The frequency of vitamin D deficiency in adults with Crohn's disease

Department of Medicine, University of Alberta, Edmonton.
Canadian journal of gastroenterology = Journal canadien de gastroenterologie (Impact Factor: 1.98). 09/2003; 17(8):473-8.
Source: PubMed


Vitamin D deficiency is a putative, pathogenic cofactor in the increase in osteopenia and osteoporosis seen in patients with Crohn's disease.
To determine the frequency of low serum 25-hydroxy-vitamin D3 (25-OHD) levels and the associated alterations in bone mineral density in a cohort of adults with Crohn's disease.
25-OHD levels were determined in 242 consecutive patients with Crohn's disease seen in two tertiary inflammatory bowel disease referral centres. Bone mineral density was assessed by dual energy x-ray absorptiometry.
Nineteen (8%) patients exhibited vitamin D deficiency (25-OHD less than 25 nmol/L) and 52 (22%) patients exhibited vitamin D insufficiency (25-OHD less than 40 nmol/L). Mean T-scores at the lumbar spine, femoral neck, total hip and ultradistal radius in the group with low 25-OHD did not differ from those of the normal 25-OHD group. Serum alkaline phosphatase and parathyroid hormone levels were higher in the low 25-OHD group than in the normal group. Decreased red blood cell (RBC) folate predicted low 25-OHD in male patients, while smoking, RBC folate and serum iron predicted low 25-OHD in female patients. The rate of low 25-OHD deficiency in the winter was significantly higher than that in the summer (11.9% versus 2.8%, respectively).
Vitamin D-deficient Crohn's disease patients exhibit biochemical evidence of metabolic bone disease, without detectable differences in bone mineral density. Sunlight exposure, nutrition and smoking status were predictors of vitamin D deficiency in this patient cohort.

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    • "However, sunshine and UVB are hypothesized to have beneficial effects [2]. Both diseases have been associated with lower serum 25[OH] vitamin D levels [16,17] but the association is stronger with CD [2,18-23]. Although, not yet proven two trials have been published using supplemental vitamin D for therapy of CD [24]. One suggested a possible reduction in clinical relapse [25]. "
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