Mon Nov 27, 3:23 PM ET
Children with inflammatory bowel disease have a high prevalence of vitamin D deficiency, according to a new study published in the journal Pediatrics.
Inflammatory bowel disease refers to the inflammation of the large or small colon and is characterized by diarrhea, abdominal pain and cramping, bloody stool, weight and appetite loss, and ulceration of the bowel lining. Crohn’s disease and ulcerative colitis are two common types of inflammatory bowel disease.
Other studies of vitamin D in children with inflammatory bowel disease have produced mixed results, Dr. Helen M. Pappa and colleagues from Children’s Hospital, Boston, note. To further investigate, they evaluated 130 subjects with inflammatory bowel disease who were between the ages of 8 and 22 years old. Of these, 94 had Crohn’s disease and 36 had ulcerative colitis.
The team measured the patients’ blood levels of 25-hydroxy-vitamin D, a frequently used and accurate means of estimating vitamin D levels in the body. They measured levels of intact parathyroid hormone, which is secreted by the parathyroid gland and works with vitamin D to form new bone tissue. The bone mineral density of the lower spine was also measured.
Thirty-five percent of the children had vitamin D deficiency and 11 percent had severe deficiency. The rates of vitamin D deficiency were similar in patients with Crohn’s disease and ulcerative colitis.
Blood levels of 25-hydroxy-vitamin D were 53-percent lower among children with darker skin complexions, 33-percent lower during the winter months and 32-percent higher among children who were receiving vitamin D supplements compared with those who were not, Pappa’s team reports.
The researchers also observed a positive correlation between 25-hydroxy-vitamin D and weight, bone mineral density, disease duration and blood levels of albumin.
Patients with Crohn’s disease that affected the upper gastrointestinal tract were more likely to be vitamin D deficient than those without it, according to the authors. No association was found between 25-hydroxy-vitamin D levels and bone mineral density of the lower spine or blood levels of parathyroid hormone.
The mechanism involved in vitamin D deficiency in patients with inflammatory bowel disease is not completely clear, and additional studies are needed to better understand this process and to develop successful treatment, the investigators conclude.
SOURCE: Pediatrics, November 2006.