The nondietary determinants of vitamin D status in pediatric inflammatory bowel disease
Department of Pediatrics; Department of Quantitative Health Sciences
Dietetics and Clinical Nutrition | Digestive System Diseases | Endocrinology, Diabetes, and Metabolism | Pediatrics
OBJECTIVES: The aim of this study was to investigate the relationships between 25-hydroxy vitamin D (25[OH]D) and markers of vitamin D status in inflammatory bowel disease (IBD).
METHODS: We conducted a retrospective case-control study of 59 pediatric patients with IBD (age 16.4 ± 2.2 y) and 116 controls (age 14.6 ± 4.4 y), to investigate the association between 25(OH)D and albuminemia for protein-losing enteropathy (PLE) and hepatic dysfunction; alanine transaminase (ALT) for hepatic inflammation; erythrocyte sedimentation rate (ESR) for intestinal inflammation; body mass index (BMI) for adiposity; seasons and skin pigmentation for insolation. Vitamin D deficiency was defined as 25(OH)D < 50 nmol/L; abnormal liver enzyme by ALT >40 U/L; overweight status by BMI of ≥85th but <95th >percentile, and obesity by BMI ≥95th percentile. Seasons were categorized as summer, winter, spring, and fall.
RESULTS: Patients with IBD had a higher prevalence of vitamin D deficiency (42.4% versus 26.7%; P = 0.04), elevated ALT (16.9% versus 2.6%; P < 0.001), and lower albumin (41.1 ± 4.8 versus 45.1 ± 3.8; P < 0.001) than controls. In both the IBD cohort and controls, 25(OH)D was highest in summer and lowest in winter, and significantly higher in white than in non-white patients. ESR varied significantly with 25(OH)D (R(2) = 0.24; β = -0.32; P = 0.010), and only patients with IBD with elevated ESR had lower 25(OH)D than controls (49.5 ± 25.2 versus 65.3 ± 28.0 nmol/L; P = 0.045).
CONCLUSION: Intestinal inflammation, not the loss of albumin-bound vitamin D in the gut, is the primary intestinal determinant of vitamin D status in IBD. The extraintestinal determinants are seasons and skin pigmentation, but not adiposity and hepatic inflammation.
Adiposity, Alanine transaminase, Crohn's disease, Hepatic inflammation, Hypoalbuminemia, Inflammatory bowel disease, Intestinal inflammation, Protein-losing enteropathy, Ulcerative colitis, Vitamin D
Veit, Lauren E.; Maranda, Louise S.; and Nwosu, Benjamin U., "The nondietary determinants of vitamin D status in pediatric inflammatory bowel disease" (2015). Endocrinology/Diabetes. 55.