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High prevalence of vitamin D deficiency and osteoporosis in out-patients with intestinal failure.
Clin Nutr. 2013 Dec; 32(6):983-7.CN

Abstract

BACKGROUND

In intestinal failure, specific nutrient deficiencies especially for fat-soluble vitamins can be expected in addition to energy-protein malnutrition. We report serum levels of fat soluble vitamins, and bone density in out-patients with intestinal failure (IF).

METHODS

106 outpatients with IF were assessed during routine visits. 78 patients underwent DXA-scan for bone density. Vitamin D levels < 50 nmol/l were defined as deficiency, and 75-150 as optimal. Vitamin A and E deficiencies were defined as <1.0 and <14 μmol/l respectively. INR ≥ 1.2 without liver disease or anti-vitamin K therapy was classified as vitamin K deficiency.

RESULTS

Mean serum vitamin D level was 45 nmol/l at first visit, and 64 nmol/l at follow up (n = 76, p = 0.0001 by paired t-test). Overall prevalence of vitamin D deficiency was 67%. Only 12% of all patients had optimal D-vitamin status. 88% of assessed patients had low bone density. 12% had subnormal vitamin A levels and 25% had subnormal vitamin E levels. 32% had abnormal INR values. At follow up 34% remained vitamin D deficient whereas 29% had optimal levels. By oral substitution, vitamin A and E status were normalised, and K status improved.

CONCLUSION

Vitamin D deficiency and osteoporosis are common in outpatients with intestinal failure, and should be adequately substituted.

Authors+Show Affiliations

Department of Clinical Nutrition, Sahlgrenska University Hospital, Göteborg, Sweden. Electronic address: lasse.ellegard@nutrition.gu.se.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23481225

Citation

Ellegård, L, et al. "High Prevalence of Vitamin D Deficiency and Osteoporosis in Out-patients With Intestinal Failure." Clinical Nutrition (Edinburgh, Scotland), vol. 32, no. 6, 2013, pp. 983-7.
Ellegård L, Kurlberg G, Bosaeus I. High prevalence of vitamin D deficiency and osteoporosis in out-patients with intestinal failure. Clin Nutr. 2013;32(6):983-7.
Ellegård, L., Kurlberg, G., & Bosaeus, I. (2013). High prevalence of vitamin D deficiency and osteoporosis in out-patients with intestinal failure. Clinical Nutrition (Edinburgh, Scotland), 32(6), 983-7. https://doi.org/10.1016/j.clnu.2013.02.005
Ellegård L, Kurlberg G, Bosaeus I. High Prevalence of Vitamin D Deficiency and Osteoporosis in Out-patients With Intestinal Failure. Clin Nutr. 2013;32(6):983-7. PubMed PMID: 23481225.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High prevalence of vitamin D deficiency and osteoporosis in out-patients with intestinal failure. AU - Ellegård,L, AU - Kurlberg,G, AU - Bosaeus,I, Y1 - 2013/02/21/ PY - 2012/08/13/received PY - 2013/01/14/revised PY - 2013/02/12/accepted PY - 2013/3/14/entrez PY - 2013/3/14/pubmed PY - 2014/8/19/medline KW - BMD KW - Bone density KW - DXA KW - HEN KW - HPN KW - IF KW - INR KW - Intestinal failure KW - PN KW - Parenteral nutrition KW - Vitamin D, fat malabsorption KW - Vitamin substitution therapy KW - bone mineral density KW - dual energy X-ray absorptiometry KW - home enteral nutrition KW - home parenteral nutrition KW - international normalized ratio KW - intestinal failure KW - parenteral nutrition SP - 983 EP - 7 JF - Clinical nutrition (Edinburgh, Scotland) JO - Clin Nutr VL - 32 IS - 6 N2 - BACKGROUND: In intestinal failure, specific nutrient deficiencies especially for fat-soluble vitamins can be expected in addition to energy-protein malnutrition. We report serum levels of fat soluble vitamins, and bone density in out-patients with intestinal failure (IF). METHODS: 106 outpatients with IF were assessed during routine visits. 78 patients underwent DXA-scan for bone density. Vitamin D levels < 50 nmol/l were defined as deficiency, and 75-150 as optimal. Vitamin A and E deficiencies were defined as <1.0 and <14 μmol/l respectively. INR ≥ 1.2 without liver disease or anti-vitamin K therapy was classified as vitamin K deficiency. RESULTS: Mean serum vitamin D level was 45 nmol/l at first visit, and 64 nmol/l at follow up (n = 76, p = 0.0001 by paired t-test). Overall prevalence of vitamin D deficiency was 67%. Only 12% of all patients had optimal D-vitamin status. 88% of assessed patients had low bone density. 12% had subnormal vitamin A levels and 25% had subnormal vitamin E levels. 32% had abnormal INR values. At follow up 34% remained vitamin D deficient whereas 29% had optimal levels. By oral substitution, vitamin A and E status were normalised, and K status improved. CONCLUSION: Vitamin D deficiency and osteoporosis are common in outpatients with intestinal failure, and should be adequately substituted. SN - 1532-1983 UR - https://www.unboundmedicine.com/medline/citation/23481225/High_prevalence_of_vitamin_D_deficiency_and_osteoporosis_in_out_patients_with_intestinal_failure_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0261-5614(13)00051-4 DB - PRIME DP - Unbound Medicine ER -