Division of Endocrinology, Department of Pediatrics; Department of Quantitative Health Sciences; Division of Gastroenterology, Department of Pediatrics
Digestive System Diseases | Endocrinology, Diabetes, and Metabolism | Gastroenterology | Pediatrics
IMPORTANCE: Irritable 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.
AIM: To characterize the vitamin D status of pediatric patients with IBS using a case-control study design.
HYPOTHESIS: Serum 25-hydroxyvitamin D [25(OH)D] concentration will be similar between patients with IBS and controls.
SUBJECTS AND METHODS: A 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 butpercentile, and obesity as BMI ≥95th percentile. Vitamin D deficiency was defined as 25(OH)D of/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.
RESULTS: More than 50% of IBS subjects had vitamin D deficiency at a cut-off point of/L (53% vs. 27%, p = 0.001); and >90% of IBS subjects had vitamin D deficiency at a cut-off point of/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).
CONCLUSIONS: Pediatric 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.
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Copyright: © 2017 Nwosu et al. Citation: PLoS One. 2017 Feb 13;12(2):e0172183. doi: 10.1371/journal.pone.0172183. eCollection 2017. Link to article on publisher's website
Vitamin D, Irritable bowel syndrome, Vitamin D deficiency, Pediatrics, Adolescents, Inflammatory bowel disease, Albumins, Migraine
Nwosu, Benjamin U.; Maranda, Louise; and Candela, Ninfa, "Vitamin D status in pediatric irritable bowel syndrome" (2017). Endocrinology/Diabetes. 60.
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