Title

The nondietary determinants of vitamin D status in pediatric inflammatory bowel disease

UMMS Affiliation

Department of Pediatrics; Department of Quantitative Health Sciences

Publication Date

2015-07-01

Document Type

Article

Disciplines

Dietetics and Clinical Nutrition | Digestive System Diseases | Endocrinology, Diabetes, and Metabolism | Pediatrics

Abstract

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.

Keywords

Adiposity, Alanine transaminase, Crohn's disease, Hepatic inflammation, Hypoalbuminemia, Inflammatory bowel disease, Intestinal inflammation, Protein-losing enteropathy, Ulcerative colitis, Vitamin D

DOI of Published Version

10.1016/j.nut.2015.03.010

Source

Veit LE, Maranda L, Nwosu BU. The nondietary determinants of vitamin D status in pediatric inflammatory bowel disease. Nutrition. 2015 Jul-Aug;31(7-8):994-9. doi: 10.1016/j.nut.2015.03.010. Epub 2015 Apr 20. PubMed PMID: 26059374. Link to article on publisher's site

Journal/Book/Conference Title

Nutrition (Burbank, Los Angeles County, Calif.)

Related Resources

Link to article in PubMed

PubMed ID

26059374

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