Vitamin D status in Crohn's disease: association with nutrition and disease activity.

Harries, Anthony; Brown, Ronald; Heatley, R. V.; Williams, Lynn; Woodhead, Stuart; Rhodes, J.

doi:10.1136/gut.26.11.1197

Cited by 125 publications

(105 citation statements)

References 21 publications

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“…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. 50 Two studies report PTH status in pediatric patients with IBD.…”

Section: Discussioncontrasting

confidence: 48%

“…Other studies report that smoking 21 and small bowel resection 30,32 are also negatively correlated with 25OHD concentration, whereas sunlight exposure and nutritional status are positively correlated. 29 Fewer studies have described the vitamin D status of adults with UC compared with those with CD. Serum 25OHD concentrations have been found to be normal in some studies of patients with UC, 33,34 whereas others report serum 25OHD concentrations <12 ng/mL in 15%.…”

Section: Introductionmentioning

confidence: 99%

“…[21][22][23][24][25][26][27][28][29][30][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.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussioncontrasting

confidence: 48%

Section: Introductionmentioning

confidence: 99%

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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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“…The US Endocrine Society's Clinical Practice Guideline suggests 75 nmol/l as a cut-off for adequacy and intakes of 37·5-50μg (1500-2000 IU) vitamin D 3 /d to achieve this concentration. Irrespective of the cut-off applied (30,50 or 75 nmol/l), several studies have reported a high prevalence of vitamin D insufficiency and deficiency in established IBD cases (Table 1) and in 80 % of new Crohn's disease diagnoses (9) . In paediatric cases, 25 % of patients have severe deficient levels (18) (Table 1).…”

Section: Optimal Vitamin D Statusmentioning

confidence: 99%

“…Several factors predict vitamin D deficiency in Crohn's disease including; longer disease duration, higher Crohn's disease activity index (CDAI) scores, C-reactive protein levels, poor nutrition status, smoking (28)(29)(30)(31) , small bowel involvement (31) and resection (32) , non-Caucasian ethnicity (33) , sunlight exposure, impaired conversion of vitamin D to its active metabolite, increased catabolism and increased excretion due to steatorrhoea.…”

Section: Factors Influencing Vitamin D Levels In Crohn's Diseasementioning

confidence: 99%

Optimal vitamin D levels in Crohn's disease: a review

Raftery

O’Sullivan

2014

Proc. Nutr. Soc.

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Vitamin D deficiency is common among patients with Crohn's disease. Serum 25-hydroxyvitamin D (25(OH)D) is the best measure of an individual's vitamin D status and current cut-off ranges for sufficiency are debatable. Several factors contribute to vitamin D deficiency in Crohn's disease. These include inadequate exposure to sunlight, inadequate dietary intake, impaired conversion of vitamin D to its active metabolite, increased catabolism, increased excretion and genetic variants in vitamin D hydroxylation and transport. The effects of low 25(OH)D on outcomes other than bone health are understudied in Crohn's disease. The aim of the present review is to discuss the potential roles of vitamin D and the possible levels required to achieve them. Emerging evidence suggests that vitamin D may have roles in innate and adaptive immunity, in the immune-pathogenesis of Crohn's disease, prevention of Crohn's disease-related hospitalisations and surgery, in reducing disease severity and in colon cancer prevention. The present literature appears to suggest that 25(OH)D concentrations of ≥75 nmol/l may be required for non-skeletal effects; however, further research on optimal levels is required.

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Bones and Crohn's: Problems and solutions

Buchman

2007

Inflamm Bowel Dis

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Inflammatory bowel disease may manifest in various extra intestinal manifestations. Osteopenia and various arthropathies may be debilitating. These may be related to the disease itself, patient genetics, lifestyle, or disease treatment. Calcium and vitamin D malabsorption, vitamin K deficiency, malnutrition, corticosteroid and other immunosuppressive medications, smoking, lack of exercise and postmenopausal state may all play important roles. Treatment may be undertaken to correct nutrient deficiencies, inhibit bone resorption and increase bone formation.

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Vitamin D status in Crohn's disease: association with nutrition and disease activity.

Cited by 125 publications

References 21 publications

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

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

Optimal vitamin D levels in Crohn's disease: a review

Bones and Crohn's: Problems and solutions

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