Vitamin D status in pediatric irritable bowel syndrome

Abstract

ImportanceIrritable bowel syndrome (IBS) is associated with significant morbidity in children and adolescents, and the therapeutic efficacy of available treatment options is limited. The role of vitamin D supplementation in pediatric IBS is unclear as the vitamin D status of pediatric patients with IBS is unknown. Equally, the relationship of vitamin D status with psychosomatic symptoms in children and adolescents is unclear.AimTo characterize the vitamin D status of pediatric patients with IBS using a case-control study design.HypothesisSerum 25-hydroxyvitamin D [25(OH)D] concentration will be similar between patients with IBS and controls.Subjects and methodsA retrospective case-controlled study of 116 controls (age 14.6 ± 4.3 y), female (n = 67; 58%) and 55 subjects with IBS (age 16.5 ± 3.1y), female (n = 44; 80%). Overweight was defined as BMI of ≥85th but <95th percentile, and obesity as BMI ≥95th percentile. Vitamin D deficiency was defined as 25(OH)D of <50 nmol/L, while seasons of vitamin D draw were categorized as summer, winter, spring, and fall. Major psychosomatic manifestations included in the analysis were depression, anxiety, and migraine.ResultsMore than 50% of IBS subjects had vitamin D deficiency at a cut-off point of <50 nmol/L (53% vs. 27%, p = 0.001); and >90% of IBS subjects had vitamin D deficiency at a cut-off point of <75 nmol/L (93% vs. 75%, p = 0.006). IBS subjects had significantly lower mean 25(OH)D: 53.2 ± 15.8 nmol/L vs. 65.2 ± 28.0 nmol/L, p = 0.003; and albumin: 6.2 ± 0.6 vs. 6.5 ± 0.6 μmol/L, p = 0.0.01. IBS subjects with migraine had significantly lower mean 25(OH)D concentration compared to controls (p = 0.01). BMI z-score was similar between the controls and IBS subjects (0.5 ± 1.4 vs. 1.2 ± 2.9, p = 0.11).ConclusionsPediatric patients with IBS had significantly lower 25(OH)D concentration compared to controls despite having similar mean BMI values as controls. Only 7% of the children and adolescents with IBS were vitamin D sufficient, and >50% of the subjects with IBS had vitamin D deficiency. This is a much higher prevalence of vitamin D deficiency compared to IBD and other malabsorption syndromes. Monitoring for vitamin D deficiency should be part of the routine care for patients with IBS. Randomized control trials are warranted to determine the role of adjunctive vitamin D therapy in pediatric IBS.

Vitamin D3 Supplementation in Diarrhea-Predominant Irritable Bowel Syndrome Patients: The Effects on Symptoms Improvement, Serum Corticotropin-Releasing Hormone, and Interleukin-6 – A Randomized Clinical Trial

“…Vitamin D deficiency or insufficiency has been estimated to affect about 1 billion people worldwide [16]. Vitamin D deficiency is more common in IBS patients than in a healthy population, and studies have shown that the severity of the symptoms is inversely correlated with serum vitamin D concentration [17][18][19][20]. Moreover, studies demonstrated that vitamin D deficiency is related to symptoms of psychological disorders [21,22].…”

Gene Expression Profiling and Assessment of Vitamin D and Serotonin Pathway Variations in Patients With Irritable Bowel Syndrome

“…For example, while commonly associated with its role in Ca 2+ /PO 4 3-homeostasis, vitamin D is crucial in the modulation of a variety of other pathways, including those involved in anti-inflammatory and immunomodulatory activity. 22 Thus, vitamin D has been proposed as a potential treatment for IBS 23 as well as IBD. 24 Moreover, in a recent report, the production of the rate-limiting enzyme in serotonin production, TPH, was significantly stimulated by the active hormonal vitamin D metabolite, 1,25-dihydroxyvitamin D (1,25D), in serotonergic neurons.…”

Assessment of vitamin D Concentration and Many Biochemical Parameters in Irritable Bowel Syndrome Patients in Kirkuk City

“…The areas of the gut involved in vitamin D absorption is centered predominantly in the ileum (70-80%) [10] , with most of the vitamin D receptors and regulatory mechanisms in the cecum and colon regions, the importance of vitamin D deficiency needs to be addressed seriously in IBS patients as well [11,12] . Nwosu [13] . Also, In study of and vitamin D level was found [14] .…”