHD concentration correlated positively with BMD of the forearm in unselected patients with CD, 26 and lower serum 25OHD concentration correlated significantly with low hip and spine BMD in patients with small intestinal resections. 48 On the other hand, many investigators found that BMD was not related to vitamin D status in either adults 22,25 or children 18 with IBD. Moreover, BMD was found to be low despite normal serum 25OHD concentration in many studies of patients with IBD.…”

Section: Discussionmentioning

confidence: 99%

“…In accordance with findings in healthy subjects, some investigators found a negative association of serum 25OHD concentration with serum PTH concentration in IBD patients. 21,31 Others have observed an increased prevalence of secondary hyperparathyroidism only after intestinal resection 25,26,48 and in undernourished patients with CD. 29 In contrast to findings in healthy subjects, serum PTH concentrations similar to those of healthy controls were found in patients with IBD despite their lower serum concentrations of 25OHD, 22,49 and serum PTH and 25OHD concentrations actually lower than those of healthy controls were found by others in patients with IBD.…”

Section: Discussionmentioning

confidence: 99%

Vitamin D Status in Children and Young Adults With Inflammatory Bowel Disease

Pappa¹,

Gordon

Saslowsky³

et al. 2006

Pediatrics

188

144

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OBJECTIVES-Previous studies of vitamin D status in pediatric patients with inflammatory bowel disease have revealed conflicting results. We sought to report (1) the prevalence of vitamin D deficiency (serum 25-hydroxy-vitamin D concentration ≤15 ng/mL) in a large population with inflammatory bowel disease, (2) factors predisposing to this problem, and (3) its relationship to bone health and serum parathyroid hormone concentration.PATIENTS AND METHODS-A total of 130 patients (8-22 years of age) with inflammatory bowel disease, 94 with Crohn disease and 36 with ulcerative colitis, had serum 25-hydroxyvitamin D, intact parathyroid hormone, and lumbar spine bone mineral density (using dual-energy x-ray absorptiometry) measured at Children's Hospital Boston. RESULTS-The prevalence of vitamin D deficiency was 34.6%. Mean serum 25-hydroxyvitamin D concentration was similar in patients with Crohn disease and ulcerative colitis, 52.6% lower among patients with dark skin complexion, 33.4% lower during the winter months (December 22 to March 21), and 31.5% higher among patients who were taking vitamin D supplements. Serum 25-hydroxy-vitamin D concentration was positively correlated with weight and BMI z score, disease duration, and serum albumin concentration and negatively correlated with erythrocyte sedimentation rate. Patients with Crohn disease and upper gastrointestinal tract involvement were more likely to be vitamin D deficient than those without it. Serum 25-hydroxyvitamin concentration was not associated with lumbar spine bone mineral density z score or serum parathyroid hormone concentration.CONCLUSIONS-Vitamin D deficiency is highly prevalent among pediatric patients with inflammatory bowel disease. Factors predisposing to the problem include having a dark-skin complexion, winter season, lack of vitamin D supplementation, early stage of disease, more severe disease, and upper gastrointestinal tract involvement in patients with Crohn disease. The long-term significance of hypovitaminosis D for this population is unknown at present and merits additional study. Copyright © 2006 by the American Academy of PediatricsAddress correspondence to Helen M. Pappa, MD, MPH, Division of Gastroenterology and Nutrition, Children's Hospital Boston, 300 Longwood Ave, Boston, MA 02115. helen.pappa@childrens.harvard.edu. The authors have indicated they have no financial relationships relevant to this article to disclose. NIH Public Access Author ManuscriptPediatrics. Author manuscript; available in PMC 2011 November 1. Available reports on the vitamin D status of adults with CD place the prevalence of 25OHD concentration ≤15 ng/mL between 22% and 70%, depending on the study. 21-31 Serum 25OHD concentration was found to be <10 ng/mL in 8% to 45% of adults with CD. 21,22,24,26 One study reports a negative relationship among disease duration, Crohn Disease Activity Index, ferritin, C-reactive protein, cholesterol, 24 and 25OHD concentration.Other studies report that smoking 21 and small bowel resection 30,32 are also negativel...

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“…Vitamin D deficiency/insufficiency is also common in patients with Crohn's disease (CD) (Driscoll et al, 1982;Harries et al, 1985;Haderslev et al, 2003), with some suggesting it as one of the commonest nutritional complications in CD patients (Tajika et al, 2004). Although the prevalence of vitamin D insufficiency peaks during winter-time (with reported low serum 25-hydroxyvitamin D (25 (OH) D) in 30-68% of patients; Driscoll et al, 1982;Harries et al, 1985;Jahnsen et al, 2002), even during late summer-time, serum 25 (OH) D has been shown to be lower in CD patients than age-and sex-matched healthy control subjects in Ireland (McCarthy et al, 2005) as well as elsewhere in Europe (Harries et al, 1985;Andreassen et al, 1998).…”

Section: Introductionmentioning

confidence: 99%

Determinants of vitamin D status in adult Crohn's disease patients, with particular emphasis on supplemental vitamin D use

2006

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Objective: To investigate determinants (pathophysiologic and physiologic, behavioural and lifestyle) of vitamin D status in Irish Crohn's disease (CD) patients. Design: A cross-sectional observational study. Setting: Cork City, Ireland (521N). Subjects: Crohn's Disease patients (n ¼ 58; mean age 38.1 years) were recruited from Cork University Hospital. Results: Fifty and nineteen percent of Irish CD patients were vitamin D deficient (defined by serum 25 hydroxyvitamin (OH) D levels o50 nmol/l) during winter and summer, respectively. Multiple regression analysis showed that summer-time serum 25 (OH) D levels were positively associated with use of vitamin D supplements (P ¼ 0.033) and negatively associated with smoking (P ¼ 0.006) and being male (P ¼ 0.063). During winter-time, use of vitamin D supplements (P ¼ 0.041) and sun habits (P ¼ 0.066) were positively associated, whereas small intestinal involvement (P ¼ 0.005) and body mass index (BMI) (P ¼ 0.083) were negatively associated with serum 25 (OH) D levels. There was no significant association between other nonpathophysiologic (age, dietary calcium or vitamin D) or pathophysiologic factors (steroid use, resection), and serum 25 (OH) D levels, at either season. Approximately 41 and 60% of the total variation in summer-and winter-time serum 25 (OH) D, respectively, was explained by this model. Conclusion: A high proportion of Irish CD patents had some level of vitamin D deficiency (o50 nmol/l) during late-wintertime. Use of regular low-dose supplemental vitamin D, particularly by patients with small intestinal involvement, cessation of smoking and adequate, but responsible, exposure to summer sunlight as well as maintaining BMI in the normal range could help maintain adequate vitamin D levels during wintertime.

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Vitamin D status and measurements of markers of bone metabolism in patients with small intestinal resection

Abstract: We found reduced 25(OH)D concentrations in patients with small intestinal resection, and showed that a deficient 25(OH)D concentration is associated with significantly increased markers of bone resorption and decreased BMD values.

Cited by 62 publications

References 41 publications

Hypovitaminosis D and Low Bone Mineral Density in Inflammatory Bowel Disease Patients

Hypovitaminosis D and Low Bone Mineral Density in Inflammatory Bowel Disease Patients

Vitamin D Status in Children and Young Adults With Inflammatory Bowel Disease

Determinants of vitamin D status in adult Crohn's disease patients, with particular emphasis on supplemental vitamin D use

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