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The nondietary determinants of vitamin D status in pediatric inflammatory bowel disease.
Nutrition 2015 Jul-Aug; 31(7-8):994-9N

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.

Authors+Show Affiliations

Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA, USA.Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA.Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA, USA. Electronic address: benjamin.nwosu@umassmemorial.org.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26059374

Citation

Veit, Lauren E., et al. "The Nondietary Determinants of Vitamin D Status in Pediatric Inflammatory Bowel Disease." Nutrition (Burbank, Los Angeles County, Calif.), vol. 31, no. 7-8, 2015, pp. 994-9.
Veit LE, Maranda L, Nwosu BU. The nondietary determinants of vitamin D status in pediatric inflammatory bowel disease. Nutrition. 2015;31(7-8):994-9.
Veit, L. E., Maranda, L., & Nwosu, B. U. (2015). The nondietary determinants of vitamin D status in pediatric inflammatory bowel disease. Nutrition (Burbank, Los Angeles County, Calif.), 31(7-8), pp. 994-9. doi:10.1016/j.nut.2015.03.010.
Veit LE, Maranda L, Nwosu BU. The Nondietary Determinants of Vitamin D Status in Pediatric Inflammatory Bowel Disease. Nutrition. 2015;31(7-8):994-9. PubMed PMID: 26059374.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The nondietary determinants of vitamin D status in pediatric inflammatory bowel disease. AU - Veit,Lauren E, AU - Maranda,Louise, AU - Nwosu,Benjamin Udoka, Y1 - 2015/04/20/ PY - 2014/11/03/received PY - 2014/12/18/revised PY - 2015/03/13/accepted PY - 2015/6/11/entrez PY - 2015/6/11/pubmed PY - 2016/5/3/medline KW - Adiposity KW - Alanine transaminase KW - Crohn's disease KW - Hepatic inflammation KW - Hypoalbuminemia KW - Inflammatory bowel disease KW - Intestinal inflammation KW - Protein-losing enteropathy KW - Ulcerative colitis KW - Vitamin D SP - 994 EP - 9 JF - Nutrition (Burbank, Los Angeles County, Calif.) JO - Nutrition VL - 31 IS - 7-8 N2 - 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. SN - 1873-1244 UR - https://www.unboundmedicine.com/medline/citation/26059374/The_nondietary_determinants_of_vitamin_D_status_in_pediatric_inflammatory_bowel_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0899-9007(15)00157-4 DB - PRIME DP - Unbound Medicine ER -