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Vitamin D status in pediatric irritable bowel syndrome.
PLoS One 2017; 12(2):e0172183Plos

Abstract

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 but <95th percentile, and obesity as BMI ≥95th percentile. Vitamin D deficiency was defined as 25(OH)D of <50 nmol/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 <50 nmol/L (53% vs. 27%, p = 0.001); and >90% of IBS subjects had vitamin D deficiency at a cut-off point of <75 nmol/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.

Links

  • PMC Free PDF
    • Publisher Full Text
    ncbi.nlm.nih.gov
    dx.plos.org

    Authors+Show Affiliations

    Nwosu BU
    Division of Endocrinology, Department of Pediatrics, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America.
    Maranda L
    Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America.
    Candela N
    Division of Gastroenterology, Department of Pediatrics, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America.

    MeSH

    AdolescentAnxietyBody Mass IndexBody WeightCase-Control StudiesChildDepressionFemaleHumansIrritable Bowel SyndromeLinear ModelsMaleMigraine DisordersMultivariate AnalysisRetrospective StudiesVitamin DVitamin D DeficiencyYoung Adult

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    28192499

    Citation

    Nwosu, Benjamin Udoka, et al. "Vitamin D Status in Pediatric Irritable Bowel Syndrome." PloS One, vol. 12, no. 2, 2017, pp. e0172183.
    Nwosu BU, Maranda L, Candela N. Vitamin D status in pediatric irritable bowel syndrome. PLoS ONE. 2017;12(2):e0172183.
    Nwosu, B. U., Maranda, L., & Candela, N. (2017). Vitamin D status in pediatric irritable bowel syndrome. PloS One, 12(2), pp. e0172183. doi:10.1371/journal.pone.0172183.
    Nwosu BU, Maranda L, Candela N. Vitamin D Status in Pediatric Irritable Bowel Syndrome. PLoS ONE. 2017;12(2):e0172183. PubMed PMID: 28192499.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Vitamin D status in pediatric irritable bowel syndrome. AU - Nwosu,Benjamin Udoka, AU - Maranda,Louise, AU - Candela,Ninfa, Y1 - 2017/02/13/ PY - 2016/12/13/received PY - 2017/01/31/accepted PY - 2017/2/14/entrez PY - 2017/2/14/pubmed PY - 2017/8/30/medline SP - e0172183 EP - e0172183 JF - PloS one JO - PLoS ONE VL - 12 IS - 2 N2 - 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 but <95th percentile, and obesity as BMI ≥95th percentile. Vitamin D deficiency was defined as 25(OH)D of <50 nmol/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 <50 nmol/L (53% vs. 27%, p = 0.001); and >90% of IBS subjects had vitamin D deficiency at a cut-off point of <75 nmol/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. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/28192499/Vitamin_D_status_in_pediatric_irritable_bowel_syndrome_ L2 - http://dx.plos.org/10.1371/journal.pone.0172183 DB - PRIME DP - Unbound Medicine ER -