Vitamin D status in gastrointestinal and liver disease.
ABSTRACT The purpose of this review is to report on the vitamin D status and its relationship with bone health in individuals with gastrointestinal and liver disorders. In addition, recommendations regarding replacement and maintenance of optimal vitamin D stores, as well as the state of knowledge regarding its effect on the disease through its actions on the immune system, will be reviewed.
The scientific community has revised upward the serum levels of vitamin D considered optimal, and doses of vitamin D much larger than those currently recommended may be needed to maintain these levels, especially in individuals with gastrointestinal and liver disorders. The relationship between vitamin D and bone health in this population is controversial. The role of vitamin D in the regulation of the immune system continues to be elucidated.
Hypovitaminosis D is prevalent among individuals with gastrointestinal and liver disease. Although replacement and supplementation guidelines have not been well defined, practitioners should aim for a serum 25-hydroxyvitamin D level of at least 32 ng/ml. The contribution of vitamin D to the bone health of these individuals and its role in altering disease course through its actions on the immune system remain to be elucidated.
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ABSTRACT: Micronutrients are defined as those compounds necessary for the adequate physiological status of the organism and that may be administered through the daily diet either enteral or parenteral. The term micronutrient encompasses the vitamins and oligoelements, also termed trace elements. Vitamins cannot be synthesized by the organism and are categorized in two groups: water-soluble vitamins (the vitamin B group, C, folic acid, and biotin) and lipid-soluble vitamins (A, D, E, and K). Oligoelements are found in small amounts in the human body, and copper, cobalt, chrome, iron, iodine, manganese, molybdenum, nickel, selenium, and zinc are considered to be essential. The important role of micronutrients in critically-ill patients has been demonstrated, and their influence on the immune system, cancer, burnt, septic, and poly-traumatized patients has extensively been put in evidence. It is important to establish the micronutrients demands for each individual in order to achieve an adequate intake. However, there is little evidence on the necessary intake to achieve proper physiological functioning under different pathologies; therefore, studies bringing light to this situation are needed. The aim of this review is to update the current state of knowledge on micronutrients supplementation in the adult population with pathologies such as cancer, coronary and cardiovascular disease, bowel inflammatory disease, short-bowel syndrome, cystic fibrosis, liver disease, renal failure, respiratory failure, the surgical patient, big-burnt patient, pancreatitis, poly-traumatized patients, sepsis and HIV. After the bibliographical search, we describe the current state of knowledge regarding micronutrients intake in artificial nutrition under the above-mentioned pathologies.Nutricion hospitalaria: organo oficial de la Sociedad Espanola de Nutricion Parenteral y Enteral 02/2011; 26(1):37-47. · 1.25 Impact Factor
- Official journal of the South African Academy of Family Practice/Primary Care 08/2014; 55(2):157-160.
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ABSTRACT: Background: The interaction between vitamin D deficiency (VDD) and dysfunction of both the kidney and liver is still poorly understood in different health states of SCA. This study determined serum levels of vitamin D and indices of liver and renal function in adult sickle cell anaemia subjects. Methods: Sixty subjects with sickle cell anaemia (30 in steady state [SSCA] and 30 in vaso-occlusive crisis [VOC]) and 30 apparently healthy individuals with HbAA genotype were recruited into this study. Standard methods were used for the determination of total protein, albumin, bilirubin, urinary creatinine and albumin while serum vitamin D was determined using ELISA. Differences between groups were determined using Student’s t-test or Man-Whitney U test as appropriate. P<0.05 was considered as statistically significant. Results: Serum vitamin D was significantly lower in sickle cell anemia (SCA) subjects and the deficiency was more profound in VOC when compared with the control subjects. SCA subjects with vitamin D level <50 nmol/L had significantly higher levels of total bilirubin (TBIL) and conjugated bilirubin (CBIL) compared with those who had ≥50 nmol/L vitamin D level. No significant difference in vitamin D level between SCA subjects with once or less episodes of SCA crisis per year and SCA subjects with two or more episodes of SCA crisis per year although, the median vitamin D level was lower in the latter. Conclusion: Vitamin D deficiency is more pronounced in SCA subjects in vaso-occlusive crisis and hyperbilirubinaemia was observed in SCA subjects with low serum vitamin D level.Archives of Basic and Applied Medicine. 01/2015; 2(2):77-82.